Chapter 18: Health Problems of Adolescent (TEST 2)

A 15-year-old girl tells the school nurse that she has not started to menstruate yet. Onset of secondary 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. Refer the adolescent for an evaluation.

The middle school nurse is planning a behavior modification program for overweight children. 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. Identify and eliminate inappropriate eating habits.

What method is the most commonly used in completed suicides? a. Firearms b. Drug overdose c. Self-inflicted laceration d. Carbon monoxide poisoning

a. Firearms

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. Prevention of subsequent pregnancies

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. Slow down eating meals.

A pregnant 15-year-old adolescent tells the nurse that she did not use any form of contraception 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. This is a frequent reason given by adolescents.

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. Use of condoms

An adolescent girl tells the nurse that she is very suicidal. The nurse asks her if she has a specific 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. An appropriate part of the assessment

An important distinction in understanding substance abuse is that drug misuse, abuse, and addiction 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. Voluntary behaviors based on psychosocial needs

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 immediate medical attention 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. refer him immediate medical attention

The clinic nurse is evaluating a patient with a vaginal infection. The nurse knows that the normal 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. 4.0 to 5.0

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. Cervical cancer

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 adolescents development.

b. Fetopelvic disproportion is a common problem.

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. Gay and lesbian adolescents are at a particularly high risk for suicide.

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. Hard, painless mass

Descriptions of young people with anorexia nervosa (AN) often include which criteria? a. Impulsive b. Extroverted c. Perfectionist d. Low achieving

c. Perfectionist

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. Drugs actual content b. Mode of administration c. Adolescents level of interest in rehabilitation d. Function the drug plays in the adolescents life

b. Mode of administration

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. One of a variety of behaviors normally seen in rape victims

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. Parental overweight

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 period of menstruation to be diagnosed as secondary amenorrhea? a. 3 months b. 4 months c. 5 months d. 6 months

d. 6 months

What do nursing responsibilities regarding weight gain for an adolescent with anorexia nervosa include? a. Administer tube feedings until target weight is achieved. b. Restore body weight to within 10% of the adolescents 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. Restore body weight to within 10% of the adolescents ideal weight.

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. Social isolation

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. Treatment of all sexual contacts is essential.

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. 6 to 8 weeks

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. Applying of the medication occurs at least 20 to 30 minutes after washing.

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. Both men and women may have asymptomatic infections.

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. Correct malnutrition.

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. Has a marked preoccupation with food.

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. It may have devastating effects on the reproductive tract of affected adolescents.

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. Miconazole (Monistat)

A 14-year-old boy is of normal weight, and his parents are concerned about bilateral breast enlargement. The nurses 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. Most likely part of normal pubertal development

The nurses 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 infants grandmother to take responsibility for care

c. Providing information and feedback about positive parenting skills

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. Refer the adolescent for immediate medical evaluation.

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. Regular cigar use is becoming more common.

The nurse has determined that an adolescents body mass index (BMI) is in the 90th percentile. 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 adolescent is at risk for becoming overweight.

The nurse is presenting an educational program to a group of parents about differences between 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 extrovert 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. A child with AN is usually sexually active and seeks intimacy, but a child with BN avoids intimacy and is usually not sexually active.

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. Erosion of tooth enamel

The nurse is teaching an adolescent about acne care. What statement by the adolescent indicates 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. I will use my antibacterial soap to cleanse my face.

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 nurses 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. NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity.

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. Peer-led programs emphasizing the social consequences of smoking

An adolescent girl calls the nurse at the clinic because she had unprotected sex the night before 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. Postcoital contraception is available to prevent implantation and therefore pregnancy.

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. Provides a defense against depression

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. They can result in strong psychologic dependence.

During a well-child visit, the nurse plots the childs 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. To provide a consistent measure of obesity

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. Unconventional behavior