Prior to competition, wrestlers often cut significant amounts of weight in order to match the weight that they and their opponent agreed upon. After reaching this weight and having it officially confirmed, the wrestlers rehydrate and eat in order to nourish their bodies as well as possibly gain an advantage over their opponent. This practice of rapid weight loss and subsequent weight gain can come with a plethora of potential health complications such as dehydration, syncope, malnutrition, and more. So the nurse practitioner should alert the teenager to the risks associated with repeatedly losing and gaining weight.
The NP could include an electrocardiogram or echocardiogram in the physical examination and discuss what its results may indicate with regard to participation in wrestling, such as increased risk of experiencing a cardiovascular event. However, if there is no suspicion that the teenager's heart health may be compromised (e.g. a heart murmur detected during vital signs), such procedures may not be necessary for a routine pre-participation physical.
If the wrestler is interested in education about the "anabolic window," workout recovery, and protein uptake in muscle post-exercise, you could certainly inform them about consuming a particular amount of protein based on the patient's body weight.
Lastly, the NP should inform the wrestler that they should be replenishing their fluids and electrolytes with the exercise they are performing. Water-loading and excessive sweating does occur in weight cutting which could diminish the body's normal quantities. However, replacing those lost to sweat and urine can be done with waters that are fortified with electrolytes and eating certain foods, as well as with the sports drinks -- point being sports drinks are solely necessary prior to or following physical activity lasting more than an hour, nor is this information a necessity during a pre-participation physical examination.