EAQ F - Adolescents

Arrange these health risks in decreasing order of the frequency at which they cause death among adolescents. a. Suicide b. Substance abuse c. Accidents d. Violence and homicide

1-c, 2-d, 3-a, 4-b Accidents remain the leading cause of death in adolescence. As of 2011, motor vehicle accidents, which are the most common cause of death, resulted in 74% of all unintentional deaths among adolescents aged 10 to 19 years. Homicide is the second leading cause of death in the 15- to 24-year-old age group. Suicide is the third leading cause of death in adolescents 13 to 19 years of age. Substance abuse is the fourth leading death risk among adolescents.

Which action would the nurse take first when an adolescent client presents to the clinic with complaints of amenorrhea for 2 months? a. Help evaluate the adolescent's stress factor. b. Ask the adolescent to take a pregnancy test. c. Make a proper dietary and exercise plan with the adolescent. d. Refer the adolescent to use biofeedback or massage therapy.

B Absence of menstrual flow can be due to pregnancy, so the nurse would first ask the adolescent to take a pregnancy test. Finding this out is the priority, and once the pregnancy test is done, the nurse can perform other interventions. If it is not due to pregnancy, amenorrhea can be due to extreme stress, so the nurse may help the adolescent find the stress factor and ways cope with it. Exercise-associated amenorrhea is common in female athletes and to overcome it, the nurse would help the adolescent make a proper dietary and exercise plan. In the case of extreme stress, the nurse can recommend that the adolescent use biofeedback or massage therapy to help reduce stress.

Which treatment would the primary health care provider offer for unilateral breast enlargement in a 14-year-old male client who states he has had this condition for 18 months? a. Testosterone b. Plastic surgery c. Calcium channel blockers d. Testing for Klinefelter syndrome

B Gynecomastia is a condition in which the adolescent has some degree of unilateral or bilateral breast enlargement. If gynecomastia persists or is extensive enough to cause embarrassment, plastic surgery is indicated for cosmetic and psychological reasons. Administering testosterone and calcium channel blockers may aggravate the condition. When gynecomastia has a prepubertal onset, the adolescent should be evaluated for Klinefelter syndrome.

Which oral agent would be effective for treating severe cystic acne that is unresponsive to other treatments? a. Tretinoin b. Azelaic acid c. Isotretinoin d. Benzoyl peroxide

C Isotretinoin, 13-cis-retinoic acid, is used to treat severe cystic acne that has not responded to other treatments. Tretinoin is used for management of comedonal acne. Azelaic acid is a topical antibacterial that is used to treat inflammatory lesions that accompany comedones. Benzoyl peroxide is an effective first-line topical agent that is used to treat inflammatory and noninflammatory acne.

Which is the minimum heart rate of a 14-year-old? Record your answer using a whole number.

60 beats per minute The minimum heart rate of. a 14-year-old is 60 beats per minute.

Which heart rate is the maximum normal for a 16-year-old? Record your answer using a whole number.

90 beats per minute The maximum acceptable heart rate of a 16-year-old is 90 beats per minute.

Which Korotkoff sound represents the diastolic blood pressure in an adolescent? a. First b. Third c. Fifth d. Fourth

C In adolescents, the fifth Korotkoff sound corresponds to the diastolic pressure. The first Korotkoff sound, which is sharp, represents systolic blood pressure, which is heard in all individuals. The third Korotkoff sound is a crisper, more intense tapping. The fourth Korotkoff sound is muffled and low. This sound corresponds to diastolic pressure in the toddler.

Which characteristic would a nurse expect to be exhibited by an adolescent? Select all that apply. a. A belief in their own vulnerability b. Personal fable c. Temper tantrums d. Attempts to control situations e. Eagerness for formal education

A, B Adolescents believe they are invulnerable, which frequently leads to risk-taking behaviors, especially in early adolescence. They show personal fable because they think their thoughts and feelings are unique. When the parents try to control the behavior of a toddler, it often leads to temper tantrums and negative behavior. Toddlers get to know their abilities to control situations and seem pleased with it. Preschoolers refine the mastery of their bodies and eagerly await the beginning of formal education.

Which action would the nurse take to ensure accuracy of the pulse oximeter reading when prescribed for an adolescent? a. Attach the probe to a finger or earlobe. b. Wait 30 minutes before obtaining a reading. c. Calibrate the oximeter at least every 8 hours. d. Place the probe on the abdomen or upper leg.

A Capillary beds are closest to the surface in a finger or earlobe; this proximity permits more accurate measurement of arterial oxygen saturation. An almost instantaneous, accurate readout may be obtained with the use of a pulse oximeter. The pulse oximeter does not require routine calibration. Placing the probe on the abdomen or upper leg is contraindicated because the capillary beds are not close to the surface on the abdomen or upper thigh.

Which information would the nurse include in the teaching plan of an adolescent who is found to have type 1 diabetes? Select all that apply. a. Insulin therapy b. Prophylactic antibiotics c. Blood glucose monitoring d. Oral hypoglycemic agents e. Adherence to the treatment regiment

A, C, E Because clients with type 1 diabetes have little or no endogenous insulin, they must take insulin. Blood glucose monitoring is an important aspect of therapy because it aids evaluation of the effectiveness of diabetic control. Dietary control and exercise reduce the amount of exogenous insulin needed. Although adhering to the diabetic regimen is difficult, especially for adolescents who need to identify with their peers, its importance in promoting euglycemia should be discussed. Although infection increases insulin requirements, prophylactic antibiotics are not needed. Oral hypoglycemics are ineffective in stimulating insulin secretion in clients with type 1 diabetes.

Which stage is a part of conventional reasoning, according to the Kohlberg's theory of moral development? Select all that apply. a. Social contract orientation b. Good boy-nice girl orientation c. Society-maintaining orientation d. Instrument relativist orientation e. Universal ethical principle orientation

B, C According to Kohlberg's theory, good boy-nice girl orientation and society-maintaining orientation are parts of conventional reasoning. Social contract orientation is stage 5 under postconventional reasoning. Instrument relativist orientation is stage 2 of preconventional reasoning. Universal ethical principle orientation is stage 6 under postconventional reasoning of Kohlberg's theory.

Which period of Piaget's theory explains self-consciousness in an adolescent? a. Period I b. Period II c. Period III d. Period IV

D In period IV of Piaget's theory, an adolescent demonstrates feelings and behaviors characterized by self-consciousness. During period I, an infant develops a schema or action pattern for dealing with the environment. During period II, the child demonstrates animism, in which he or she personifies objects. While going through period III, the child thinks about an action that earlier was performed physically.

Which contraceptive method is 99% effective if used correctly? a. Diaphragm b. Calendar method c. Coitus interruptus d. Oral contraceptives

D Oral contraceptives, such as estrogen and progesterone-like compounds, inhibit ovulation and are 99% effective if used correctly. A diaphragm is a cervical covering that prevents sperm reaching the egg. It is associated with high failure rate because it is inconvenient to use. The calendar method is preferred for clients who have a regular menstrual cycle. However, this method is also associated with high failure rates.Coitus interruptus is associated with high failure rate because some seminal fluid may enter into the vagina before ejaculation.

Which respiratory rate is the minimum normal in an adolescent? Record your answer using a whole number.

16 breaths/minute The minimum acceptable respiratory rate in a normal adolescent is 16 breaths/minute.

Which behavior will the nurse notice in 13-year-old students according to Erikson's theory? Select all that apply. a. Such students want to know "Who am I?" b. Such students exhibit the sense of care for others c. Such students show eagerness to learn social skills d. Such students like to pretend and try out different new roles e. Such students show a marked preoccupation with body appearance

A, E The nurse is likely to notice that during puberty, students want an answer to "Who am I?" This stage is called identity versus role confusion in Erikson's theory. At this stage, adolescents are concerned about their own body appearance. Young adults exhibit the sense of care for others at the stage of intimacy versus isolation. Children from 6 to 11 years of age show eagerness to learn social skills. This stage is identified as industry versus inferiority. Children like to pretend and try out new roles at the stage of initiative versus guilt. This is seen at the age of 3 to 6 years.

Which condition is likely in an adolescent displaying low self-esteem who complains of inflamed, red, and painful lesions on his forehead? a. Varicocele b. Acne vulgaris c. Open comedone d. Close comedone

B Acne vulgaris is a common skin problem that adolescents experience. It is an inflammatory manifestation to the proliferation of Propionibacterium acnes. . A varicocele is a collection of elongated and twisted superficial veins near the spermatic cord, superior to the testicle. Comedones are noninflammatory lesions.

Which reason may explain irregular menses in an adolescent whose mother complains that her child often fears gaining weight, has poor caloric intake, and has a distorted self-image? a. Bulimia b. Anorexia c. Orthorexia d. Binge disorder

B Anorexia is characterized by a lack of caloric intake motivated by a obsessive fear of becoming fat; this leads to a decline in nutrition that may in turn cause irregular menses. Bulimia is characterized by repeated episodes of binge eating followed by inappropriate compensatory behavior. Orthorexia is a disorder in which the individual avoids certain foods, believing them to be harmful. Binge disorder is excessive consumption of large amounts of high-calorie food.

Which nursing intervention would be provided to a hospitalized client during the identity versus role confusion stage? a. Choosing creative ways to promote social participation b. Providing information to the client about the treatment plann c. Encouraging the client to participate actively in treatment procedures d. Involving the client's partners or family members in the caring process

B During the identity versus role confusion or puberty stage, the nurse would help hospitalized adolescents deal with their illness by giving them enough information to allow them to make decisions about their treatment plan. During the generativity versus self-absorption and stagnation stage, the nurse would help clients choose ways to promote social participation. This action helps clients find a sense of fulfillment. During the industry versus inferiority stage, a nurse would ensure the active participation of a hospitalized client. If an individual in the intimacy versus isolation stage is admitted to the hospital, the nurse would try involving the client's partners or family members in the caring process so that the client can have a strong support structure.

Which assessment would the nurse use to identify the possible origin of the problem when an adolescent who has been tardy to school twice in the past week comes to the school nurse complaining of a 2-day history of low-grade fever, exhaustion, lack of energy, and decreased appetite? a. Eliciting the Kernig sign b. Eliciting the Brudzinski sign c. Checking for lymphadenopathy d. Checking the pupillary response to light and accommodation

C Infectious mononucleosis is caused by the Epstein-Barr virus. Mononucleosis is common in people between the age of 15 and 30 years. Signs and symptoms of mononucleosis include fever, fatigue, swollen lymph glands, and enlargement of the liver and spleen. The Kernig sign (asking the child to straighten a leg that is bent at a 90-degree angle at the knee) and Brudzinski sign (asking a child who is lying flat to bend his head and try to put his chin on his chest) are elicited as part of the assessment when meningitis is suspected.Pupillary response to light and accommodation is checked as part of a neurologic assessment.

How do adolescents establish group identity during psychosocial development? a. By evaluating their own health with a feeling of well-being b. By fostering their independence with balanced family structure c. By achieving marked physical changes with masculine and feminine behaviors d. By building close peer relationships to achieve acceptance in the society

D By building close peer relationships, adolescents develop a sense of belonging, approval, and the opportunity to learn acceptable behavior. This action establishes group identity. An adolescent establishes health identity by evaluating his or her own health with a feeling of well-being. An individual establishes family identity by fostering his or her independence within a balanced family structure. The sound and healthy growth of an adolescent, with marked physical changes, helps the adolescent build sexual identity.