Exam 1: Health Promotion of Adolescent

a

How does the onset of the pubertal growth spurt compare in girls and boys? a. In girls, it occurs about 1 year before it appears in boys. b. In girls, it occurs about 3 years before it appears in boys. c. In boys. it occurs about 1 year before it appears in girls. d. It is about the same in both boys and girls.

c

In girls, what is the initial indication of puberty? a. Menarche b. Growth spurt c. Breast development d. Growth of pubic hair

b

Intimate relationships are not necessarily characterized by a. concern for eachother's well-being b. sharing of sexual intimacy c. a willingness to disclose private, sensitive topics d. sharing of common interests and activities

c

Julia, 12 years old, is brought to the nurse practitioner's office by her mother. Julia has started to develop breast tissue and some pubic hair. Both the mother and her are concerned because Julia has been having increased vaginal discharge. Julia tells the nurse, "I wash my private area every day, but I still have fluid that comes out" What is the nurse's best response? a. It sounds like you have an infection. We'll have the nurse practitioner check you to see what is causing this discharge b. have you been using soap when you wash? c. this sounds like a normal discharge that happens to all girls as they start to mature. It is a sign that your body is preparing for your periods to begin d. this is probably not related to hygiene. Are you concerned that this discharge might be causing an odor?

b

What does the nurse take into consideration when planning sex education and contraceptive teaching for adolescents? a. Both sexual activity and contraception require planning. b. Teenagers frequently lack a fundamental understanding of fertility. c. Most teenagers today are knowledgeable about reproductive anatomy and physiology. d. Most teenagers who become pregnant do so as an act of hostility, especially toward their parents.

Erotic Daydreaming Without Preferred Identification

Sexuality Some sexual orientation milestones include: 1. Realization of romantic or ______ attraction 2. Erotic _________ about one or both genders 3. Romantic partners ______ sexual activity 4. Sexual activity with people of _______ gender 5. ______________ of best fitting orientation

b d e

What are characteristics of dating relationships in early adolescence? Select all that apply a. One-on-one dating b. Follow ritualized scripts c. Are psychosocially intimate d. Involve playing stereotypic roles e. Participating in mixed-gender group activities

c d e

What are characteristics of early adolescence (11-14 years) with regard to identity? Select all that apply a. Mature sexual identity b. Increase in self-esteem c. Trying out of various roles d. Conformity to group norms e. Preoccupied with rapid body changes

c d e

What are characteristics of late adolescence (18-20 years) with regard to sexuality? Select all that apply a. Exploration of self-appeal b. Limited dating, usually group c. Intimacy involves commitment d. Growing capacity for mutuality and reciprocity e. May publicly identify as gay, lesbian, or bisexual

a b d

What are characteristics of middle adolescence (15-17 years) with regard to relationships with peers? Select all that apply a. Behavioral standards set by peer group b. Acceptance of peers extremely important c. Seeks peer affiliations to counter instability d. Exploration of ability to attract opposite sex e. Peer group recedes in importance in favor of individual friendship

b

What aspects of cognition develop during adolescence? a. Ability to see things from the point of view of another b. Capability of using a future time perspective c. Capability of placing things in a sensible and logical order d. Progress from making judgments based on what they see to making judgments based on what they reason

a b e

What guidelines should the nurse use when interviewing adolescents? Select all that apply a. Ensure privacy. b. Use open-ended questions. c. Share your thoughts and assumptions. d. Explain that all interactions will be confidential. e. Begin with less sensitive issues and proceed to more sensitive ones.

c

What is an important consideration for the school nurse planning a class on injury prevention for adolescents? a. Adolescents generally are not risk takers. b. Adolescents can anticipate the long-term consequences of serious injuries. c. Adolescents need to discharge energy, often at the expense of logical thinking. d. During adolescence, participation in sports should be limited to prevent permanent injuries.

Gynecomastia

Sexual Maturation in Boys Breast enlargement and tenderness known as ___________ is common during midpuberty

Orientation

Sexuality Sexual __________ is a pattern of sexual arousal or romantic attraction toward person of the opposite gender, of the same gender, or of both genders

a

What is most descriptive of the spiritual development of older adolescents? a. Beliefs become more abstract. b. Rituals and practices become increasingly important. c. Strict observance of religious customs is common. d. Emphasis is placed on external manifestations, such as whether a person goes to church.

Monotonous

Work Most teenagers have jobs that are _________, require little initiative or decision making, and rarely use skills learned in school

d

Expected characteristics of emotional autonomy during early adolescence include a. increased independence from friends b. increased need for parental approval c. belief that parents are all knowing and all powerful d. less emotional dependence on parents

Pubertal

Physical Growth The _______ growth spurt refers to the general increase in growth of the skeleton, muscles, and internal organs, which reaches a peak rate at about 12 years of age

Scrotum

Sexual Maturation in Boys The first pubescent changes are testicular enlargement accompanied by thinning, reddening, and increasing looseness of the _________

Dieting

Sexual Maturation in Girls A common response to changes in body shape among teenage girls is to engage in extensive _______ at a time when nutritional requirements are at a peak

Moratorium

Psychosocial Development Individuals who demonstrate identity achievement have established a coherent identity after actively exploring possible alternatives, and these individuals are in the stage of _____________

Achievement

Psychosocial Development The study of ____________ is focused on performance in educational settings and on the development and implementation of plans for future scholastic and occupational careers

Leukorrhea

Sexual Maturation in Girls Early in puberty there is often an increase in normal vaginal discharge, also known as physiologic ___________

Appearance

Sexual Maturation in Girls For girls, physical maturation can lead to grater dissatisfaction with their ____________

Pubarche

Sexual Maturation in Girls The appearance of pubic hair, known as ________, usually follows initial breast development by about 2-6 months

Ovulation

Sexual Maturation in Girls ___________ and regular menstrual period usually begin 6-14 months after menarche

17

Sexuality The average age of sexual initiation is about _____ years

c

A 16 year old client who has been confined to a wheelchair since early childhood has lately been acting rebellious and rude. Her parents ask the nurse, "Are all adolescents like this?" The nurse should respond with which statement? a. "Yes, although your daughter's behaviors are more like those of an adolescent boy." b. "No. Your daughter must need some help in dealing with her feelings." c. "Your daughter's behavior seems to be typical adolescent behavior. Let us talk more about it" d. "Your daughter's behavior results from feelings about her disability. Ignore them"

d

A 16-year-old adolescent boy tells the school nurse that he is gay. The nurses response should be based on what? a. He is too young to have had enough sexual activity to determine this. b. The nurse should feel open to discussing his or her own beliefs about homosexuality. c. Homosexual adolescents do not have concerns that differ from those of heterosexual adolescents. d. It is important to provide a nonthreatening environment in which he can discuss this.

b

A nurse is caring for an adolescent whose guardian expresses concerns about the child sleeping such long hours. Which of the following conditions should the nurse inform the guardian as requiring additional sleep during adolescence? a. sleep terrors b. rapid growth c. elevated zinc levels d. slowed metabolism

a d e

A nurse is providing anticipatory guidance to the caregiver of a 13 year old adolescent. Which of the following screenings should the nurse recommend for the adolescent? Select all that apply a. body mass index b. blood lead level c. 24 hours dietary recall d. weight e. scoliosis

a

A nurse is providing teaching about expected changes during puberty to a group of guardians of early adolescent girls. Which of the following statements by one of the guardians indicates an understanding of the teaching? a. "Girls usually stop growing about 2 years after menarche" b. "Girls are expected to gain about 65 lbs during puberty" c. "Girls experience menstruation prior to breast development" d. "Girls typically grow more than 10 in during puberty"

c

A nurse is teaching a class about puberty in boys. Which of the following should the nurse include as the first manifestation of sexual maturation? a. pubic hair growth b. vocal changes c. testicular enlargement d. facial hair growth

b

An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago. She has not received any medical care. She smokes but denies any other substance use. What is the priority nursing action? a. Notify her parents. b. Refer her for prenatal care. c. Explain the importance of not smoking. d. Discuss dietary needs for adequate fetal growth.

b c d

According to Piaget, adolescent cognitive development is represented by the stage of formal operational thought that includes which of the following? Select all that apply a. believing that thoughts are all-powerful b. thinking in abstract terms c. thinking about hypotheses d. using a future time perspective e. thinking in the here and now

b

Adolescent egocentrism may lead to a pattern of personal fable. An example of this is a. Everyone is coming to the play just to see me b. Mary Sue got pregnant, but it wont happen to me c. I hate taking my clothes off for gym because everyone stares at me d. Mary is very envious of how I dress

d

Adolescents are more likely to participate in health care services when a. they understand the potentially negative consequences of their health behavior b. they rank confidential care and respect higher than site cleanliness c. they view their health problems as not organic in nature d. they see the health provider as caring and respectful

b

Adolescents develop the social cognition change of mutual role-taking. Which of the following is the best description of this ability? a. heightened sense of self-consciousness b. understanding the perspectives of others and the actions that can influence others c. beliefs that are more abstract and rooted in ideologic principles d. realization that others have thoughts and feelings

d

Adolescents often do not use reasoned decision making when issues such as substance abuse and sexual behavior are involved. What is this because of? a. They tend to be immature. b. They do not need to use reasoned decision making. c. They lack cognitive skills to use reasoned decision making. d. They are dealing with issues that are stressful and emotionally laden.

d

An adolescent asks the nurse what causes primary dysmenorrhea. What information does the nurse include in her response? a. It is an inherited problem. b. Excessive estrogen production causes uterine pain. c. There is no physiologic cause; it is a psychologic reaction. d. One factor is the onset of ovulatory cycles.

c

An adolescent tells the nurse that she would like to use tampons during her period. The nurse should first: a. assess her usual mentrual flow pattern b. determine whether she is sexually active c. provide information about preventing toxic shock syndrome d. refer her to a specialist in adolescent gynecology

d

Ben has just turned 16 years of age and is in for his routine physical. The nurse notes that Ben has pubescent changes and determines that Ben is in Tanner stage 3. What findings would best describe this Tanner stage? a. testes, scrotum, and penis are adult size and shape b. no pubic hair is present c. there is initial enlargement of scrotum and testes; reddening and texture changes of the scrotal skin; long, straight downy hair at base of penis d. there is initial enlargement of penis in length; testes and scrotum are enlarged; hair is darker, coarser, and curly over entire pubis

20-25%

By the end of the pubertal growth spurt, children have a ____-_____% increase in linear growth

50%

By the end of the pubertal growth spurt, children will have _____% of the ideal body weight

Estrogen

Changes in Reproductive Hormones In females, _______ causes growth and development of the vagina, uterus, and fallopian tubes, as well as the darkening of the breast areola and nipples. It also promotes the growth of axillary and pubic hair

Primary

Changes in Reproductive Hormones The ________ male sexual characteristic is the development of viable sperm

Primary

Changes in Reproductive Hormones The ________ sexual characteristics in girls is the development and release of an egg from the ovaries approximately every 28 days

Fertile

Changes in Reproductive Hormones The adolescent should be considered _____ with a first menstrual period or a first ejaculation

Testosterone

Changes in Reproductive Hormones ___________ and other androgens have a direct impact on the growth of the penis, scrotum, prostate, and seminal vesicles

Future

Cognitive Development Adolescents also become capable of using _______ time perspective instead of the here and now thinking of childhood

Role

Cognitive Development Teenagers are able to engage in _____-taking capabilities, which is understanding the perspectives of others and see how the thoughts and actions of one person can influence those of others

Imaginary Audience

Cognitive Development This common conception of self type thinking involves having such a heightened sense of self-consciousness that an adolescent imagines that everyone notices and is focused on their behavior

Personal Fable

Cognitive Development This common conception of self type thinking is the belief that one's feelings and experiences are completely unique, or that one is all knowing or invulnerable Ex. "You just don't understand"

Value

Cognitive Development _______ autonomy is the struggle to clarify values, created in part by an expanded behavioral independence

Formal Operational

Cognitive Development __________ ____________ thought includes being able to think in abstract terms, think about possibilities, and think through hypotheses

a

Compared with childhood peer groups, adolescent peer groups are a. more likely to include peers from the opposite sex b. less autonomous c. less likely to influence members' socialization skills d. more likely to require parental supervision

Intimate

Sexuality Many teenagers begin to shift from relationships with same gender peers to ________ relationships with opposite gender partners during middle adolescence

c

Elements of principled moral reasoning emerge during adolescence. Which of the following is the best description of this moral development? a. moral guidelines are seen to emanate from authority figures b. moral standards are seen as objective and not to be questioned c. absolutes and rules are questioned and subject to disagreement d. a personal value system is developed

a

Girls experience an increase in weight and fat deposition during puberty. What do nursing considerations related to this include? a. Give reassurance that these changes are normal. b. Suggest dietary measures to control weight gain. c. Encourage a low-fat diet to prevent fat deposition. d. Recommend increased exercise to control weight gain.

a

Growth and development during middle adolescence includes which of the following? a. characterized by a transition to a dominant peer orientation b. characterized by the changes of puberty and the responses to those changes c. characterized by the taking on of adult roles d. characterized by excellent conflict resolution over parental control

Principled

Moral Development __________ moral reasoning includes adolescents questioning absolutes and rules and view moral standards as subjective and based on points of view that are subject to disagreement

a

One of the key factors in addressing the health concerns and needs of the adolescent in a clinic or primary care office setting is to: a. provide confidentiality b. include the parent in a discussion about sexual health c. ask the adolescent if they are sexually active d. discuss the negative effects of tobacco use

a b e

Parents of an adolescent ask the school nurse, It is OK for our adolescent to get a job? The nurse should answer telling the parents the effects of adolescents who work more than 20 hours a week are what? Select all that apply a. Can lead to fatigue b. Can lead to poorer grades c. Improves an interest in school d. Enhances development and identity e. Can reduce extracurricular involvement

Shoes Pants Shirts

Physical Growth Teenagers tend to follow a linear growth pattern in which they outgrow their _____ first, then their _____, and finally their ________

Behaviorally

Psychosocial Development An individual who is _____________ autonomous is able to turn to others for advice when it is appropriate, weigh alternative courses of action, and reach an independent conclusion about how to behave

Diffusion

Psychosocial Development Identity ________ refers to a lack of firm identity commitments, along with a lack of effort to make those commitments

Identity

Psychosocial Development The task of ________ formation is to develop a stable, coherent picture of oneself that includes integrating one's past and present experiences with a sense of where one is headed in the future

Foreclosure

Psychosocial Development ________ refers to making identity commitments without a period of exploration or experimentation

Emotional

Psychosocial Development _________ autonomy is that aspect of independence related to changes in an individual's close relationships

Tanner

Pubertal Sexual Maturation Development of secondary sexual characteristics occurs in a predictable sequence of stages known as _______ stages

Maturation Growth

Puberty involves a predictable sequence of hormonal and physical changes that encompass both sexual _________ and physical _________

b

Routine nutrition screening for all adolescents should include a. a complete laboratory evaluation b. questions about meal patterns and consumption of foods c. a complete physical examination d. a complete family history

c

Several high school seniors are referred to the nurse because of suspected alcohol misuse. When the nurse assesses the situation, what would be most important to determine? a. what they know about the legal implications of drinking b. the type of alcohol they usually drink c. the reasons they choose to use alcohol d. when and with whom they use alcohol

Ejaculation

Sexual Maturation in Boys Spontaneous ________ may occurs as a nocturnal emission, masturbation, or during sexual activity

Identity

Sexuality Part of adolescent identity formation involves the development of sexual ________

Credible

Social Environments Peers serve as ______ sources of information, role models of new behavior, sources of social reinforcement, and bridges to alternative lifestyles

Learning

Social Environments Safety and respect for all students are critical issues, since students have difficulty _______ in unsafe environments where bullying occurs

Authoritative

Social Environments __________ parenting is related to greater psychosocial maturity and school performance and less substance abuse among young people

Internal

Spiritual Development Adolescents place more emphasis on the ________ aspects of religious commitment, such as what a person believes

c

Spiritual development during adolescent years can be best described by which of the following? a. places less emphasis on what a person believes b. places more emphasis on whether a person attends religious services c. becomes more focused on spiritual and ideologic matters and less on observing religious customs d. becomes more focused on observing religious customs and less on ideologic matters

b

The first pubescent change in boys is a. appearance of pubic hair b. testicular enlargement with thinning, reddening, and increased looseness of the scrotum c. penile elargement d. temporary breast enlargement and tenderness

c

The greatest single cause of death in the adolescent group and claims more lives than all other causes combined is? a. Firearms b. Motor vehicle-related injuries c. Physical injuries d. Sports injuries

b

The most appropriate way to prevent firearm injury among adolescents is a. teaching the adolescent proper use of firearms b. counseling the adolescent on nonviolent ways to resolve conflict c. passing laws to prevent parents from having guns d. telling parents to keep guns and ammunition in separate locations within the house

c

The nurse is assessing the Tanner stage in an adolescent female. The nurse recognizes that the stages are based on which? a. The stages of vaginal changes b. The progression of menstrual cycles to regularity c. Breast size and the shape and distribution of pubic hair d. The development of fat deposits around the hips and buttocks

b e f

The nurse is caring for children on an adolescent-only unit. What growth and development milestones should the nurse expect from 11- and 14-year-old adolescents? Select all that apply a. Self-centered with increased narcissism b. No major conflicts with parents c. Established abstract thought process d. Have a rich, idealistic fantasy life e. Highly value conformity to group norms f. Secondary sexual characteristics appear

d

The nurse is preparing a pamphlet for parents of adolescents about guidance during the adolescent years. What suggestion should the nurse include in the pamphlet? a. Provide criticism when mistakes are made or when views are different. b. Use comparisons with older siblings or extended family to promote good outcomes. c. Begin to disengage from school functions to allow the adolescent to gain independence. d. Provide clear, reasonable limits and define consequences when rules are broken.

a

The parents of an adolescent boy are concerned their son seems to need 9 hours of sleep a night. The nurse should advice the parents: a. "As long as he seems otherwise well, this sounds like a typical teenager" b. "Adolescents need only 8 hours of sleep a night; anything over this is excessive" c. "Your son is probably engaged in too many activities and is wearing himself out" d. "The side effect of many drugs is sleepiness"

c

The school nurse is discussing testicular self-examination with adolescent male students. Why is this important? a. Epididymitis is common during adolescence. b. Asymptomatic sexually transmitted infections may be present. c. Testicular tumors during adolescence are generally malignant. d. Testicular tumors, although usually benign, are common during adolescence.

d

The school nurse is teaching a class on injury prevention. What should be included when discussing firearms? a. Adolescents are too young to use guns properly for hunting. b. Gun carrying among adolescents is on the rise, primarily among inner-city youth. c. Nonpowder guns (air rifles, BB guns) are a relatively safe alternative to powder guns. d. Adolescence is the peak age for being a victim or offender in the case of injury involving a firearm.

c

The school nurse is teaching an adolescent about social networking and texting on phones. What statement by the adolescent indicates a need for further teaching? a. Social networking can help me develop interpersonal skills. b. I will have an opportunity to interact with people like myself. c. My text messaging during class time in school will not cause any disruption. d. I should be cautious, as the online environment can create opportunities for cyberbullying.

c

The school nurse recognizes that pubertal delay in boys is considered if no enlargement of the testes or scrotal changes have occurred by what age? a. 11 1/2 to 12 years b. 12 1/2 to 13 years c. 13 1/2 to 14 years d. 14 1/2 to 15 years

d

The school nurse recognizes that pubertal delay in girls is considered if breast development has not occurred by which age? a. 10 years b. 11 years c. 12 years d. 13 years

a b c e

The school nurse recognizes that students who are targeted for repeated harassment and bullying may exhibit what? Select all that apply a. Skip school b. Attempt suicide c. Bring weapons to school d. Attend extracurricular activities e. Report symptoms of depression

b d e

The school nurse teaches adolescents that the detrimental long-term effects of tanning are what? Select all that apply a. Vitamin D deficiency b. Premature aging of the skin c. Exacerbates acne outbreaks d. Increased risk for skin cancer e. Possible phototoxic reactions

a

To best effect adolescent health promotion activity, the nurse should incorporate which of the following in the plan? a. the adolescents definition of health b. the adolescents past health promotion activities c. a complete assessment of the adolescents past medical treatment d. a complete physical examination

b

What is true concerning masturbation during adolescence? a. Homosexuality is encouraged by the practice of masturbation. b. Many girls do not begin masturbation until after they have intercourse. c. Masturbation at an early age leads to sexual intercourse at an earlier age. d. Development of intimate relationships is delayed when masturbation is regularly practiced.

d

What is true concerning the development of autonomy during adolescence? a. Development of autonomy typically involves rebellion. b. Development of autonomy typically involves parentchild conflicts. c. Parent and peer influences are opposing forces in the development of autonomy. d. Conformity to both parents and peers gradually declines toward the end of adolescence.

a b c d f

When talking to adolescents about health promotion, the health nurse should also include which additional topics? Select all that apply a. Body Art b. Hearing c. Posture d. Tanning e. Upper respiratory infection f. Vision

a b c d e

When talking to adolescents about stress, the most common areas of stress in their lives include? Select all that apply a. Body image b. Conflicts with sexuality c. Competitive pressures d. Relationships with parents e. Relationships with peers f. Vehicle safety

2

Which Tanner Stage?

3

Which Tanner Stage?

4

Which Tanner Stage?

5

Which Tanner Stage?

a b d

Which of the following are the primary causes of mortality among adolescents in the US? Select all that apply a. injuries b. suicide c. congenital anomalies d. homicide e. chronic illness

c

Which of the following best describes the formal operational thinking that occurs between the ages of 11 and 14 years? a. thought process includes thinking in concrete terms b. thought process includes information obtained from the environment and peers c. though process includes thinking in abstract terms, possibilities, and hypotheses d. though process is limited to what is observed

b c

Which of the following immunization booster vaccines should be considered for a 13 year old adolescent who has completed all recommended routine childhood vaccines? Select all that apply a. DTaP Vaccine b. Tdap vaccine c. meningococcal vaccine d. pneumococcal vaccine e. hepatitis b vaccine f. hib vaccine

b

Which of the following statements about adolescents and school is true? a. transition from elementary school to middle school has no negative effects on adolescents b. teenagers whose grades fall below average spend more time in perceived negative environments and feel alienated from school c. students who repeat one or more grades are more likely to bring weapons to school d. students with above average grades have been identified as more likely to engage in suicide attempts

Behavioral

___________ autonomy is the capacity to make independent decisions and follow through with them