Exam 3

A mother is concerned because her 13-year-old daughter comes home happy one day and sad the next. The girl also argues with her younger sister more than she did in the past, and does not like participating in family activities anymore. Which of the following is the best initial response from the nurse? a. "The changes during adolescence can be stressful as they struggle to come to terms with who they are. What other types of behaviors has she been displaying?" b. "Changes in affect can be a warning sign for suicide. Has she had any increase in risk-taking behaviors or physical violence?" c. "Is there any history of psychological disorders in your family?" d. "Withdrawal can be a sign of substance abuse. Has she given you any indication she might be using illicit drugs?"

a. "The changes during adolescence can be stressful as they struggle to come to terms with who they are. What other types of behaviors has she been displaying?" Although dramatic swings in affect can be a warning sign for suicide, and withdrawal can be a sign of substance abuse, additional information is required before suggesting a diagnosis. Often, mood swings and spending more time with peers and less time with the family is normal adolescent behavior during this period of rapid change in physical, psychosocial, spiritual, moral, and cognitive growth. Parents and teenagers should be aware of and prepared for these changes.

After offering a teenager the HPV vaccine, the teenager responds by saying, "I can't have the vaccine because I have already been sexually active." Which of the following statements is the best response by the nurse? a. "You can still benefit from the vaccine, but there is a chance it will not be as effective." b. "The best way to protect yourself now is to make sure all your future sexual partners have received the vaccine." c. "You are correct, the vaccine is only indicated for females who have never been sexually active." d. "It depends on the number of partners you have had. If you have had less than five partners, you are still eligible for the vaccine."

a. "You can still benefit from the vaccine, but there is a chance it will not be as effective." The HPV vaccine is recommended for 11- to 12-year-old girls and for 13- to 26-year olds who have not yet received or completed the vaccine series. Ideally, females should receive the vaccine before they are sexually active because girls who have not been infected with any of the four HPV types covered by the vaccine will receive the full benefits of the vaccine. Females who are sexually active may also benefit but to a lesser degree. It is not known if the vaccine is effective in boys or men. Thus, the best response is, "You can still benefit from the vaccine, but there is a chance it will not be as effective."

The school nurse is evaluating children for signs and symptoms of depression. Which of the following children may be most at risk for depression? (select all that apply) a. 11-year-old girl who has been involved in fighting during the past month b. 10-year-old boy who no longer wants to play on the school's soccer team c. 12-year-old boy who has started lifting weights d. 9-year-old girl who visits the nurse on a daily basis for vague complaints

a. 11-year-old girl who has been involved in fighting during the past month b. 10-year-old boy who no longer wants to play on the school's soccer team d. 9-year-old girl who visits the nurse on a daily basis for vague complaints Symptoms of depression in school-age children include anorexia, sleeplessness, lethargy, changed affect, aggressive behavior, frequent crying, or withdrawal from previously enjoyed activities.

According to the American Heart Association, at what age should blood pressure screening begin? a. 3 b. 6 c. 9 d. 12

a. 3 Blood pressure screening should begin at 3 years of age and should be measured annually.

A community health nurse has received a grant to present a program about violence prevention. Which of the following individuals has a higher than average risk of homicide? (select all that apply) a. 33-year-old woman who served 5 years in prison b. 20-year-old homeless man c. 28-year-old man with a history of bipolar disorder d. 24-year-old woman who has a female partner

a. 33-year-old woman who served 5 years in prison b. 20-year-old homeless man c. 28-year-old man with a history of bipolar disorder Homicide is closely associated with alcohol and drug abuse and frequently is related to other violent acts, such as robbery. Other risk factors for homicide include a history of loss of employment, detention or prison experience, access to firearms, abuse in the home, mental illness, social isolation, and homelessness.

A nurse is working in a domestic violence shelter. Which of the following individuals would the nurse expect to encounter? (select all that apply) a. 34-year-old White woman who is vice president of a communications company b. 26-year-old Black woman who has a live-in boyfriend c. 29-year-old Hispanic man who has been married for 2 years d. 21-year-old unemployed White woman who has been with her boyfriend for 3 years

a. 34-year-old White woman who is vice president of a communications company b. 26-year-old Black woman who has a live-in boyfriend c. 29-year-old Hispanic man who has been married for 2 years d. 21-year-old unemployed White woman who has been with her boyfriend for 3 years Abusive behavior victims come from all racial, ethnic, and socioeconomic

A 30-year-old woman with a BMI of 36 is counseled by the nurse regarding interventions to assist with weight reduction. In which order would the nurse discuss the implementation of these interventions? 1. Gastric stapling2. Medication to reduce appetite3. Nutrition and exercise education4. Assessment of lipid profile and blood pressure a. 4, 3, 2, 1 4, 2, 3, 1 3, 4, 2, 1 3, 2, 1, 4

a. 4, 3, 2, 1 Assessment data must be complete before intervention. Diet and exercise are used first, and then pharmaceutical agents to reduce appetite. Bariatric surgery is used when all other options have failed.

Which of the following teenagers is at risk for not meeting his developmental task? a. Arrested for petty theft b. Decided he wants to major in accounting c. Has recently broke up with his girlfriend d. Is a member of the varsity basketball team

a. Arrested for petty theft The central task of adolescence according to Erikson is the establishment of identity, with the primary risk being role confusion. As the adolescent searches for direction, he makes choices in social, recreational, volunteer, academic, familial, and occupational activities. When the threat of confusion is exceedingly great, delinquent behavior and alterations in mental health can occur. Thus, a teenager arrested for petty theft is displaying delinquent behavior that may place him at risk for not meeting his developmental task of identity.

An occupational health nurse is conducting a blood pressure screening. Which of the following clients is at greatest risk of mortality from cardiac disease? (select all that apply) a. Black man with a blood pressure of 130/80 b. Mexican American man with a blood pressure of 110/60 c. White woman with a bold pressure of 120/80 d. Black woman with a blood pressure of 128/78

a. Black man with a blood pressure of 130/80 d. Black woman with a blood pressure of 128/78 According to the JNC VII, the risk for cardiovascular events rises when blood pressure is greater than 115/75. Blacks have a higher death rate from heart disease than do Whites. Mexican Americans have the lowest rate of hypertension.

During a physical exam, a teenager asks the nurse if she can have a stronger medication for her constipation because the laxatives she has been taking are not helping. During the physical exam, the nurse observes mild to moderate erosion of the tooth enamel. Which of the following disorders is the client most likely experiencing? a. Bulimia nervosa b. Binge eating disorder c. Idiopathic constipation d. Irritable bowel syndrome

a. Bulimia nervosa Bulimia nervosa is characterized by binge eating and then purging by self-induced vomiting and/or laxatives. Purging can also lead to erosion of the tooth enamel. Bulimia nervosa occurs more commonly in females. A teenage girl asking for stronger laxatives with tooth enamel erosion should cause any health care provider to consider the possibility of bulimia nervosa.

A nurse is conducting a community health education program for Hispanic women ages 18 to 35. Which of the following items should the nurse recommend that they increase in their diet on a daily basis? (select all that apply) a. Calcium b. Folic acid c. Iron d. Sodium

a. Calcium b. Folic acid c. Iron Women of childbearing age frequently consume a diet deficient in calcium, iron, and folic acid.

A nurse is conducting a school-wide in-service program about child abuse and is asked to describe common indicators of abuse. Which of the following signs would the nurse include? (select all that apply) a. Caregivers and parents who are reluctant to take the child for treatment for an injury b. Statement by the day care provider that the child was injured by falling off a chair c. Explanation of the injury from the child and caregiver or parent that are similar d. Lack of emotional response from child to a playground injury

a. Caregivers and parents who are reluctant to take the child for treatment for an injury b. Statement by the day care provider that the child was injured by falling off a chair d. Lack of emotional response from child to a playground injury Signs of abuse may include physical evidence, conflicting stories about the "accident" or injury from parents or others, an injury or complaint inconsistent with the child's history or developmental level, inappropriate response of the caregiver or child, the child's report of abuse, previous reports of abuse in the family, or repeated visits to emergency facilities with injuries.

A nurse is planning activities to help children learn about good nutritional practices. Which of the following strategies should the nurse implement? a. Coordinate a "Try This" food day offering a variety of nutritious snacks. b. Find a book about nutrition to read the students. c. Plan a game using the concept of MyPlate. d. Search on-line for a video about nutrition to the students.

a. Coordinate a "Try This" food day offering a variety of nutritious snacks. Children frequently prepare their own snacks and are more likely to learn from activities that foster active participation rather than passivity.

A nurse is planning health care for young adults. Which of the following factors about the interventions should be recognized by the nurse as having the greatest impact on whether they are effective? a. Culturally sensitive b. Match the person's health care beliefs c. Cost effective d. Gender neutral

a. Culturally sensitive Unless the interventions are culturally sensitive, they are not likely to be successful. Although the other factors are important, the priority consideration is cultural sensitivity.

A child who has a BMI of 34 visits the school nurse. Which of the following factors does the nurse recognize that the child may be experiencing? a. Increased bullying by peers b. Increased self-esteem c. Increased resiliency d. Increased motivation to lose weight

a. Increased bullying by peers Children may not be concerned about being overweight/obese and may therefore not be motivated to adopt healthier eating/exercise patterns. They may demonstrate impulsive behavior and have low self-esteem. Obese children are often ridiculed by peers.

A school nurse is assessing the child's social environment. Which of the following strategies would the nurse implement? a. Interview family members. b. Conduct a windshield assessment. c. Review the child's past medical history. d. Evaluate the child's activity and rest patterns.

a. Interview family members. The child's social environment includes the family, school, and playmates. Thus, the best way to collect information about this is to interview the child's family members.

Which of the following are symptoms or warning signs of anorexia nervosa? (select all that apply) a. Lack of menstruation in females b. Preoccupation with food c. Eating only small amounts of certain foods d. Dramatic weight fluctuations

a. Lack of menstruation in females b. Preoccupation with food c. Eating only small amounts of certain foods d. Dramatic weight fluctuations Symptoms or warning signs of anorexia nervosa include the relentless pursuit of thinness, self-starving with significant weight loss, lack of menstruation in females, decreased sexual interests in males, compulsive physical activity, preoccupation with food, portioning food carefully, eating only small amounts of only certain foods, and a distorted body image. Dramatic weight fluctuations are seen with bulimia nervosa.

The university health services nurse is preparing a disease prevention program for college students. Which of the following information should the nurse include in the program? a. Living in the dorm increases one's risk of developing meningococcal disease. b. The mortality rate from meningococcal disease is very low. c. There are no antiviral medications that can treat meningococcal outbreaks. d. A vaccine for meningococcal disease has not been developed.

a. Living in the dorm increases one's risk of developing meningococcal disease. Although most outbreaks of meningococcal disease are sporadic, young adults living in dormitories or crowded conditions may be more susceptible than young adults not living in close settings. Meningococcal disease has a high mortality rate. It is caused by a bacterium, not a virus, and antibiotics to treat the disease are readily available. A preventive vaccine is available.

A nurse is planning a flu prevention fair for 9- to 11-year-old children. Which of the following activities should be included? (select all that apply) a. Microscopes set up to show bacteria on common objects b. Games such as "find the germs" in a cartoon picture c. Research poster showing germ transmission d. Hand-washing booth with colored soap

a. Microscopes set up to show bacteria on common objects b. Games such as "find the germs" in a cartoon picture d. Hand-washing booth with colored soap Age-appropriate interactive activities such as games and demonstrations are effective teaching strategies. Formal research poster presentations are not appropriate for this age group.

Which of the following children may have difficulty with Erikson's "industry versus inferiority" stage of development? (select all that apply) a. Poor motor skills and is rarely chosen for team play during recess b. Difficulty with math homework c. Difficulty making friends d. Cannot speak his or her native language fluently

a. Poor motor skills and is rarely chosen for team play during recess c. Difficulty making friends d. Cannot speak his or her native language fluently The "industry versus inferiority" stage of development as described by Erikson is mastered when the child has a sense of accomplishment, rather than an inability to perform at the expected level. Children with poor motor skills who are not selected by their peers for a team, those who find it difficult to make new friends, and those who have difficulty assimilating into their dominant culture all are likely to have a sense of inferiority. A child who has difficulty with math homework may not be noticed by his/her peer group.

A nurse is planning community health programming for young adults. Based on the objectives for Healthy People 2020, which of the following topics would be priority areas for programming? (select all that apply) a. Prenatal care b. Physical activity c. HIV d. Suicide

a. Prenatal care b. Physical activity Healthy People 2020 objectives targeted for the young adult include increasing the proportion of adults who engage in regular aerobic activity of moderate intensity and increasing the proportion of women who receive early and adequate prenatal care. HIV and suicide rates are not mentioned in the target areas for young adults.

Which of the following behaviors is most reflective of a teenager? a. Riding an ATV without a helmet b. Not skiing for fear of falling and getting hurt c. Obeying a new parental rule without a challenge d. Walking away from a group of friends who are smoking cigarettes

a. Riding an ATV without a helmet Teenagers are known for their risk-taking behaviors. They do not always consider the health risks associated with their behaviors. In addition, they often do things because their friends do it. Therefore, riding an ATV without a helmet and risking a head injury is most reflective of a teenager's behavior.

Which of the following is responsible for ensuring that children are up-to-date on their immunizations? (select all that apply) a. School nurse b. Parent or caregiver c. Teacher d. School principal

a. School nurse b. Parent or caregiver The parent or caregiver bears the major responsibility for ensuring that their child has had all of the required immunizations; however, it is also the school nurse's responsibility to ensure that the immunizations are current.

The school nurse is working on a campaign in the school to prevent adolescent pregnancies. Which of the following interventions should the nurse implement? a. Talk to teenagers about sex, including abstinence, contraception, and sexually transmitted diseases. b. Tell the teenagers they should abstain from sex until they are old enough to cope with the potential consequences such as an unwanted pregnancy. c. Encourage parents of all teenage girls to make sure their daughters start oral contraceptives early. d. Offer all teenagers free condoms when they come in for physical exams.

a. Talk to teenagers about sex, including abstinence, contraception, and sexually transmitted diseases. The emergence of secondary sexual characteristics increases adolescents' awareness of themselves as sexual human beings leading to experimentation. Primary prevention is necessary to help prevent adolescent pregnancies. Parents, teachers, and health care providers will be more successful in assisting teens to manage their health needs if they treat them as joint partners. Talking to teenagers about sex, contraceptive options, and sexually transmitted diseases gives them the information and anticipatory guidance they need to help them make a decision.

A school nurse is planning a series on nutrition. Which of the following factors should the nurse take into account? a. Television commercials frequently advertise food-related products. b. Children watch approximately two hours of television a day. c. Each day, approximately 60% of children eat fast food. d. A child is three times more likely to eat in a restaurant than at home.

a. Television commercials frequently advertise food-related products. Children watch over 3 hours of television a day. About one third of children eat fast food each day, and parents spend approximately 40% of their food budget for restaurant meals, including fast food restaurants.

Which of the following statements concerning hearing in school-age children is correct? a. The rate of otitis media infections met Healthy People 2010 targets. b. Hearing and visual problems occur with the same frequency. c. All 50 states require routine hearing evaluations. d. The use of tympanograms has improved the accuracy of hearing screenings.

a. The rate of otitis media infections met Healthy People 2010 targets. Hearing problems occur with less frequency than do vision problems. Many states, but not all, require routine hearing evaluations. Tympanograms measure how well the tympanic membrane vibrates.

A nurse is working in the community to prevent bicycle and motorcycle fatalities. Which of the following measures would be most effective for the nurse to promote? a. Use of helmets b. Increasing the minimum age for motorcycle licensure c. Construction of bike paths along busy roads d. Right-of-way laws for bicyclists

a. Use of helmets Head injury is the major cause of death related to bicycle or motorcycle accidents. Bicycle helmets are believed to be the single most effective preventive measure available to decrease the incidence of brain and head injury.

A parent asks the nurse working in a pediatric clinic how she can help her 6-year-old child feel good about himself. Which of the following statements should be made by the nurse? a. "Doing most things for your child will give them a sense of security, and they will have a positive self-image." b. "Having your child help around the house with tasks such as setting the table will increase self- esteem." c. "Make sure to highly praise even the smallest effort your child makes at completing a task." d. "There is little you can do to increase your child's self-esteem. Their peers have much more of an influence than parents at this age."

b. "Having your child help around the house with tasks such as setting the table will increase self- When children succeed at age-specific tasks, they increase their sense of self-worth. Doing everything for a child prevents him or her from becoming proficient at a task. Too much praise makes positive feedback lose its value and gives the child a false sense of mastery. Although peers are important, at age 6, parents influence their children more than do peers.

Which of the following statements made by a parent is most helpful when discussing rules of the household? a. "You did not feed the dog like you promised, so you cannot have ice cream for dessert." b. "I was upset when you did not feed the dog like you promised. We all need to help take care of him because he depends on us. Let's talk about what happened." c. "Why did you forget to feed the dog? Would you like me to forget to feed you?" d. "What you did was bad. We all need to care for the dog."

b. "I was upset when you did not feed the dog like you promised. We all need to help take care of him because he depends on us. Let's talk about what happened." When correcting a child, explaining how one feels, the consequence of the action and then listening to the child discuss the situation is more beneficial than punishment and labeling the child as "bad."

The president of the Parent-Teacher Association asks the school nurse about the appropriateness of sponsoring a health fair that focuses on oral health for school-age children. Which of the following statements indicates the nurse's correct understanding of this issue? a. "Dental problems are not as prevalent a problem as asthma, so you might want to consider a health fair about respiratory problems instead." b. "Over 40% of children age 2 to 11 have dental caries, so a health fair that focuses on oral care is very appropriate." c. "Children are not usually receptive to learning about dental care, so the topic is not the best choice for a health fair." d. "This is not an appropriate focus for a health fair because the incidence of dental caries has dropped dramatically due to the use of sealants."

b. "Over 40% of children age 2 to 11 have dental caries, so a health fair that focuses on oral care is very appropriate." Dental caries are present in up to 42% of children 2 to 11 years of age. Dental caries and other oral health issues remain a problem in the school-age population. Small gains have been made in number of children receiving sealants to prevent caries. Dental caries is the most common chronic disease of children 5 to 17 years of age, 4 times more prevalent than asthma.

A mother is concerned because her daughter has been taking a nap every day after school. Which of the following statements would be the best response by the nurse? a. "Don't worry; all teenagers do that." b. "Tell me about your daughter's schedule." c. "Let's bring her in for some blood work." d. "Have you addressed the topic of drugs with you daughter?'

b. "Tell me about your daughter's schedule." Many teenagers take naps, although this does not address the mother's concern. Although the nap can be a symptom of a health problem or drug use, additional information is necessary to make that determination. Asking the mother to tell you about her daughter's schedule provides information to determine whether the behavior is normal or whether it requires further investigation.

A teenager has been using acne medications for the last 14 days. Her acne is no better, and in fact, it is a little worse. What information should the nurse offer this girl? a. "Wash your face at least four times a day, making sure to scrub well." b. "The medications can make acne appear worse at first; try to give it a few more weeks." c. "Avoid all chocolate products." d. "Because it is summertime, it would be good for your skin if you lie out in the sun for a few hours each day."

b. "The medications can make acne appear worse at first; try to give it a few more weeks." Acne is common in adolescents. Evidence indicates that dietary restrictions for acne are unnecessary. Although washing with soap and water is the best way to remove dirt, vigorous scrubbing should be discouraged. Furthermore, although sunlight can have a beneficial effect on acne, prolonged exposure should be avoided. Topical acne products make acne appear worse initially, and improvement occurs slowly over several months. Nurses should provide this information to teenagers planning to use acne products, so they are not discouraged early in therapy.

What percentage of adolescent females suffer from an eating disorder in the United States? a. 5% b. 10% c. 15% d. 20%

b. 10% Ten percent of adolescent females suffer from an eating disorder in the United States.

Each of the following children visits the school nurse on a regular basis. Which of these children would the nurse identify as being at risk for educational difficulty and suggest follow-up care? a. 9-year-old whose parents recently divorced b. 10-year-old who cannot sit still longer than 15 minutes c. 12-year-old with a 4000-word vocabulary d. 11-year-old who scored 102 on an IQ test

b. 10-year-old who cannot sit still longer than 15 minutes A 10-year-old who displays inattentive behavior should have follow-up care. Hyperactivity may indicate ADHD, which would require follow-up care and potential educational difficulty. An environmental deficit such as a divorce may cause school difficulty for a child, but this does not indicate a learning disability. The average vocabulary for a 12-year-old is 4000 words. A score of 102 on an IQ test falls within the average range of 90 to 110.

Which stage of female breast development is characterized by enlargement of the areolar diameter along with a small area of elevation around the papillae? a. 1 b. 2 c. 3 d. 4

b. 2 In stage 2, female breast development is characterized by enlargement of the areolar diameter along with a small area of elevation around the papillae.

Which of the following children should the school nurse monitor closely for hypertension (HTN)? (select all that apply) a. 7-year-old White male with no known family history of HTN b. 9-year-old White female whose maternal grandfather has HTN c. 6-year-old Black child with no family history of HTN d. 10-year-old Mexican American child with known family history of HTN

b. 9-year-old White female whose maternal grandfather has HTN c. 6-year-old Black child with no family history of HTN d. 10-year-old Mexican American child with known family history of HTN A White child with no family history of HTN can receive routine monitoring. The other children are in the high- risk category for HTN because of race and family history.

During a school gift fair, a parent asks the school nurse what gift would be most appropriate for her 6-year-old child. Which of the following should the nurse encourage the parent to purchase? a. A box of wooden blocks of various sizes for sorting b. A jar of sea shells in various shapes, colors, and textures c. A world map d. A beginning encyclopedia of animals

b. A jar of sea shells in various shapes, colors, and textures Classifying and ordering sea shells according to color, size, shape, and texture will help the child learn about classifying and numbering. These two concepts are necessary in order to learn to read and so on. A world map and encyclopedia are not age-appropriate, nor are wooden blocks.

A nurse is discussing being a safe driver as part of a driver's education course. Which of the following recommendations would the nurse include in this presentation? (select all that apply) a. Carpooling with friends b. Avoiding talking on cell phones c. Driving during daytime hours d. Wearing safety belt

b. Avoiding talking on cell phones c. Driving during daytime hours d. Wearing safety belt The risk of motor vehicle crashes is four times higher among 16- to 19-year-old adolescents than among any other age group. Research suggests that distractions, such as talking or texting on cell phones, eating, or playing with the radio, increase teen drivers' risk of being involved in a crash. Nurses should talk to teens about these distractions, which can also include riding with a car full of other teens. Teens have a much higher nighttime crash fatality rate as well.

Which of the following circumstances accounts for one of the leading cause of death in young adults? a. Tobacco use b. Binge drinking and driving c. Illegal drug use d. HIV infection

b. Binge drinking and driving Alcohol-related accidents among individuals ages 15 to 24 continue to be a leading cause of preventable morbidity, disability, and death.

The parents of a young adult female have recently divorced. Which of the following is the young adult most likely to experience? a. Relief b. Depression c. Unemployment d. Inability to sustain own relationships

b. Depression Although dissatisfaction and unhappiness are frequent precursors to separation and divorce, the decision to dissolve a marriage is not easy. Divorced young adults frequently suffer severe emotional strain and depression. Some young adults are unable to adjust to role and status changes and to threats of self-concept. Young adults whose parents divorce have an increased rate of divorce, but that does not mean that they are unable to sustain their own relationships.

The school nurse has been asked to conduct a community awareness program about accidents that impact the school-age child. Which of the following facts should be included in the program? a. Poisonings and falls are the leading causes of death. b. Drowning and motor vehicle accidents are the leading causes of fatality. c. The majority of accidents happen in the home. d. Burn accidents are more common in the summer months.

b. Drowning and motor vehicle accidents are the leading causes of fatality. Most fatal accidents during the school-age period derive from motor vehicle accidents when the child (host) is a passenger or pedestrian (walking or riding a bike). Other fatal accidents occur from fires and burns, bicycles, drowning, and firearm accidents. Accidents are the leading cause of death in children over 12 months of age. The majority of accidents occur outdoors. Burn accidents are more common in the winter.

The school nurse has been asked to plan play and recess activities for children in grades 2 through 6. Which of the following activities should be developed by the nurse? (select all that apply) a. Highly competitive games that focus on individual accomplishment and winning b. Family activity days that promote nature walks and biking c. Co-ed organized sports d. Library outings

b. Family activity days that promote nature walks and biking d. Library outings Emphasis should move away from highly competitive activities that promote more of a feeling of superiority than team work to reach a goal. Children in this age group generally prefer to play with children of the same gender.

Which of the following teenagers is at increased risk for acquiring a sexually transmitted disease and should be provided with anticipatory guidance? a. Asks the nurse for information about condoms b. Feels her friends and family do not care about her c. Has multiple friends and feels good about herself d. Talks to her boyfriend on the phone for hours

b. Feels her friends and family do not care about her Adolescents often talk on the phone for hours, providing a safe way for them to interact with members of the opposite sex. However, adolescence is a time when teenagers fantasize about relationships and sex. Teenagers decide to become sexually active for a number of reasons, including affection. This can put them at increased risk for sexually transmitted diseases; therefore, anticipatory guidance regarding protection from sexually transmitted diseases needs to be provided before the adolescent is in a situation that can place him or her at risk.

Which of the following teenagers is exhibiting a behavior that cause for concern and requires further evaluation? a. Is always very happy b. Is agitated and has trouble sleeping c. Has a lot of homework and stays up late to finish it d. Values his friend's opinion more than his parent's opinion

b. Is agitated and has trouble sleeping Nurses should be aware that the problem of substance abuse exists. They should also be aware of what the signs and symptoms are. Agitation and insomnia are signs of substance abuse and should therefore be evaluated further.

Which of the following actions should parents take to help their teenager meet his developmental task? a. Set strict rules to prevent the teenager from getting into any trouble. b. Maintain an ongoing dialogue about important issues and upcoming challenges. c. Maintain a friendship with the teenager, so he views parents as peers. d. Be very lenient with the teenager so that he can figure out who he is as a person.

b. Maintain an ongoing dialogue about important issues and upcoming challenges. Imposing strict limits and eliminating all rules are not helpful to teenagers. Families in which parents maintain a willingness to listen, demonstrate an ongoing affection for and acceptance of their adolescent, yet still maintain some consistent limits, experience more constructive, positive outcomes during adolescence. Thus, maintaining an ongoing dialogue about important issues and upcoming challenges demonstrates the parents' willingness to listen and their concern.

Which of the following interventions are appropriate relative to the nursing diagnosis: Health-Seeking Behaviors Related to Preconceptual Assessment and Preparation for Childbearing? a. Encouraging the consumption of a moderate-fat diet to prepare for pregnancy b. Referral to genetic counseling based on family history c. Counseling to avoid "hard" liquor d. Substituting a nutritional supplement for a meal so as to assure adequate vitamin intake

b. Referral to genetic counseling based on family history Assessment of biophysical risk factor is an important intervention, which includes review of genetic disorders, nutrition problems, and current medical problems. Before and during pregnancy, the diet should be well- balanced, low in fat and sodium, and high in calcium and iron. Nutritional supplements are not required unless the woman is malnourished. Alcohol in all forms including beer and wine should be avoided.

The nurse working in the college health center is planning a program about sexually transmitted diseases (STDs). Which of the following information should the nurse include in the program? a. STDs are the third most common infection in young adults. b. STDs can be transmitted by any intimate contact, not just sexual intercourse. c. STDs usually occur as a single infection. d. STDs are the most common reason for a visit to the health center.

b. STDs can be transmitted by any intimate contact, not just sexual intercourse. STDs can be transmitted from oral and anal sex, not just vaginal intercourse, and many young adults do not understand this. STDs are the most common infection in persons age 15 to 24. A person may have multiple STDs. STDs are generally unreported and not treated.

Which of the following is the third leading cause of death in adolescents between 10 and 24 years of age? a. Accidents b. Suicide c. Cancer d. Sport injuries

b. Suicide The third leading cause of death in adolescents between 10 and 24 years of age is

A teenager has a family history of Type 2 diabetes mellitus. He asks the nurse what he can do to try to prevent developing it himself. Which of the following instructions should the nurse give this client? a. Tell him to avoid any and all sweets. b. Tell him to be active and eat a balanced diet. c. Tell him he should talk to his physician about genetic testing. d. Tell him that very little can be done to avoid developing this disorder.

b. Tell him to be active and eat a balanced diet. Obesity is making Type 2 diabetes mellitus common among teens and young adults. Being overweight and inactive increases the risk. Therefore, encouraging activity and a balanced diet is the best information the nurse can give to the client. Telling him to avoid all sweets would be an impossible request, and genetic testing does not detect the development of this disorder.

A nurse is planning a community health education program for young adults. Which of the following considerations should be made by the nurse? a. The age span encompassing young adulthood is between 20 to 30 years of age. b. The number one cause of death for young adults is injury. c. The number of young adults in the United States is increasing. d. The maternal mortality rate is at its lowest point since 1980.

b. The number one cause of death for young adults is injury. Young adulthood spans the years between ages 18 to 35. The number of young adults in the United States is declining, and the maternal mortality rate is at its highest level since 1980.

A 32-year-old woman visits the occupational health nurse because of malaise. Which of the following assessment data indicates that the client may be experiencing achievement-oriented stress? a. Sleeping 10 hours per day b. Unintentional loss of 10 pounds in the past 3 weeks c. Expressed fear of company layoffs d. Calling in sick once every 2 weeks for the past month

b. Unintentional loss of 10 pounds in the past 3 weeks Achievement-oriented stress is characterized by lack of sleep, skipping meals, and workaholic habits. It differs from situational stress, which would be caused by changes in job function for example.

The mother of a 13-year-old girl is concerned because her daughter has not started menstruating yet. The girl developed breast buds and started her height spurt at 12 years of age. Which of the following statements would be the most appropriate response from the nurse? a. "Usually, girls start menstruating when they develop breast buds; an endocrine evaluation might be warranted." b. "Everyone is different; it will happen when it happens." c. "Based on when the breast buds first appeared, she should starting menstruating around the age of 14." d. "She will not start menstruating until her breasts are of adult size and contour."

c. "Based on when the breast buds first appeared, she should starting menstruating around the age of 14." The first sign of puberty in females is the appearance of breast buds, followed by a growth spurt. The onset of menstruation occurs approximately 2 years after the appearance of breast buds and near the end of the growth spurt. Thus, based on the age of breast bud appearance, the girl should start menstruating around age

The nurse working in the college health center is asked about a safe way to obtain a tan. Which of the following would be the best response by the nurse? a. "There is no safe way. Be sure to stay out of the sun as much as possible." b. "Tanning beds are much safer than exposure to actual sunlight." c. "Be sure to use sunblock agents and do not sunbathe between 10 AM and 2 PM." d. "Once you apply sunblock, you are protected all day, so be sure to use it before any outdoor activity."

c. "Be sure to use sunblock agents and do not sunbathe between 10 AM and 2 PM." Young adults should avoid sunbathing during the 2-hour period before and after noon because two-thirds of the day's ultraviolet light comes through the earth's atmosphere during this time. There is no need to stay completely out of the sun. Tanning beds are not a safe way to tan. Sunblock should be reapplied if certain outdoor activities are part of the day, such as swimming.

A nurse is initiating a discussion about alcohol consumption during a physical exam with a teenager. Which of the following questions would be most appropriate for the nurse to ask? a. "So, what do you and your friends do for fun and excitement?" b. "Do you have access to alcohol?" c. "Do any of your friends drink?" d. "Do you want to talk about alcohol or drinking?"

c. "Do any of your friends drink?" Anticipatory guidance during a physical exam is important. This includes asking about substance use. Questions should not be vague because they may be misinterpreted. Direct questions are useful when discussing sensitive topics. However, asking first about friends and the adolescent's feelings about them is a good lead-in approach to a discussion about substance use.

A nurse volunteered to work at a natural disaster site. Which of the following questions should the nurse ask to determine if the 26-year-old individual being screened is depressed or has suicide ideation? a. "Tell me about your pets." b. "What do you do for work? How has your work been affected by this disaster?" c. "Have you thought of harming yourself?" d. "Have you seen your friends since the disaster?"

c. "Have you thought of harming yourself?" Direct questioning about the intent to harm oneself is appropriate for the nurse to ask during screening/counseling sessions.

A teenager asks the school nurse for advice before getting a tattoo. Which of the following responses would be most appropriate for the nurse? a. "You should not get a tattoo." b. "It is okay to get a tattoo if you go to a licensed artist." c. "Tattoos are popular; however, they can lead to infection and/or bleeding." d. "A body piercing would be safer and less permanent."

c. "Tattoos are popular; however, they can lead to infection and/or bleeding." Tattoos and piercings carry similar risks, which include localized infection, bleeding, and dermatitis. In addition, tattoos carry a heightened concern for blood-borne disease such as hepatitis and HIV. When providing anticipatory guidance, nurses should treat teenagers as partners and give them the information they need to make an informed decision. Therefore, informing the teenager about the risk of infection is the best response.

A child's parents ask the school nurse if there is any help available to help their child receive health insurance. They state they earn too much money to qualify for Medicaid but not enough to purchase health insurance. Which of the following recommendations should the nurse provide? a. "Currently, there is no health care program available for your child." b. "The school district has a health insurance policy that you can access." c. "The state has an insurance program to assist you." d. "You will need to find coverage through another member of your family."

c. "The state has an insurance program to assist you." The State Children's Health Insurance Program was created to assist parents in this economic category. This program supports comprehensive care to children 0 to 18 years who do not meet Medicaid criteria but live in families too poor to afford private insurance.

The public health nurse is conducting a screening of young adults for metabolic syndrome. When asked about the syndrome, which of the following responses should be made by the nurse? a. "Anyone who has low blood sugar, high cholesterol, and high blood pressure has this syndrome and is at risk for cardiac disease." b. "This syndrome helps predict heart disease. Once it is diagnosed, the correct medication can be prescribed and heart disease avoided." c. "This syndrome is a warning sign that the person could develop heart disease. When someone has metabolic syndrome, dietary and activity level changes are recommended." d. "Anyone who has high cholesterol, high blood pressure, and high blood sugar has coronary artery disease. Once we make the diagnosis, we can begin to treat the disease."

c. "This syndrome is a warning sign that the person could develop heart disease. When someone has metabolic syndrome, dietary and activity level changes are recommended." Metabolic syndrome is diagnosed when a person has high cholesterol, high blood pressure, and high blood sugar. A person with this syndrome is at risk for coronary artery disease. Lifestyle changes are tried before medication is used.

A third grade teacher asks the school nurse what she can reasonably expect from children in her classroom related to language ability. Which of the following statements would be the best response from the nurse? a. "Children in the second grade should have about a 4000-word vocabulary." b. "Research has shown that children will learn to read more quickly if you use the whole word approach." c. "You can expect that the children will write 'b' and 'd' without reversing them, and all of the letters in a word will be about the same size." d. "You can evaluate the cognitive ability of the children in your classroom by noting how legible their writing is."

c. "You can expect that the children will write 'b' and 'd' without reversing them, and all of the letters The child will not have a 4000-word vocabulary until about the age of 12. Both the whole word approach and the phonics approach will help children learn to read. The legibility of handwriting has no correlation to intelligence.

When do females usually begin puberty? a. 1 year before males b. 1 year after males c. 2 years before males d. 2 years after males

c. 2 years before males Females usually begin puberty 2 years before males and experience their growth spurts earlier.

Which stage of male genital development is characterized by initial enlargement of the penis, mainly in length along with further growth of the testes and scrotum? a. 1 b. 2 c. 3 d. 4

c. 3 In stage 3, male genital development is characterized by initial enlargement of the penis, mainly in length along with further growth of the testes and scrotum.

Which of the following young adults exemplifies Kohlberg's postconventional level of moral reasoning? a. 28-year-old person who calls in sick so as to help a friend move to a new location b. 22-year-old man who uses marijuana on the weekends with friends c. 30-year-old woman who volunteers at a soup kitchen one day a month d. 35-year-old who works long hours so as to be considered for a promotion

c. 30-year-old woman who volunteers at a soup kitchen one day a month Someone in Kohlberg's postconventional level of moral reasoning is able to do what is beneficial or "right" regardless of peer pressure to take another course of action.

The school nurse has seen several students in the health office. For which of the following students should the nurse suggest a follow-up exam? a. A 14-year-old girl who has not experienced menarche b. A 7-year-old boy who has grown 2 inches in a year c. A 10-year-old girl who has gained 11 pounds in a year d. An 8-year-old boy who has lost four deciduous teeth in the past year

c. A 10-year-old girl who has gained 11 pounds in a year The average age of menarche is between 11 and 15 years of age. School-age children grow approximately 2 inches a year, gain between approximately 4.4 to 6.6 pounds a year, and lose four deciduous teeth a year between ages 6 and 13. A weight gain of 11 pounds in 1 year requires a follow-up because of the rising rate of obesity in children.

Which of the following children is at risk for developing encopresis? a. A 6-year-old child who takes Colace on a daily basis to soften stool b. A 3-year-old child who is not fully toilet-trained c. A 5-year-old child who has been in four foster care homes since age 3 d. A 4-year old child who sleeps soundly at night

c. A 5-year-old child who has been in four foster care homes since age 3 Encopresis is diagnosed after age 4. It occurs most frequently during the day, if the child has chronic constipation, which would not occur if the child takes Colace on a daily basis, and if the child has experienced early life stress.

Which of the following initiatives related to childhood nutrition outlined in Healthy People 2010 was most successful? a. Reduction of fat consumption b. Increase in consumption of fruit c. Adequate food supplies at home d. Reducing obesity rates

c. Adequate food supplies at home The target rate of 94% related to household adequate food supplies was surpassed with up to 98% of households found to be "food secure." Children continue to eat too many foods high in fat, obesity rates are increasing, and consumption of fruit and vegetables is low.

A nurse is counseling a 23-year-old woman about oral, transdermal, injectable, vaginal ring, and implant contraceptive methods. Which of the following risks of using these methods should be stressed by the nurse? a. Toxic shock syndrome b. Nausea c. Blood clots d. Ectopic pregnancy

c. Blood clots Blood clots are a potential risk with using all of these contraceptive methods. Ectopic pregnancy is a possible complication of IUDs. Nausea may occur with the use of Plan B, and toxic shock syndrome may occur with use of a diaphragm.

A nurse has recently accepted a position as a school nurse at a middle school and plans to offer sex education to the students and parents. Which of the following should be in the initial action taken by the nurse? a. Offer gender-segregated sex education classes. b. Develop information to teach about abstinence and condom use. c. Determine how this education has been provided in the past. d. Survey parents to determine their desire for this education to be provided.

c. Determine how this education has been provided in the past. The nurse employed in the school is in an ideal position to teach group sex education programs using literature and games. Children at this age appear to respond most favorably with gender-segregated classes, based on their general discomfort with sexual topics and unique needs and questions. Some schools appropriately incorporate these classes into school curricula as part of a health-promotion curriculum. Other schools have special programs focused only on sex education based on parental desires or school board policies. Therefore, the first action by the nurse should be to determine what has been done in the past.

Which of the following statements about smoking is true? a. Black children begin smoking at an earlier age than do White children. b. Almost 80% of schools prohibit tobacco use in all locations. c. Each day over 6000 children try smoking. d. Tobacco use prevention programs should be initiated in eighth grade.

c. Each day over 6000 children try smoking. Every day, more than 6000 school students try to smoke a cigarette. Most students who smoke initiate their habit around 11 years of age. White children begin smoking at an earlier age than do Black children. Approximately 64% of schools are smoke free. Tobacco use prevention programs should begin in elementary school.

Parents recently discovered that their teenage daughter has been consuming alcohol on a regular basis. They ask the nurse for advice on how to best help their daughter. Which of the following recommendations should the nurse give to the parents? a. Talk to their daughter at length regarding the dangers associated with drinking. b. Tell their daughter she will not be allowed to use her cell phone if this continues. c. Enroll their daughter in a peer support group focused on teenage drinking. d. Provide their daughter with literature regarding the dangers of drinking.

c. Enroll their daughter in a peer support group focused on teenage drinking. Teens do not always consider health risks associated with their risky behaviors. Additionally, peer influence is primary and parental input is often rejected. In this case, the teenager may risk losing her cell phone and privileges by continuing with her risky behavior, but because peer influence is primary, the parents should enroll her in a peer support group focused on teenage drinking.

A public health nurse is interested in writing a grant to improve vaccination rates of young adults. His focus should be on trying to obtain funding to support which of the following vaccination initiatives? (select all that apply) a. Rubella prevention b. Lyme disease prevention c. Hepatitis B prevention d. Human papilloma virus (HPV) prevention

c. Hepatitis B prevention d. Human papilloma virus (HPV) prevention Rubella in young adults is generally a minor disease; the population at risk is women of childbearing age. There is not a vaccine available for Lyme disease. Hepatitis B and HPV can both be prevented through immunization and young adults are at high risk for contracting these diseases.

Which of the following elements is most likely deficient in a school-age child's diet? a. Protein b. Sodium c. Iron d. Vitamin B12

c. Iron The diet of school-age children is frequently deficient in calcium, iron, and vitamin C, while it is high in fat and sodium.

A nurse is discussing optimal activity for young adults. Which of the following information should be stressed? a. Forty-five minutes of moderate exercise per day are required to maximize health benefits. b. An increase in heart rate from 70 to 200 beats/min during exercise is optimal. c. Moderately brisk walking is an appropriate aerobic exercise. d. Sixty minutes of exercise three times a week is recommended.

c. Moderately brisk walking is an appropriate aerobic exercise. The Healthy People 2020 goal is to increase the proportion of adults who engage in moderate physical activity for 150 minutes a week (30 minutes five times per week) to 47.9% from 43.5%. Aerobic conditioning achieves cardiovascular fitness through five periods of moderately intense exercise weekly for about 30 minutes or more at a heart rate of approximately 220 minus the age of the person multiplied by 65% to 85%. Young adults are encouraged to engage in fitness activities that increase the heart rate to approximately 150 beats or more per minute. Moderately brisk walking that increases the heart rate is an appropriate aerobic exercise.

During a parent-nurse conference, the parent tells the nurse that her child sleeps approximately 7 hours per night. Which of the following potential health problems would be of concern to the nurse? a. Hypertension b. Hyperactivity c. Obesity d. Type 2 diabetes

c. Obesity Based on the study by Lumeng et al, children who do not get adequate sleep tend to be less active, which promotes overweight/obesity. Type 2 diabetes and HTN may result from obesity.

Which of the following teenage behaviors is cause for concern? a. Has difficulty waking up in the morning and naps during the day b. Goes to bed late and naps during the day c. Takes frequent naps and states it is because he is bored d. Participates in after school activities and has difficulty waking up

c. Takes frequent naps and states it is because he is bored Adolescents need at least 8 hours of sleep per night. Often, they stay up late and wake up for school before their sleep cycles have finished; therefore, napping is common. However, those with a decreased energy level who use words such as "bored" or "sad" should be further evaluated for suspected depression. Therefore, a teenager who takes frequent naps and states it is because he is bored is cause for concern because this behavior might indicate depression.

A 26-year-old client has a total cholesterol of 206 mg/dL and an LDL of 110. Which of the following conclusions can be drawn by the nurse? a. The client has achieved the target levels for cholesterol in young adults. b. The client has a very low risk of developing heart disease. c. The client requires counseling about cardiac disease risk factors. d. The client has early-onset cardiac disease.

c. The client requires counseling about cardiac disease risk factors. Cardiovascular assessment of the young adult includes determining the presences of hyperlipemia, hypertension, diabetes, chest pain, or heart disease. This client has an elevated cholesterol levels and requires additional education about risk factors that may lead to cardiac disease. The Healthy People 2020 target is to reduce the mean total blood cholesterol levels among adults to 177.9 mg/dL. A diagnosis of heart disease cannot be made on the basis of these lab values.

A 14-year-old female is in for a physical exam. Which finding requires further investigation? a. A height spurt since her last visit b. Facial acne c. The lack of breast buds d. Noticeable sweating and body odor with activity

c. The lack of breast buds The onset of puberty usually begins around 11 to 13 years of age. Stage 2 is the usual time of peak height velocity for girls. Additionally, both sweat and sebaceous glands become more active during adolescence leading to sweat, body odor, and acne. Breast buds also usually appear during stage 2 of puberty. Females who have not begun pubertal development by age 14 should have an endocrine evaluation. Thus, the finding of lack of breast buds on this 14-year-old girl requires further investigation.

Which female disorder is characterized by only one X chromosome present instead of two? a. Gynecomastia b. Menstruation c. Turner syndrome d. Klinefelter syndrome

c. Turner syndrome A female disorder in which only one X chromosome is present instead of two is known as Turner syndrome.

A nurse is completing a health counseling session with a 25-year-old woman. Which of the following statements should be made by the nurse during this session? a. "A yearly Pap test is recommended for detection of ovarian cancer." b. "Research supports that breast self-exams reduce breast cancer mortality." c. "The incidence of cervical cancer is very low in your age group." d. "Daily physical activity and weight control is one way to stay healthy."

d. "Daily physical activity and weight control is one way to stay healthy." Screening is strongly recommended for cervical cancer in women who have been sexually active (Papanicolaou [Pap] smears). The incidence of carcinoma in situ is high in young adults. The US Preventative Services Task Force recommends against teaching breast self-examination and concludes that the current evidence is insufficient to assess the additional benefits and harm of clinical breast examination beyond screening mammography for women 40 and older. After age 25, the preventive emphasis is on modifying coronary disease risk factors, which would be accomplished by discussing activity and weight control.

During a well-child visit, parents report to the nurse that they are concerned that their 8-year-old son has started wetting the bed at night. Which of the following statements should the nurse make to the parents? a. "I'll be sure to mention this to the doctor because we rarely see a child who wets the bed at this age." b. "There is not much you can do to stop this problem until he gets older." c. "This is a common disease in children his age. Let's talk about some options for helping him stay dry." d. "I'm going to collect a urine sample from him and then we will talk about bed wetting."

d. "I'm going to collect a urine sample from him and then we will talk about bed wetting." Enuresis may be caused by a UTI. It is not a disease and not uncommon in school-age children. Various therapies exist to help the child maintain nighttime bladder control.

The school nurse conducting an in-service program for teachers is asked about general growth and development of school-age children. Which of the following statements would be the best response by the nurse? a. "By age 11, blood pressure readings are the same as for an adult." b. "Because of the rapid growth pattern in this age group, snacks are important to ensure sufficient caloric intake." c. "Children in this age group have some difficulty with coordination and balance, so playground supervision is important." d. "Overall growth in school-age children is slower than during infancy and adolescence."

d. "Overall growth in school-age children is slower than during infancy and adolescence." Children grow (physically) much more slowly during this time period as compared with growth during infancy and adolescence. Blood pressure readings for children in this age group are lower than for adults. Growth slows until adolescence. Children in this age group generally have good coordination and balance.

Parents of an 8-year-old boy tell the nurse that they are concerned about their son because he occasionally sleepwalks. Which of the following is the best response from the nurse? a. "Sleepwalking is much more common in girls than boys." b. "I am glad you mentioned this. Sleepwalking is sometimes a sign of a neurological deficit." c. "Does he also have nightmares? Do the two problems often occur together?" d. "This is not abnormal for a child of this age. He will most likely outgrow this tendency as his nervous system matures."

d. "This is not abnormal for a child of this age. He will most likely outgrow this tendency as Sleepwalking occurs more frequently in boys than girls, is most likely caused by an immature CNS, and is not associated with nightmares.

During orientation, the new school nurse asks his preceptor about the role of the school nurse. Which of the following statements is the best response by the nurse? a. "School nurses need to focus their attention on children who are economically disadvantaged, because other children have all the resources necessary to assist them maintain a healthy lifestyle." b. "There is little school nurses can do to improve the health of children. That really is the job of parents and caregivers. Our role is to conduct routine screening and deal with emergencies." c. "We are primarily focused on physical and psychological health, rather than environmental concerns." d. "We are an important part of the team that helps to maintain and improve children's health in a variety of ways from screenings to advocacy."

d. "We are an important part of the team that helps to maintain and improve children's health in a variety of ways from screenings to advocacy." School nurses care for children in all economic groups and recognize the unique challenges faced by each population. Nurses are a primary force related to improving children's health and well-being taking into account all facets of a child's world from the environment to health deviations.

A 19-year-old college student is seen by the health services nurse. The young woman is distraught that she had unprotected sex 4 days ago and is afraid she may have become pregnant. Which of the following statements should be made by the nurse? a. "Let's talk about your options because you must be 21 years of age to purchase emergency contraception." b. "Don't worry; you can purchase Plan B, an emergency contraception drug, without a prescription and it will terminate the pregnancy." c. "I know you are upset, but we are in one of the 40 states that allow drugstores to carry Plan B, an emergency contraception drug. Let's talk about how to use the medication." d. "You have several options. Let's discuss what would be the best thing for you to do next."

d. "You have several options. Let's discuss what would be the best thing for you to do next." Emergency contraception can reduce the number of unintended pregnancies. There is a generic two-dose form Next Choice, and a one-dose form, Plan B One-Step. Both require a prescription for girls under 17. Emergency contraception must be used within three days of unprotected sex. It works by either altering tubal transport of either sperm or ova, inhibiting implantation. It will not terminate an existing pregnancy and does not provide protection against sexually transmitted diseases.

Which of the following adults has transitioned to Erikson's intimacy versus isolation and loneliness stage of development? a. A 21-year-old man who has a part-time job, spends most of his leisure time with his buddies, and has numerous short-term intimate relationships b. A 25-year-old woman who is very concerned with how she is perceived by her coworkers and friends c. A 30-year-old man who just graduated with a PhD and is looking for his first full-time job d. A 26-year-old woman who has a long-term relationship with a female companion

d. A 26-year-old woman who has a long-term relationship with a female companion Erikson's intimacy versus isolation and loneliness stage of development involves reciprocal expressions of affection and trust. Promiscuous behavior is not characteristic of this stage of development. Reliance on a positive perception by friends and coworkers for self-esteem is not characteristic of this stage of development.

The school nurse has written a grant to obtain funding for a vision screening program and glasses for children in his pre-K to 6th grade elementary school. Which of the following statements should be included with the rationale for the need for funding? a. Many preschool children are hyperopic and need glasses to prevent headaches. b. Fewer than 10% of children entering school have had eye exams. c. Vision screening can diagnose vision/eye problems before they become severe. d. Approximately one in four children has a vision problem.

d. Approximately one in four children has a vision problem. Preschool children who are farsighted do not need corrective glasses. Their vision will improve as they mature. Approximately 33% of children entering school have had eye exams. Vision screening does not diagnose vision problems.

A school nurse is caring for a child with an upper respiratory tract infection. Which of the following nursing interventions should the nurse implement? a. Send the child with a mild sore throat back to class. b. Advise the parent of a child with a group A strep throat infection that they cannot return to school for 5 days. c. Educate the parent that treatment of group A strep infections usually requires extra fluid intake. d. Ask the parent of a child with a mild fever and mild sore throat to take the child to his or her health care provider.

d. Ask the parent of a child with a mild fever and mild sore throat to take the child to his or her health care provider. Untreated strep throat caused by group A bacteria can result in serious complications. Signs and symptoms may include a mild sore throat. After 24 hours on antibiotics, the child can return to school. Thus, the parents of a child with a mild fever and mild sore through should be evaluated by his or her health care provider.

Which of the following disorders is characterized by males having an extra chromosome, typically being tall and initially thin, and not developing secondary sex characteristics? a. Gynecomastia b. Menstruation c. Turner syndrome d. Klinefelter syndrome

d. Klinefelter syndrome A disorder in which males have an extra chromosome and typically are tall and initially thin, and do not develop secondary sex characteristics is known as Klinefelter syndrome.

A teenager is expecting her menstrual period on May 14. On which of the following dates would the nurse recommend that she perform a self-breast exam? a. May 11 b. May 14 c. May 17 d. May 23

d. May 23 The best day to perform a self-breast exam is 2 to 3 days after one's period when breasts are least likely to be tender or swollen. A typical period lasts about 6 days. Thus, a teenager who starts her period on May 14 should perform a breast self-exam on May 23 (14 + 6 = 20 + 3 = 23).

Which of the following statements is correct? a. Tonsils in a school-age child are smaller than in an adult. b. The nervous system generally matures between ages 11 to 13. c. Fractures heal more slowly in a 10-year-old child than in an adult. d. Overweight children have muscle pain more often than average-weight children.

d. Overweight children have muscle pain more often than average-weight children. Overweight children are more likely to suffer bone fractures, have joint pain, and more muscle pain than their normal weight counterparts. Tonsils, which are lymphoid tissue, are larger in a child than in an adult. The nervous system matures by ages 7 to 8. Fractures heal more quickly in children than in adults.

A nurse is discussing sleep patterns in school-age children. Which of the following should be stressed by the nurse? a. Sharing a bed with siblings/parents has a long-lasting psychological impact. b. School-age children need between 6 and 9 hours of sleep a night. c. Daytime naps are important in children until they reach the age of 9 or 10. d. School-age children generally agree with and adhere to a regular bedtime.

d. School-age children generally agree with and adhere to a regular bedtime. Research has not demonstrated that sharing a bed with siblings/parents has a long-lasting psychological impact on the child. Children sleep between 8 and 12 hours per night and do not need daytime naps.

Which of the following reflects Piaget's theory as applied to young adults? a. Voting for a candidate based on popularity b. Voting for a candidate based on media advertisements c. Voting for a candidate based on support of the candidate by peers d. Voting for a candidate based on analysis of views about various issues

d. Voting for a candidate based on analysis of views about various issues Young adults are in Piaget's formal operational thinking stage during which they analyze issues objectively and insightfully.

Which of the following statements should be considered by a nurse working in occupational health who organizes a stress reduction workshop? a. Women generally experience less workplace stress than do men. b. One's first job is exciting and leads to numerous opportunities, and therefore causes little stress. c. Young adults adapt easily to changing job demands such as telecommuting and long work hours. d. Work is of primary importance to young adults and helps form their self-image.

d. Work is of primary importance to young adults and helps form their self-image. Employment is more than a source of income to young adults; it provides self-esteem and social interaction. Women experience as much, and sometimes more, stress than do men because of child care issues. The demands of work are stressful and sometimes lead to unhealthy behavior.