Ch. 18 - Health Problems of the Adolescent

The nurse is teaching an adolescent about the use of tretinoin (Retin-A). What should the nurse include in the teaching session? (Select all that apply.) A. Begin with a pea-sized dot of medication. B. Apply additional medication to the throat. C. Use sunscreen daily and avoid the sun when possible. D. Divide the medication into the three main areas of the face. E. Apply the medication immediately after washing the face.

A, C, D

The school nurse is teaching a group of adolescent females which measures to take to prevent genital tract infections. What should the nurse include in the teaching session? (Select all that apply.) A. Use condoms. B. Douche once a week. C. Avoid tight-fitting clothing. D. Limit exposure to bubble baths. E. Avoid colored and scented toilet tissue.

A, C, D, E

What conditions are physical complications of obesity? (Select all that apply.) A. Type 2 diabetes mellitus B. QT interval prolongation C. Fatty liver disease D. Gastrointestinal dysfunction E. Abnormal growth acceleration F. Dental erosion

A, C, E

The nurse is teaching an adolescent girl strategies to relieve dysmenorrhea. What should the nurse include in the teaching session? (Select all that apply.) A. Effleurage B. Diet high in fat C. Limiting exercise D. Use of a heating pad E. Massaging the lower back

A, D, E

The nurse is teaching an adolescent with premenstrual syndrome (PMS) dietary measures to relieve the symptoms of PMS. What should the nurse include in the teaching session? (Select all that apply.) A. Limit salt in the diet. B. Limit legumes in the diet. C. Include red meat in the diet. D. Include whole grains in the diet. E. Limit consumption of refined sugar.

A, D, E

What menstrual disorders are indications for a pelvic examination? (Select all that apply.) A. Amenorrhea B. Dyspareunia C. Impaired fertility D. Irregular uterine or vaginal bleeding E. Dysmenorrhea unresponsive to therapy

A, D, E

A 15-year-old girl tells the school nurse that she has not started to menstruate yet. Onset of sec- ondary sexual characteristics was about 2 1/2 years ago. The nurse should take which action? A. Explain that this is not unusual. B. Refer the adolescent for an evaluation. C. Make an assumption that the adolescent is pregnant. D. Suggest that the adolescent stop exercising until menarche occurs.

B

An adolescent girl is brought to the hospital emergency department by her parents after being raped. The girl is calm and controlled throughout the interview and examination. The nurse should recognize this behavior is what? A. A sign that a rape has not actually occurred B. One of a variety of behaviors normally seen in rape victims C. Indicative of a higher than usual level of maturity in the adolescent D. Suggestive that the adolescent had severe emotional problems before the rape occurred

B

An adolescent girl tells the nurse that she is very suicidal. The nurse asks her if she has a spe- cific plan. How should asking about a specific plan be viewed? A. Not a critical part of the assessment B. An appropriate part of the assessment C. Suggesting that adolescent needs a plan D. Encouraging adolescent to devise a plan

B

It is important that women with anogenital warts caused by the human papillomavirus (HPV) receive adequate treatment because this sexually transmitted infection increases the risk of what? A. Gonorrhea B. Cervical cancer C. Chlamydial infection D. Urinary tract infection

B

The clinic nurse is evaluating a patient with a vaginal infection. The nurse knows that the nor- mal vaginal pH is in which range? A. 3.0 to 4.0 B. 4.0 to 5.0 C. 5.0 to 6.0 D. 6.0 to 7.0

B

The nurse is caring for an adolescent brought to the hospital with acute drug toxicity. Cocaine is believed to be the drug involved. Data collection by the nurse should include what information? A. Drug's actual content B. Mode of administration C. Adolescent's level of interest in rehabilitation D. Function the drug plays in the adolescent's life

B

The nurse is teaching a class on obesity prevention to parents in the community. What is a contributing factor to childhood obesity? A. Birth weight B. Parental overweight C. Age at the onset of puberty D. Asian ethnic background

B

What do nursing responsibilities regarding weight gain for an adolescent with anorexia ner- vosa include? A. Administer tube feedings until target weight is achieved. B. Restore body weight to within 10% of the adolescent's ideal weight. C. Encourage continuation of strenuous exercise as long as adolescent is not losing weight. D. Facilitate as rapid a weight gain as possible with a high-calorie diet.

B

What is a major physical risk for young adolescents during pregnancy? A. Osteoporosis frequently develops. B. Fetopelvic disproportion is a common problem. C. Delivery is usually precipitous in this age group. D. Pregnancy will adversely affect the adolescent's development.

B

What is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats? A. Level of stress B. Social isolation C. Degree of depression D. Desire to punish others

B

What is the usual presenting symptom for testicular cancer? A. Solid, painful mass B. Hard, painless mass C. Scrotal swelling and pain D. Epididymis easily palpated

B

What statement is true about gonorrhea? A. It is caused by Treponema pallidum. B. Treatment of all sexual contacts is essential. C. Topical application of medication to the lesions is necessary. D. Therapeutic management includes multidose administration of penicillin.

B

What statement is true concerning adolescent suicide? A. A sense of hopelessness and despair is a normal part of adolescence. B. Gay and lesbian adolescents are at a particularly high risk for suicide. C. Problem-solving skills are of limited value to the suicidal adolescent. D. Previous suicide attempts are not an indication for completed suicides.

B

What behavior is the nurse most likely to assess in an adolescent with anorexia nervosa (AN)? A. Eats in secrecy B. Uses food as a coping mechanism C. Has a marked preoccupation with food D. Lacks awareness of how eating affects weight loss

C

What goal is most important when caring for a child with anorexia nervosa (AN)? A. Limit fluid intake. B. Prevent depression. C. Correct malnutrition. D. Encourage weight gain.

C

What is true about pelvic inflammatory disease (PID)? A. It can be prevented by proper personal hygiene. B. It is easily prevented by compliance with any form of contraception. C. It may have devastating effects on the reproductive tract of affected adolescents. D. It can potentially cause life-threatening and serious defects in the future children of affected adolescents.

C

What statement is true about smoking in college students? A. The rate of smoking cigarettes is declining. B. Smokeless tobacco use is rising dramatically. C. Regular cigar use is becoming more common. D. Students in the health professions do not smoke.

C

What statement regarding chlamydial infections is correct? A. The treatment of choice is oral penicillin. B. The treatment of choice is nystatin or miconazole. C. Both men and women may have asymptomatic infections. D. Clinical manifestations include small, painful vesicles on the genital areas.

C

A health care provider prescribes leuprolide (Lupron), 3.75 mg, IM, monthly, for a patient with endometriosis. The medication label states: "Leuprolide (Lupron) 5 mg/1 ml." The nurse pre- pares to administer the monthly dose. How many milliliters will the nurse prepare to administer the dose? Fill in the blank. Record your answer using two decimal places.

0.75

A health care provider prescribes danazol (Danocrine), PO, 200 mg, once a day, for an adoles- cent with endometriosis. The medication label states: "Danazol (Danocrine), 100 mg/1 tablet." The nurse prepares to administer one dose. How many tab(s) should the nurse prepare to admin- ister one dose? Fill in the blank. Record your answer as a whole number.

2

A health care provider prescribes methylphenidate hydrochloride (Ritalin), PO, 8 mg, twice a day, for an adolescent with bulimia nervosa. The medication label states: "Methylphenidate hy- drochloride (Ritalin), 4 mg/1 tablet." The nurse prepares to administer one dose. How many tab(s) should the nurse prepare to administer one dose? Fill in the blank. Record your answer as a whole number.

2

A 13-year-old boy comes to the school nurse complaining of sudden and severe scrotal pain. He denies any trauma to the scrotum. What is the most appropriate nursing action? A. Refer him for immediate medical evaluation. B. Administer analgesics and recommend scrotal support. C. Apply an ice bag and observe for increasing pain. D. Reassure the adolescent that occasional pain is common with the changes of puberty.

A

A pregnant 15-year-old adolescent tells the nurse that she did not use any form of contracep- tion because she was afraid her parents would find out. The nurse should recognize what? A. This is a frequent reason given by adolescents. B. This suggests a poor parent-child relationship. C. This is not a good reason to not get contraception. D. This indicates that the adolescent is unaware of her legal rights.

A

A sexually active adolescent asks the school nurse about prevention of sexually transmitted infections (STIs). What should the nurse recommend? A. Use of condoms B. Prophylactic antibiotics C. Any type of contraception method D. Withdrawal method of contraception

A

An important distinction in understanding substance abuse is that drug misuse, abuse, and ad- diction are considered what? A. Voluntary behaviors based on psychosocial needs B. Problems that occur in conjunction with addiction C. Involuntary physiologic responses to the pharmacologic characteristics of drugs D. Legal use of substances for purposes other than medicinal.

A

During a well-child visit, the nurse practitioner provides guidance about promoting healthy eating in a child who is overweight. What does the nurse advise? A. Slow down eating meals. B. Avoid between-meal snacks. C. Include low-fat foods in meals. D. Use foods that child likes as special treats.

A

What is a priority goal in the postpartum care of an adolescent mother? A. Prevention of subsequent pregnancies B. Ensuring that the father of the baby cares for the child C. Returning the mother to a prepregnancy lifestyle D. Facilitating formula feeding to minimize interruptions

A

What method is the most commonly used in completed suicides? A. Firearms B. Drug overdose C. Self-inflicted laceration D. Carbon monoxide poisoning

A

The nurse is preparing to administer danazol (Danocrine) to a patient with endometriosis. What are the side effects of this medication? (Select all that apply.) A. Insomnia B. Hot flashes C. Amenorrhea D. Increased libido E. Vaginal secretions

A, B, C

The nurse is teaching an adolescent female with primary dysmenorrhea foods that are natural diuretics. What foods should the nurse include in the teaching plan? (Select all that apply.) A. Peaches B. Asparagus C. Watermelon D. Wheat bread E. Dairy products

A, B, C

The clinic nurse is assessing an adolescent on a topical antibacterial agent. The nurse should assess for which side effects that can be seen with topical antibacterial agents? (Select all that apply.) A. Burning B. Dryness C. Dry eyes D. Erythema E. Nasal irritation

A, B, D

The nurse is teaching an adolescent female about the symptoms of premenstrual syndrome (PMS). What symptoms should the nurse include in the teaching session? (Select all that apply.) A. Headaches B. Fluid retention C. Increased energy D. Emotional changes E. Premenstrual cravings

A, B, D, E

The nurse is caring for an adolescent male with gynecomastia. What groups of drugs can in- duce gynecomastia in male adolescents? (Select all that apply.) A. Oral antibiotics B. Oral ketoconazoles C. Calcium channel blockers D. Histamine-2 receptor blockers E. Cancer chemotherapeutic agents

B, C, D, E

What are risk factors of testicular cancer? (Select all that apply.) A. Hispanic B. Infertility C. Alcohol use D. Tobacco use E. Family history

B, D, E

A 14-year-old boy is of normal weight, and his parents are concerned about bilateral breast en- largement. The nurse's discussion of this should be based on what? A. The presence of too much body fat B. Symptom that a hormonal imbalance is present C. Most likely part of normal pubertal development D. Indication that he is developing precocious puberty

C

After a treatment plan for acne has been initiated, which time period should the nurse explain to an adolescent before improvement will be seen? A. 2 to 4 weeks B. 4 to 6 weeks C. 6 to 8 weeks D. 8 to 10 weeks

C

An adolescent patient has been diagnosed with a vulvovaginal candidiasis (yeast infection). The nurse expects the health care provider to recommend which vaginal cream? A. Premarin B. Estradiol (Estrace) C. Miconazole (Monistat) D. Clindamycin phosphate (Cleocin)

C

Descriptions of young people with anorexia nervosa (AN) often include which criteria? A. Impulsive B. Extroverted C. Perfectionist D. Low achieving

C

The middle school nurse is planning a behavior modification program for overweight chil- dren. What is the most important goal for participants of the program? A. Learn how to cook low-fat meals. B. Improve relationships with peers. C. Identify and eliminate inappropriate eating habits. D. Achieve normal weight during the program.

C

The nurse has determined that an adolescent's body mass index (BMI) is in the 90th per- centile. What information should the nurse convey to the adolescent? A. The adolescent is overweight. B. The adolescent has maintained weight within the normal range. C. The adolescent is at risk for becoming overweight. D. Nutritional supplementation should occur at least three times per week

C

The nurse's role in facilitating successful childrearing in unmarried teenage mothers includes what? A. Facilitating marriage between the mother and father of the baby B. Teaching the adolescent the long-term needs of the growing child C. Providing information and feedback about positive parenting skills D. Encouraging the infant's grandmother to take responsibility for care

C

The school nurse suspects a testicular torsion in a young adolescent student. What action should the nurse take? A. Place a warm moist pack on the scrotal area. B. Instruct the adolescent to lie down and elevate the legs. C. Refer the adolescent for immediate medical evaluation. D. Suggest that the adolescent wear a scrotum-protecting guard.

C

Tretinoin (Retin-A) is a commonly used topical agent for the treatment of acne. What do nursing considerations with this drug include? A. Sun exposure increases effectiveness. B. Cosmetics with lanolin and petrolatum are preferred in acne. C. Applying of the medication occurs at least 20 to 30 minutes after washing. D. Erythema and peeling are indications of toxicity and need to be reported.

C

An adolescent girl asks the school nurse for advice because she has dysmenorrhea. She says that a friend recommended she try an over-the-counter nonsteroidal anti-inflammatory drug (NSAID). The nurse's response should be based on what? A. Hormone therapy is necessary for the treatment of dysmenorrhea. B. Acetaminophen is the drug of choice for the treatment of dysmenorrhea. C. Over-the-counter NSAIDs are rarely strong enough to provide adequate pain relief. D. NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity.

D

An adolescent girl calls the nurse at the clinic because she had unprotected sex the night be- fore and does not want to be pregnant. What should the nurse explain? A. It is too late to prevent an unwanted pregnancy. B. An abortion may be the best option if she is pregnant. C. The risk of pregnancy is minimal, so no action is necessary. D. Postcoital contraception is available to prevent implantation and therefore pregnancy.

D

During a well-child visit, the nurse plots the child's BMI on the health record. What is the purpose of the BMI? A. To determine medication dosages B. To predict adult height and weight C. To identify coping strategies used by the child D. To provide a consistent measure of obesity

D

During the physical examination of an adolescent with significant weight loss, what finding may indicate an eating disorder? A. Diarrhea B. Amenorrhea C. Appetite suppression D. Erosion of tooth enamel

D

Many adolescents use alcohol for self-medication. How does an adolescent view the benefit of alcohol? A. Believes it has a stimulant effect B. Believes it increases alertness C. Provides a sense of euphoria D. Provides a defense against depression

D

The clinic nurse is evaluating an adolescent with menses that have stopped occurring. The nurse understands that which minimum amount of time should the menses be absent after a peri- od of menstruation to be diagnosed as secondary amenorrhea? A. 3 months B. 4 months C. 5 months D. 6 months

D

The nurse is presenting an educational program to a group of parents about differences be- tween anorexia nervosa (AN) and bulimia nervosa (BN) at a community outreach program. What statement by a parent would indicate a need for additional teaching? A. "A child with AN will turn away from food to cope, but a child with BN turns to food to cope." B. "A child with AN maintains rigid control and is introverted, but a child with BN is an extro- vert and frequently loses control." C. "A child with AN denies the illness, but a child with BN recognizes the illness." D. "A child with AN is usually sexually active and seeks intimacy, but a child with BN avoids intimacy and is usually not sexually active."

D

The nurse is teaching an adolescent about acne care. What statement by the adolescent indi- cates a need for further teaching? A. "I will cleanse my face twice a day." B. "I will frequently shampoo my hair." C. "I will brush my hair away from my forehead." D. "I will use my antibacterial soap to cleanse my face."

D

What best describes central nervous system (CNS) stimulants? A. Acute intoxication can lead to coma. B. They produce strong physical dependence. C. Withdrawal symptoms are life threatening. D. They can result in strong psychologic dependence.

D

What factor is most likely to increase the likelihood that an adolescent will misuse alcohol? A. Female gender B. Regular school attendance C. Rural environment D. Unconventional behavior

D

What strategy is considered one of the best for preventing smoking in teenagers? A. Large-scale printed information campaigns B. Emphasis on the long-term effects of smoking on health C. Threatening the social norms of groups most likely to smoke D. Peer-led programs emphasizing the social consequences of smoking

D