HESI Peds: Adolescents

What percentage of his or her adult weight does an individual gain during the adolescent years? Record your answer using a whole number._____%

50

At which stage of Kohlberg's theory does an individual show societal concerns?

Stage IV

Which statements are true regarding ectopic pregnancy? Select all that apply. 1 Smoking is one of the risk factors for ectopic pregnancy. 2 Ectopic pregnancy is directly related to fetopelvic incompatibility. 3 Ectopic pregnancy occurs when the fertilized egg implants in the fallopian tubes. 4 When a young women exhibits abdominal pain, ectopic pregnancy is suspected. 5 If the adolescent exhibits abdominal pain and hypotension, the ectopic pregnancy may have ruptured

1 3 4 5 Smoking is a risk factor for ectopic pregnancy. Ectopic pregnancy occurs when the fertilized egg implants outside the uterus, usually in the fallopian tubes. An adolescent exhibiting severe abdominal pain with hypotension is indicative of rupture of ectopic pregnancy and may need immediate surgery. Fetopelvic incompatibility is related to prolonged labor in younger teenagers of 12 to 16 years of age. However, it is not associated with ectopic pregnancy. Abdominal pain associated with or without bleeding, may indicate possible ectopic pregnancy. A pregnancy test and further assessment is needed.

Which event is considered as the hallmark of late puberty in young girls? 1 Breast enlargement 2 Adult type sexual hair 3 First menstrual period 4 Physiologic leukorrhea

3 First menstrual period is considered the hallmark of late puberty in young girls. Breast enlargement along with change in pubic hair to adult type sexual hair covering the mons pubis and labia majora occurs during mid-puberty stage. Physiologic leukorrhea (increased normal vaginal discharge) marks the uterine development early in puberty.

A physician orders a nucleic acid amplified test for an adolescent client who sustained a sexual assault. Which infections can be diagnosed with this test? Select all that apply. 1 Syphilis 2 Hepatitis B 3 Chlamydia 4 Gonorrhea 5 Trichomoniasis

3 4 Nucleic acid amplified testing (NAATs) is used to check for chlamydial and gonorrheal infections. Serum evaluations will reveal syphilis and hepatitis B infection. Trichomoniasis is detected by evaluating the specimen of a vaginal swab.

An adolescent is undergoing radiation for Hodgkin lymphoma. What important factor should the nurse discuss with the family? 1 Keeping up with schoolwork 2 Accelerated sexual maturation 3 Consistent skin care with lotion 4 Overwhelming fatigue and the need for rest

4 The major side effect of radiation therapy is overwhelming fatigue. Lotions can cause irritation if the skin reacts to the radiation. Schoolwork is not a major concern at this time. Accelerated sexual maturation is not an effect of irradiation.

A 19-year old client is diagnosed with a heavy and palpable hard mass on the anterior aspect of the testis. Which treatment would be appropriate? 1 Radiotherapy 2 Chemotherapy 3 Testicular biopsy 4 Radical inguinal orchiectomy

4 Treatment for testicular cancer may include a radial inguinal orchiectomy (a surgical removal of the diseased testicle). Radiotherapy and chemotherapy are usually implemented after an orchiectomy based on the stage of the tumor. A testicular biopsy is no longer recommended because it may cause the spread of malignant cells.

What instructions should a nurse give an adolescent who is taking benzoyl peroxide for acne? Select all that apply. 1 "Avoid frequent hair shampooing." 2 "Comb your hair to cover your forehead. " 3 "Apply the gel 20 to 30 minutes after washing your face." 4 "Use light-colored towels and bed sheets while on benzoyl peroxide treatment." 5 "Increase the frequency of the application gradually to prevent the drying effect."

4 5 Benzoyl peroxide may have a drying effect on the skin; the client can adjust to this effect by gradually increasing the frequency of application. Benzoyl peroxide causes a bleaching effect on clothes. Therefore, the adolescent should be instructed to use light-colored towels and bed sheets. Frequent shampooing reduces sebum secretion and thus acne. Brushing the hair away from forehead helps to reduce acne on the forehead due to dandruff. Tretinoin gel should be applied at least 20 to 30 minutes after face washing to reduce the burning sensation.

According to Piaget's theory, which of these is true about the period of formal operations? Select all that apply.

Children have the capacity to reason with respect to possibilities Children have a belief that their actions are scrutinized by imaginary audience

The nurse is teaching cleansing procedures to a client with acne. Which statement made by the client indicates a need for further teaching? 1 "I will avoid frequent shampooing." 2 "I will use a mild cleanser twice a day." 3 "I will brush my hair away from the forehead." 4 "I will avoid washing my face with antibacterial soap."

1 Frequent shampooing will help to improve a client's acne. Gentle cleansing with a mild cleanser twice a day helps improve acne. Brushing the hair away from the forehead will help to improve acne. Antibacterial soaps are ineffective and may cause drying; these soaps should be avoided.

What is true about psychosocial changes observed in adolescents? Select all that apply. 1 "They search for personal identity." 2 "They develop their own ethical systems." 3 "They consider themselves invincible." 4 "They think of their parents as materialistic." 5 "They get emotionally dependent on their parents."

1 2 An adolescent tends to search for his or her personal identity and develop his or her own ethical system during psychosocial development. During cognitive development, adolescents consider themselves invincible and consider their parents materialistic. Adolescents work at becoming emotionally independent from their parents while retaining family ties.

Which statements about acne in adolescents are true? Select all that apply. 1 Early acne occurs in the midface region. 2 Acne is more common in girls than boys. 3 Acne usually occurs in middle to late adolescence. 4 Intake of dairy products can contribute to acne severity. 5 Acneiform eruptions are predominant in young children.

1 3 4 Acne occurs in more than 50% of adolescents in middle to late adolescence. Early acne occurs in the midface region, such as the chin, nose, and middle of the forehead. The intake of dairy products may contribute to acne severity. Acne is more common in boys than in girls. Acneiform eruptions occur in infants, neonates, and young children.

The nurse is caring for several adolescent clients. Which are at increased risk for testicular cancer? Select all that apply. 1 Client with infertility 2 Client with hemophilia 3 Client with liver disease 4 Client with cryptorchidism 5 Client with Klinefelter syndrome

1 4 5 Risk factors for testicular cancer include cryptorchidism, Klinefelter syndrome, and infertility. The client with liver disease may be at increased risk of gynecomastia. Hemophilia, a hematologic disorder, is not a risk factor for testicular cancer.

A young adolescent couple asks a community health nurse about using condoms as a method of contraception. Arrange the steps of using a condom in sequential order. 1. Open the package to remove the condom and check for breaks or holes. 2. Contraceptive jelly is squeezed onto the tip of the condom. 3. Leave 0.5 inch of space at the tip of the condom. 4. Condom is unrolled on the erected penis. 5. Hold the rim of the condom in place when withdrawing. 6. Throw the condom away.

1 OPEN 2 LUBE 3 UNROLL 4 LEAVE SPACE 5 WITHDRAW 6 TRASH The first step is to open the package and remove the condom. Check for breaks or holes in the condom. Once that is complete, squeeze a dab of contraceptive jelly onto the tip of the condom. Then, unroll the condom on the erect penis, leaving 0.5 inch gap at the tip. Once sexual activity is complete, the rim of the condom should be held in place while withdrawing the penis. The used condom should be disposed of properly.

A nurse is educating a group of teenage girls about dietary sources of iron. Which statement by one of the teenagers indicates to the nurse the need for more instruction? 1 "Fish is a good source of iron." 2 "We need 8 mg of iron each day." 3 "We need more iron during pregnancy." 4 "Iron can be taken with 6 oz (180 mL) of orange juice."

2 Adolescents need 18 mg, not 8 mg, of iron per day. Excellent sources of iron that can be absorbed by the body include meat, poultry, and fish. Iron requirements increase during pregnancy and lactation, and iron supplementation may be needed. Juices and fruits high in vitamin C, taken with foods that contain iron, promote iron absorption.

An adolescent on gonadotropin-releasing hormone agonist therapy reports hot flashes and an absence of menses. Which treatment would be most appropriate? 1 NSAIDs 2 Counseling 3 Oral contraceptives 4 Nutritious diet

2 Gonadotropin-releasing hormone agonist therapy may cause hot flashes and an absence of menses for a short duration. A nurse should counsel the client that these symptoms resolve after the medication is stopped. NSAIDs are only recommended when there is pain and inflammation. Oral contraceptives are used to postpone pregnancy in cases of amenorrhea. A correction in the nutritional diet will not treat hot flashes.

What behavioral findings correspond to intimate partner violence in young adolescents? Select all that apply. 1 Sexually acting out 2 Attempting suicide 3 Pattern of substance abuse 4 Fear of certain people or places 5 Preoccupation with others or one's own genitals

2 3 Adolescent undergoing intimate partner violence may attempt suicide or have patterns of substance abuse. The behavioral findings in children undergoing sexual abuse include sexually acting out, fear of certain people or places, and a preoccupation with genitalia.

A client visits a primary healthcare provider because of painful urination. The primary healthcare provider confirms that the client has candidiasis. Which medications would be prescribed? Select all that apply. 1 Tinidazole 2 Miconazole 3 Clotrimazole 4 Azithromycin 5 Metronidazole

2 3 Miconazole and clotrimazole are used to treat candidiasis. Tinidazole is used to treat trichomoniasis. Azithromycin is used to treat chlamydia. Metronidazole is used to treat bacterial vaginosis.

A nurse on the adolescent unit is planning to discuss smoking prevention. What is the most effective approach for the nurse to use? 1 Sharing personal experiences with a smoking-cessation program 2 Showing pictures of the effects of smoking on the cardiopulmonary system 3 Presenting information on how smoking affects appearance and odor of the breath 4 Citing statistics about the relationship between smoking and cardiopulmonary diseases

3 Establishing an identity is the major developmental task of the adolescent; to achieve this task, the adolescent needs to conform to group norms that include appearance and acceptance. Appealing to this need may achieve more success than other teaching strategies. Sharing personal experiences with a smoking-cessation program is a teaching strategy that may be successful with an older, more secure group of people. Adolescents tend to believe that they are invincible and probably will not relate to this teaching strategy. They are also concerned about the present, not the future. Because adolescents believe they are invincible, they would not relate to a teaching strategy based on statistics about the harmful effects of smoking.

According to Tanner stages, which figure indicates the pubertal stage in males? 1 2 3 4

3 The pubertal stage is characterized by the initial enlargement of scrotum and testes along with reddening of scrotum slightly pigmented hair at base of penis. Figure 1 indicates stage 1 (prepubertal) as there is no pubic hair grown. Figure 2 indicates stage 5 (mature) as the testes, scrotum, and penis has grown to adult in size and shape and pubic hair is spreading towards the inner thigh surface. Figure 4 indicates stage 3 as the pubic hair became darker, coarser, and curly and spread sparsely over entire pubis.

A young woman who is receiving treatment for premenstrual syndrome visits the primary healthcare provider and reports a headache and dry mouth. Which drugs would be responsible for these side effects? Select all that apply. 1 Danazol 2 Ibuprofen 3 Sertraline 4 Fluoxetine 5 Escitalopram

3 4 5 Drugs used to treat premenstrual syndrome include sertraline, fluoxetine, and escitalopram. The side effects of these drugs are headaches, dry mouth, dizziness, and sleep disturbances. Danazol is used to treat endometriosis. Side effects are edema and oily skin. Ibuprofen is used to treat primary dysmenorrhea. The side effects include nausea, vomiting, and indigestion.

The nurse receives an order to prepare a solution for administering a cleansing enema for a 15-year-old client. What is the volume of solution that the nurse should prepare? 1 150 to 250 mL 2 250 to 350 mL 3 300 to 500 mL 4 500 to 750 mL

4 In adolescents, the volume of solution required is 500 to 750 mL. The nurse should prepare 150 to 250 mL of warmed solution for infants. The nurse should prepare 250 to 350 mL of warmed solution for administering a cleansing enema in a toddler. In school-age children, the volume of warmed solution is 300 to 500 mL.

After an assessment, an adolescent is diagnosed with a perceived inability to ingest food. Which nursing interventions would be appropriate for identifying hyponatremia? Select all that apply. 1 Monitor vital signs 2 Monitor fluid and electrolyte status 3 Monitor nutritional intake and behavior 4 Monitor for targeted daily calorie intake 5 Monitor activities for detrimental behaviors

1 2 The nurse should monitor an adolescent's vital signs and fluid and electrolyte balance to identify hyponatremia. Nutritional intake and behavior are monitored to identify physiological changes that may be life-threatening. The target daily calorie intake should be monitored for clients who are underweight. Detrimental behaviors such as excessive exercise are monitored to help identify behaviors that are not acceptable.

An adolescent reports irritation in the vagina and yellowish green, malodorous discharge. Which infection is the adolescent likely to have? 1 Candidiasis 2 Trichomoniasis 3 Bacterial vaginosis 4 Gonorrhea

2 Trichomoniasis is a protozoan infection characterized by yellowish to greenish, frothy, mucopurulent, copious, malodorous discharge. Irritation of the vagina is also common. Candidiasis causes itching of the vagina along with painful urination, and the discharge is thick, white, lumpy, and cottage cheese-like. Bacterial vaginosis has a characteristic "fishy odor" along with white, gray, or milky and thin discharge. Gonorrhea causes severe pain along with diarrhea and greenish yellow discharge.

What nursing actions are appropriate for an adolescent girl undergoing a pelvic examination? Select all that apply. 1 Teach the adolescent about hygiene, body function, and sexuality. 2 Invite the adolescent's parent in the examination room. 3 Postpone giving details about an exam as it may arouse fear in the adolescent. 4 Encourage the discussion of safer sex practices. 5 Display drawings, models, and equipment to help educate the adolescent.

1 4 5 Adolescents are often apprehensive about a pelvic examination. During the pelvic examination, the nurse should give the adolescent information regarding hygiene, body functions, and sexuality. Drawings, models, and equipment should be displayed to better educate the adolescent. In addition, the nurse should discuss safer sex practices, sexually transmitted infection prevention, and the postponing of sexual activity until the adolescent feels emotionally ready. The adolescent's parents should not be invited without the adolescent's consent.

A nurse is working in a school health promotion program for adolescents. Which of these actions should be included in the assessment process? Select all that apply. 1 The nurse should conduct a school violence assessment. 2 The nurse should assess the sleep pattern of the students. 3 The nurse should try identifying individuals at risk for substance abuse. 4 The nurse should identify the need for fluoride supplements to prevent dental caries. 5 The nurse should enquire about the presence of guns in the home to reduce the incidence of homicide.

1 3 5 School violence is a serious problem among adolescents. Hence, in a school educational health promotional program for adolescents, the nurse should conduct a school violence assessment. The adolescent population is at increased risk for drug abuse, so the nurse should try to identify individuals who are engaging in substance abuse and counsel them. The presence of gun at home can increase the risk of homicide. Therefore, the nurse should also counsel parents to avoid keeping guns at home. Assessment of the sleep pattern is performed in infants because the sleep pattern fluctuates in children of this age. In preschoolers and school-age children, the need for fluoride supplements should be assessed to help prevent dental caries.

Which statements are true regarding primary dysmenorrhea? Select all that apply. 1 During the luteal phase, F2-alpha is secreted 2 Anovulatory bleeding that occurs after menarche is painful 3 Primary dysmenorrhea usually appears 2 to 5 months after menarche 4 Pain usually begins at the onset of menstruation and lasts for 8 to 48 hours 5 Excessive release of prostaglandin F2-alpha decreases the frequency of uterine contractions

1 4 Primary dysmenorrhea is a condition associated with the ovulatory cycle. During the luteal phase and subsequent menstrual flow, F2-alpha is secreted. The pain usually begins at the onset of menstruation and lasts for 8 to 48 hours. Anovulatory bleeding, which is common in the few months or years after menarche, is painless. Primary dysmenorrhea usually appears 6 to 12 months after menarche when ovulation is established. Excessive release of prostaglandin F2-alpha increases the amplitude and frequency of uterine contractions.

Which nursing interventions are appropriate while performing an adolescent girl's first pelvic examination? Select all that apply. 1 Providing a pillow to the adolescent 2 Helping the adolescent get into a supine position 3 Discussing the findings with the adolescent 4 Allowing the adolescent to handle the speculum 5 Avoiding other individuals during the examination

1 4 While performing an adolescent girl's first pelvic examination, the nurse should provide a pillow to help the adolescent feel more comfortable and less vulnerable. The nurse should allow the adolescent to handle the speculum to reduce fears associated with the instrument. The nurse should help the adolescent get into a semi-sitting position to allow eye contact. The findings will be discussed with the adolescent after the examination is completed. The adolescent should be allowed to select a supportive person to be present during the examination.

A nursing instructor asks a nursing student to explain the characteristics of substance abuse in adolescents. Which statements by the student indicate inadequate learning? Select all that apply. 1 "Fifty percent of adolescents have used alcohol by the end of high school." 2 "Adolescents believe that substance abuse imparts a feeling of well-being." 3 "Adolescents in dysfunctional families have a higher risk of substance abuse." 4 "Adolescents believe that substance abuse will make them feel more mature." 5 "Twenty-five percent of adolescents have tried smoking by the end of high school."

1 5 Current statistics show that by the end of their high school years, 85% of adolescents have used alcohol. Current statistics also show that 65% of adolescents have tried smoking by the end of high school. Hence, the nursing student's statement that only 50% of adolescents have used alcohol by the end of high school and 25% have tried smoking indicates inadequate learning. Adolescents believe that substance abuse imparts a feeling of well-being. They also feel that substance abuse make them feel more mature. Adolescents from dysfunctional families are at greater risk for chronic use and physical dependency.

Which stages are a part of conventional reasoning, according to the Kohlberg's theory of moral development? Select all that apply. 1 Social contract orientation 2 Good boy-nice girl orientation 3 Society-maintaining orientation 4 Instrument relativist orientation 5 Universal ethical principle orientation

2 3 According to Kohlberg's theory, good boy-nice girl orientation and society-maintaining orientation are parts of conventional reasoning. Social contract orientation is stage 5 under postconventional reasoning. Instrument relativist orientation is stage 2 of preconventional reasoning. Universal ethical principle orientation is stage 6 under postconventional reasoning of Kohlberg's theory.

A nursing instructor asks a nursing student about the formal operations stage of Piaget's theory of cognitive development. Which of these statements by the student indicate a need for further teaching? Select all that apply. 1 During this stage, the individual engages in risk-taking. 2 During this stage, there's an absence of egocentric thought. 3 During this stage, reversibility in thought is the primary characteristic. 4 During this stage, the individual's thinking moves toward abstract theory. 5 During this stage, the individual develops the capacity to reason with respect to possibilities.

2 3 During the formal operations stage, egocentric thought prevails. During the concrete operation stage, reversibility is the primary characteristic of the thought. Reversibility refers to the ability to recognize that numbers or objects can be changed and returned to their original conditions. When the student says that there is no egocentric thought in adolescents and reversibility is the primary characteristic in the formal operation stage, this indicates a need for further teaching. During the formal operations stage, the adolescent is preoccupied by the thought that he or she is invulnerable and engages in risk-taking behavior. As adolescents mature, their thinking moves to abstract and theoretical subjects. During the formal operations stage, individuals develop the capacity to reason with respect to possibilities.

The nurse is teaching crutch-walking to a 12-year-old adolescent. What does the child do that indicates the need for more teaching? 1 Takes short steps of equal length 2 Looks forward to maintain balance 3 Looks down when placing the crutches 4 Assumes an erect posture when walking

3 The child should maintain an erect walking posture, without looking down, to ensure equilibrium and prevent loss of balance. Taking short steps is the correct technique for safe ambulation while crutch-walking. Looking forward is the correct technique for safe ambulation while crutch-walking; it keeps the body's center of gravity over the hips. Maintaining an erect posture is the correct technique for safe ambulation during crutch-walking; it keeps the body's center of gravity over the hips.

How does a family identity aid psychosocial development in the adolescent? 1 It helps the adolescent evaluate his or her health 2 It helps the adolescent develop a sense of admiration and acceptance 3 It helps the adolescent develop skills in decision-making and budgeting 4 It helps assuage the adolescent's feeling of being different from his or her peers

3 When an adolescent cannot have a part-time job because of studies, school-related activities, or other factors, the parents can provide an allowance for clothing and incidentals, encouraging the child to develop decision-making and budgeting skills. Thus family identity aids the psychosocial development of the adolescent. A health identity helps the adolescent evaluate his or her own health. A group identity helps the adolescent develop a sense of being admired and accepted. Peer groups provide the adolescent with a sense of belonging, approval, and the opportunity to learn acceptable behavior. Sexual identity helps the adolescent assuage the fear of being different from his or her peers. Adolescents depend on sexual clues because of a need for assurance of their maleness or femaleness and the wish not to be different from their peers.

After an assessment, a nurse observes a feeling of an altered perception of body appearance in an adolescent. Which nursing interventions would be beneficial in this situation? Select all that apply. 1 Developing a mutually agreeable targeted daily caloric intake goal 2 Monitoring activities of detrimental behaviors like purging and bingeing 3 Providing a therapeutic discussion of personal attributes perceived as positive 4 Encouraging a discussion of maladaptive behaviors surrounding food and fluid intake 5 Involving the adolescent in activities designed to promote a positive image of self-worth and accomplishment

3 4 5 Providing a therapeutic discussion of positive personal attributes would be beneficial for an adolescent who has a feeling of an altered perception of body appearance. Encouraging a discussion on maladaptive behaviors surrounding food and fluid intake would provide consistency in therapy and allow for a mutual discussion. Involving the adolescent in activities designed to promote a positive image of self-worth and accomplishment also promotes a sense of accomplishment and enhances the self-image of the adolescent. When an adolescent's weight is below the ideal weight, then the nurse should develop a mutually agreeable targeted daily calorie intake goal with the adolescent. If an adolescent has misconceptions about his or her body image, then the nurse should monitor for detrimental activities such as purging and bingeing in the adolescent.

The client reports excessive bleeding during the menstruation. Which herbal therapies are unlikely to be prescribed by the primary healthcare provider? Select all that apply. 1 Raspberry 2 Chamomile 3 Lady's mantle 4 Chaste tree fruit 5 Shepherd's purse

2 4 Chamomile is an antispasmodic agent that helps to reduce breast pain. Chaste tree fruit is used to reduce breast pain by reducing the prolactin levels. Raspberry, lady's mantle, and shepherd's purse are uterotonic drugs used to treat menorrhea.

What teaching methods should be adopted for an adolescent? Select all that apply. 1 Using teaching as a collaborative activity 2 Encouraging questions and offering explanations 3 Teaching psychomotor skills needed to maintain health 4 Using role play, imitation, and play to make learning fun 5 Allowing adolescents to make decisions about health and health promotion

1 5 Teaching should be framed as a collaborative activity in adolescents. An adolescent should be allowed to make decisions about health and health promotion. Preschoolers should be encouraged to ask questions, and answers should be provided through simple explanations and demonstrations. School-age children should be taught about the psychomotor skills needed to maintain health. The nurse should instruct mothers to include role play, imitation, and play to make learning fun for preschoolers. Independent learning should be encouraged in young and middle-aged adults.

A primary healthcare provider is reviewing the previous medical history of a client before prescribing danazol. Which conditions would cause a primary healthcare provider to not prescribe danazol to a client? Select all that apply. 1 The client is in her first trimester of pregnancy 2 The client has rheumatic heart disease 3 The client has a chronic kidney disease 4 The client has a history of pyelonephritis 5 The client is recently diagnosed with fatty liver

1 5 Danazol is a mild-acting synthetic steroid that suppresses follicle stimulating hormone and luteinizing hormone. This drug should not be prescribed to pregnant women because it may produce pseudohermaphroditism in female fetuses. Danazol is also contraindicated in a client with liver diseases. Danazol may be used with caution in clients with cardiac and renal diseases.

The nurse is teaching an 18-year-old athlete about measures to reverse amenorrhea. Which statements made by the adolescent indicates effective learning? Select all that apply. 1 "I will do hatha yoga daily." 2 "I will increase my food intake." 3 "I will perform weight training exercises." 4 "I will take lower back massage frequently." 5 "I will use oral contraceptive pills to regulate the menstrual cycle."

2 3 Low energy availability is a major cause of amenorrhea in adolescents who are athletes. Increasing food intake and performing weight training exercises may help to reverse amenorrhea. Oral contraceptive pills may mask any underlying problems and allow other effects such as osteoporosis continue to develop. Hatha yoga and lower back massages would help clients with primary dysmenorrhea.

How does sexual identity aid psychosocial development in the adolescent? Select all that apply. 1 It helps them evaluate their own health. 2 It helps develop masculine and feminine behaviors. 3 It helps them feel a sense of admiration and acceptance. 4 It helps them develop decision-making and budgeting skills. 5 It helps them lessen the feeling that they are different from peers

2 5 Physical evidence of maturity encourages the development of masculine and feminine behaviors and enhances sexual identity in the adolescent. Sexual identity assuages the adolescent's fear of being different from his or her peers. Adolescents depend on sexual clues because they want assurance of maleness or femaleness and do not wish to be different from their peers. Health identity helps the adolescent evaluate his or her own health. A group identity helps the adolescent develop a sense of being admired and accepted. A peer group provides the adolescent with a sense of belonging and approval and the opportunity to learn acceptable behavior. A family identity helps the adolescent develop decision-making and budgeting skills.