Pediatric Nursing: Adolescence

Which of the following conditions may lead to development of obesity in children and adolescents? Select all that apply. 1. Hereditary low metabolism 2. Physical inactivity. 3. Socioeconomic status 4. Use of food as a positive reinforce of desired behavior 5. Availability of energy-dense foods and drinks 6. Positive self-esteem

2, 3, 4, 5

The parent of an adolescent tells the nurse, "I am curious about why my child looks a little unusual. His hands and feet appear larger than before." What is the best response by the nurse? A. "Hands and feet appear to be larger in adolescence." B. "Everything will be alright in a few days." C. "You must speak to the health care provider." D. "This is unusual. Let me assess your child."

A. "Hands and feet appear to be larger in adolescence." Rationale: Physical changes in adolescence take place in a characteristic sequence. The length of extremities and neck increases before there is growth in other areas such as hips and chest breadth. Therefore the adolescent might appear gawky with larger hands and feet. To say that everything will be alright may not be interpreted correctly by the parent and may increase anxiety. The nurse can inform the parent that the appearance of larger hands and feet is normal in the adolescent instead of advising the parent to see the health care provider. The nurse knows these physical changes are normal and therefore does not say that they are unusual.

A nurse is teaching a class about puberty in boys. Which of the following should the nurse include as the first manifestation of sexual maturation? A. Pubic hair growth B. Vocal changes C. testicular enlargement D. facial hair growth

A. . Pubic hair appears during early puberty, but is not the first manifestation of sexual maturation in males. B. Vocal changes occur after the appearance of pubic hair, typically in early to midpuberty, and are not the first manifestation of sexual maturation in males. C. CORRECT: testicular enlargement is the first manifestation of sexual maturation in males. D. facial hair growth typically appears about 2 years after pubic hair, and is not the first manifestation of sexual maturation in males.

How does the onset of the pubertal growth spurt compare in girls and boys? A.In girls, it occurs about 2 years before it appears in boys B.In girls, it occurs about 3 years before it appears in boys. C.In boys, it occurs about 1 year before it appears in girls. D.It is about the same in both boys and girls.

A. In girls, it occurs about 2 years before it appears in boys Rationale:The average age of onset for puberty is 12 years in girls and 14 years in boys. Although this may be true for an individual, the average difference is approximately 2 years. Usually, girls begin puberty and their growth spurt earlier than boys

The nurse is assessing a female child according to Tanner's stages of development. Which physiologic developmental event should the nurse expect during the first of Tanner's stages of development? A. Elevation of papillae B. Enlargement of areolar diameter C. Recession of areola into general contour to project papilla D. Projection of areola and papilla to form a secondary mound

A. Elevation of papillae Rationale: Prepubertal stage is the first stage of development according to Tanner's stages. In this stage, elevation of the papillae only occurs. Enlargement of the areolar diameter occurs during the pubertal stage. The projection of papilla caused by recession of areolar into a general contour occurs during the fifth stage of Tanner's stages. In the fourth stage, projection of the areola and papilla occurs to form a secondary mound.

Sexual orientation as a concept related to the adolescent period is A.not aligned with sexual identity. B. refers to patterns of arousal of feelings only between heterosexual couples. C. is different for each individual based on their own preferences.. D. can be measured by hormones levels.

C. is different for each individual based on their own preferences Rationale: Sexual orientation is the pattern of sexual arousal or romantic attraction between individuals regardless of whether it is based on heterosexual, same sex of transgender identification. It is not measured by hormone levels and is correlated with sexual identity

The nursing instructor is teaching a group of students about different stages of puberty. Which stages of puberty does the nurse mention? Select all that apply. 1 Prepubescence 2 Postpubescence 3 Adolescence 4 Early adolescence 5 Late Adolescence

1, 2 Rationale: Puberty has three stages: prepubescence, puberty, and postpubescence. Prepubescence is the time period of about 2 years before puberty in which there are preliminary physical changes. Postpubescence is the time period of 1 to 2 years after puberty in which skeletal growth is complete and reproductive functions are well developed. Adolescence is the psychologic, social, and maturational process brought about by pubertal changes. Early adolescence (11 to 14 years of age) and late adolescence (18 to 20 years of age) are phases of adolescence.

An adolescent is accompanied by his mother for an annual physical examination. On which topic does the nurse, drawing on knowledge of this age group, avoid questioning the adolescent? Select all that apply. 1Alcohol use 2 Sexual activity 3 Cigarette smoking 4 School performance 5 Use of car seat belts

1, 2, 3 Rationale: The nurse must maintain confidentiality, which is between the nurse and adolescent. Therefore while the mother is in the room the nurse should not ask personal questions. The nurse can ask general questions about academic performance or safety issues such as use of car seat belts without breaching confidentiality.

The nurse is assessing the social factors that influence an adolescent. What factors does the nurse assess? Select all that apply. 1 Relationships with parents 2 Relationships with peers 3 Interests and activities 4 Sexual activity 5 Self-concept and body image

1, 2, 3, 4 Rationale: The relationship of adolescents with their parents changes to mutual affection and equality during adolescence. There may be conflicts between parents and adolescents, because adolescents want to be free of parental restraints. Peer groups have intense influence on adolescents' behavior and also influence their decision making. Leisure time activities also help in the development of social, physical, and cognitive skills of the adolescent. Sexual activity is common in late teen years and needs to be assessed to ensure that the adolescent practices safe sex. Self-concept and body image are not social factors but are more related to how the adolescent feels about the new changes that have taken place in the body.

What physiologic changes occur in children due to pubertal changes? Select all that apply. 1 Strength of the heart increases. 2 Systolic blood pressure increases 3 Basal heat production increases. 4 Pulse rate decreases. 5 Respiratory volume increases.

1, 2, 4, 5 Rationale: The size and strength of the heart increases after puberty, which increases systolic blood pressure and decreases pulse rate. Respiratory volume increases after puberty to a greater extent in males than in females. Basal heat production decreases due to pubertal changes.

Girl A of 10 years shows development of breast buds but no visible hair in the pubic region. Girl B has started developing hair on the mons pubis but does not show any breast development. What can be predicted about the development of the girls? Select all that apply. 1 Girl A will have menarche earlier than B. 2 Girl B will have menarche earlier than A. 3 Girl A will be taller than B at menarche. 4 Girl B will be taller than A at menarche. 5 Girl A will have greater body weight than B at menarche. 6 Girl B will have greater body weight than A at menarche.

1, 5 Rationale: Girl A has attained thelarche first, and girl B has attained adrenarche first. It is seen that girls who have thelarche first experience earlier menarche and a higher body mass index at menarche than girls who reach adrenarche first. Therefore, girl A will have earlier menarche and greater body weight at menarche than girl B. Height cannot be predicted based on the sexual development of the girls.

Which of the following should the nurse discuss with a 14-year-old adolescent female taking isotretinoin (Accutane) for the treatment of acne? Select all that apply. 1. Birth control methods 2. Feelings of depression 3. Sudden thoughts about hurting oneself. 4. Blurred vision 5. Mood swings

1. 2. 3. 5

The primary health care provider asks a nurse to determine the stage of pubertal development in an adolescent female based on Tanner stages. What should the nurse assess? Select all that apply. 1 The distribution of pubic hair 2 The size of the vagina 3 The length of the clitoris 4 The development of breasts 5 The growth of body hair

1. 4 Rationale: The Tanner stages describe the stages of pubertal growth in males and females. In order to determine the stage of pubertal growth in females, the nurse should assess the distribution of pubic hair and the development of breasts. Assessment of the size of the vagina is not a part of determination of Tanner stages of pubertal development. Development of the clitoris is not a major determining factor of pubertal development. The growth of body hair is variable in the population and is not used to determine the sexual development of an individual.

The nursing instructor is teaching a group of students about sexual maturation in boys. What is included in the teaching? Select all that apply. 1 Testicular enlargement is the last pubescent change in boys. 2 Pubescent changes occur between 9.5 and 14 years of age. 3 Early puberty can be identified with the initial appearance of pubic hair. 4 Increasing muscularity and voice changes are characteristics of puberty. 5 Sometimes there is temporary breast enlargement in midpuberty.

2, 3, 4, 5 Rationale: Pubescent changes in boys occur between 9.5 and 14 years of age. There is testicular enlargement, thinning, reddening, and looseness of the scrotum during this period. The initial appearance of pubic hair, increasing muscularity, and voice changes also indicate pubescent changes. Temporary breast enlargement or tenderness called gynecomastia occurs in one third of the boys in midpuberty. Testicular enlargement is the first pubescent change in boys.

The nurse is teaching health promotion activities to a group of adolescents. What is included in the teaching? Select all that apply. 1 "Fat intake should only be about half of your diet." 2 "Use safety apparel while driving." 3 "Use adequate sunscreen." 4 "Avoid alcohol during water sports." 5. "Refuse to ride with reckless drivers."

2, 3. 4. 5 Rationale: Adolescents are more prone to indulge in risky activities and health-damaging behaviors. Therefore the nurse advises the adolescents to take proper precautions while driving, swimming, or participating in other sports activities. The nurse asks them to use safety apparel while driving to reduce risks. The nurse advises them to use proper sunscreen to avoid burns from exposure to the sun. The nurse advises them to avoid alcohol during water sports to avoid accidents such as drowning. The nurse cautions the adolescents to avoid riding with reckless drivers. The current Dietary Guidelines for Americans recommend decreasing fat intake to approximately 25% to 36% of total daily intake.

Oral contraceptive pills (estrogen and progesterone) have been prescribed for contraception. What are other benefits of oral contraceptives that the nurse should emphasize to this female patient? Select all that apply. 1 Prevents sexually transmitted infections 2 Prevents ovarian cysts 3 Safer in elderly women 4 Prevents ovarian cancer 5 Available without prescription

2, 4 Rationale: Oral contraceptives are used to prevent pregnancy. The pills used for contraception are associated with reductions in the risk of development of ovarian cysts and ovarian cancers. Oral contraceptives do not provide protection against sexually transmitted infections. They are safer in adolescents. Obtaining oral contraceptives from a pharmacy requires a prescription.

What nursing care guidelines should be used when the nurse is interviewing adolescents? Select all that apply. 1 Using adolescent slang 2 Ensuring confidentiality and privacy 3 Interviewing adolescents with their parents 4 Maintaining objectivity and avoiding judgments 5 Offering a nonthreatening explanation for the questions you ask

2, 4, 5 Rationale: When interviewing adolescents it is important for the nurse to ensure confidentiality and privacy. Offering a nonthreatening explanation for the questions you ask, such as "First I'd like to talk about your main concerns," is helpful. It is also important to maintain objectivity and avoid judgments. Slang should be avoided; instead, terms that both the nurse and the adolescent understand should be used. It is important to interview adolescents without their parents

A 14-year-old adolescent male tells a nurse, "My trunk seems so short compared to my legs. Do I have any problem?" What is the nurse's best response? A. "You are completely normal." B."You should do a lot of exercises." C. "You require growth pills." D. "You should have your testosterone levels checked."

A. "You are completely normal" Rationale: Growth in the length of the body in adolescent males follows a specific sequence. The extremities grow first, followed by the trunk. Thus, adolescent males have a gawky appearance, with long limbs and a short trunk. The person does not have any health-related problem; therefore the nurse should not recommend exercise as a remedy. The differences in the lengths of body parts are not abnormal in this situation, and the nurse need not ask the patient to take growth pills. Because the patient has normal growth, the nurse should not advise the patient to have testosterone levels checked.

An adolescent tells the nurse "I grew up in a rural area and have recently moved to New York City. I don't feel like I fit in. I really find it difficult to make friends here." What suggestion should the nurse give to this adolescent? A. "You join a club at school in your free time." B. "You should go online to find friends." C. "You should change schools." D. "You should read up about the things that your peers talk about."

A. "You should join a club at school in your free time" Rationale: Leisure activities are at the center of adolescents' social lives, so the nurse may suggest that the student join a club at school that will put him or her in more frequent contact with classmates. A nurse would not likely encourage an adolescent to try to find friends online because of the increasing dangers of online predators and the risks of sharing personal information online. The nurse would not necessarily encourage the student to change schools because this is a decision that should be made by the student and his or her parents, and would not automatically help the adolescent adjust to life in a larger city. Reading about the topics mentioned by peers will not necessarily help the student make friends and feel more socially adjusted.

The nurse is administering meningococcal vaccine (MCV) to a 12-year-old adolescent. What instruction does the nurse give to the patient? A. "You will have to take a booster dose after 4 years." B. "You need not take a booster dose of this vaccine." C. "You need to take a booster dose on an annual basis." D. "You can take the booster dose between 13 and 18 years of age."

A. "You will have to take a booster dose after 4 years" Rationale: The first dose of MCV is usually given at 11 to 12 years of age. The next booster dose of the vaccine has to be taken when the patient is 16 years of age, which is 4 years after the initial dose. If the patient has not received the MCV vaccine at 11 to 12 years of age, the patient has to take only one dose of the vaccine between 13 and 18 years. MCV is not administered annually.

Which is most descriptive of the spiritual development of the older adolescent? A. Beliefs become more abstract B. Rituals and practices become increasingly important. C. Strict observance of religious customs is common. D. Emphasis is placed on external manifestations, such as whether a person goes to church.

A. Beliefs become more abstract Rationale:Because of their abstract thinking abilities, adolescents are able to interpret analogies and symbols related to their spiritual development. Rituals and practices become less important as the adolescent questions values and ideals of families. Strict observation of religious customs becomes less important as the adolescent questions values and ideals of families. Adolescents question external manifestations when not supported by adherence to supportive behaviors. The adolescent's spiritual development is more internally driven.

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

A. CORRECT: Girls usually stop growing about 2 years after menarche. this statement by the parent indicates and understanding of the teaching. B. Girls are expected to gain 7 to 25 kg (15.5 to 55 lb) during puberty. this statement by the parent does not indicate an understanding of the teaching. C. Breast development is usually the first manifestation of sexual maturity in girls, and appears before menstruation. this statement by the parent does not indicate an understanding of the teaching. D. Girls typically grow 5 to 20 cm (2 to 8 in) during puberty. this statement by the parent does not indicate an understanding of the teaching

A nurse is providing anticipatory guidance to the parent of a 13‑year‑old adolescent. Which of the following screenings should the nurse recommend for the adolescent? (select all that apply.) A. Body mass index B. Blood lead level C. 24‑hr dietary recall D. Weight e. scoliosis

A. CORRECT: the nurse should recommend that the adolescent have a body mass index screening annually. B. Blood lead level screenings are recommended for children at the age of 1 and 2 years, and for children between the ages of 3 and 6 years who have not previously been screened. C. a 24‑hr dietary recall is not a routine screening for an adolescent. D CORRECT: the nurse should recommend that the adolescent have a weight screening annually. E. CORRECT: the nurse should recommend that the adolescent have a scoliosis screening annually.

An adolescent is brought to the emergency department after sustaining a small clean cut to his right thumb. The nurse learns that the adolescent sustained injury with a clean, unused knife. On examination, the nurse finds that the cut measured 1 × 1 cm and is not contaminated. The adolescent has been immunized against tetanus in childhood but has never taken a booster dose. What should be the most appropriate step of the nurse? A. Inform the parent that the adolescent requires tetanus booster dose. B. Inform the parent that the adolescent requires tetanus immunoglobulin. C. Inform the parent that tetanus injection is not needed for the adolescent. D. Inform the parent that the adolescent requires hospital admission immediately.

A. Inform the parent that the adolescent requires tetanus booster dose. Booster doses of tetanus should be given to all adolescents aged between 11 and 18 years who have been immunized in childhood and have never received a booster dose later. This adolescent does not require tetanus immunoglobulin, because the wound is not contaminated. It would be incorrect to inform the parent that the adolescent does not require a tetanus injection. Because the adolescent does not show any signs of infection, he does not be admitted to the hospital.

The most likely source of injury, whether intentional or unintentional in adolescents is associated with? A. Motor vehicle accidents B. Poisoning C. Drowning D. Homicide

A. Motor vehicle accidents Rationale: Motor vehicle accidents are the most common cause of injury and death in adolescents. Homicide is the second leading cause.

While caring for hospitalized adolescents, the nurse observes that sometimes they are skeptical of their parents' religious beliefs and practices. The nurse should recognize that this is A. Normal in spiritual development B. abnormal in spiritual development. C.related to illness and occurs only at times of crisis. D.related to the parents' inability to adequately explain their beliefs and practices.

A. Normal in spiritual development Rationale:The behavior described occurs in stage 4 in spiritual development. Adolescents attempt to determine which of their parents' standards and beliefs to incorporate into their own. The behavior described is not abnormal. The behavior described is not applicable only during times of crisis. The behavior described is not related to the parents' inability to explain their beliefs and practices.

The registered nurse is teaching a group of student nurses about body art. Which information should the nurse include in the teaching plan? A. Piercing may result in cyst or keloid formation. B. Punching guns are useful for piercing the nose and ear lobes. C. Sterilized needle usage may cause human immune deficiency virus (HIV) infection. D. Contaminated tattoo ink may cause tuberculous skin infections.

A. Piercing may result in cyst ot keloid formation Rationale: Cyst or keloid formation is one of the side effects of piercing. Punching guns should not be used for piercing anything other than the earlobe because guns place the piercing too deeply. Unsterilized needle usage may cause HIV infections. Contaminated tattoo ink may cause nontuberculous Mycobacterium chelonae skin infections. This bacterium is not tuberculous.

A nurse is caring for an adolescent whose mother expresses concerns about her child sleeping such long hours. Which of the following conditions should the nurse inform the mother as requiring additional sleep during adolescence? A. sleep terrors B. rapid growth C. elevated zinc levels D. slowed metabolism

A. Sleep tremors occur most often in preschool-age children, and do not contribute to the adolescent's need for additional sleep. B. CORRECT: rapid growth during the adolescent years results in the need for additional sleep. C. Zinc levels do not typically elevate during the adolescent years, and do not contribute to the adolescent's need for additional sleep. Zinc is often identified as deficient due to inadequate dietary intake during adolescence. D. an increased metabolism contributes to the adolescent's need for additional sleep.

Evidence-based research shows that the most successful strategy for preventing smoking in teenagers is A. emphasis on immediate effects of smoking. B. emphasis on long-term effects of smoking. C. large-scale public information campaigns. D. threatening the social norms of groups most likely to smoke.

A. emphasis on immediate effects of smoking Rationale: An emphasis on immediate effects of smoking has proven to be one of the most effective strategies for preventing smoking. Information focuses on tobacco smell and other aesthetic issues. Because this age-group is neither future oriented nor consequence oriented, emphasis on the long-term effects of smoking does not work as well as focusing on the immediate effects. Public campaigns can be effective when focused on the immediate effects of smoking, but they often focus on the more long-term effects of smoking. Threatening social norms in adolescents is not an effective strategy for the prevention of smoking.

Girls experience an increase in weight and fat deposition during puberty. Nursing considerations related to this include A.giving reassurance that these changes are normal B.suggesting dietary measures to control weight gain. C.recommending increased exercise to control weight gain. D. encouraging a low-fat diet to prevent fat deposition.

A. giving reassurance that these changes are normal Rationale:A certain amount of fat is increased along with lean body mass to fill the characteristic contours of the child's gender. A healthy balance must be achieved between expected healthy weight gain and obesity as related to these normal and expected physical changes. This should not be done unless weight gain is excessive. Eating disorders can develop in this group, and diet management should be considered only under a health care practitioner's care. Exercise is an important component in weight management but should never be done or encouraged in increased amounts or in excess to control weight gain that occurs normally during puberty. Some fat deposition is essential for normal hormonal regulation. Menarche is delayed in girls with body fat contents that are too low; therefore, a low-fat diet is not a recommended intervention.

A 15-year-old female diagnosed previously with anorexia nervosa is admitted to the ED. Her mother states that her daughter has not voided in 24 hours and has been lethargic for the last 12 hours. The patient appears cachectic and pale, and her weight is recorded as 78 pounds. She is minimally responsive to painful stimuli. A number of diagnostic tests are obtained. Which one of these represents the most immediate life threat to her life requiring intervention? A. Serum Na of 149 B. Serum K of 2,6 C. Hemoglobin 6.8 D. Arterial pH of 7.30

B. Serum K of 2.6

When conducting a class on sex and sexual activities with adolescents, the most appropriate approach by the nurse is to A. use dolls to teach the content B. present normal body functions in a straightforward manner C. Refer the adolescents to their parents for sexual information D. Delay giving information about pregnancy unless the adolescents are sexually active

B Present normal body functions in a straightforward manner Rationale:The nurse should provide accurate and complete information using correct terminology that is understandable to the adolescent. Dolls are appropriate for teaching a younger age-group of children. Using the correct terminology is more appropriate for a group of adolescents. Parents are important for conveying the morals and values surrounding sexual activities, but nurses may provide adolescents with accurate, complete information. Adolescents should have information before they become sexually active about the potential consequences of sex, including the practice of safe sex to prevent pregnancy and the transmission of sexually transmitted diseases.

A nurse is addressing a group of adolescent females and explaining to them about the importance of proper diet. What is the reason for the nurse to choose this group to educate about diet? A. Adolescent females usually have a high body mass index. B. Adolescent females tend to eat less due to fear of becoming overweight. C. Adolescent females tend to eat more in order to gain size and strength. D. Adolescent females are highly predisposed to have cardiovascular diseases.

B. Adolescent females tend to eat less due to fear of becoming overweight. Rationale: Adolescent females tend to eat less, because they are very conscious about their physique and have a fear of becoming overweight. In this process, adolescents may deprive themselves of certain essential nutrients. Thus it is very important to educate these females about the importance of having a proper diet. All adolescent females may not always have a high body mass index. Adolescent males tend to eat more in order to gain size and strength. Adolescent females are less prone to have cardiovascular diseases, because they have high estrogen levels. Estrogen has a cardioprotective effect.

The nurse is assessing a 10-year-old female and finds that the girl has reached puberty at an early age. What finding has led the nurse to conclude the child has reached actual puberty? A. Hoarsening of the voice B. Beginning of menstruation C. Development of breasts D. Development of axillary and pubic hair

B. Beggining of menstration Rationale: Puberty is the phase in which sexual maturity is attained. In females this phase is characterized by the beginning of menstrual flow. Hoarsening of the voice is a secondary sexual characteristic in males. Secondary sexual characteristics such as development of breasts and axillary and pubic hair appear before puberty (in the prepubescence stage). These characteristics do not imply that the girl has attained puberty.

Almost half of all cases of PID in the US are caused by: A. Neisseria gonorrhoeae B. Chlamydia trachomatis C. Treponema pallidum D. Human papillomavirus (HPV)

B. Chlamydia trachomatis

Which statement is true about physical growth? A. The average boy gains 2 to 8 inches in height during the growth spurt period. B. Growth in height typically ceases 2 to 2½ years after menarche in girls. C. The growth spurt begins in girls usually between 10½ and 16 years of age. D. The average girl gains 7 to 25 kg in weight during the fast growth spurt period.

B. Growth in height typically ceases 2-21/2 years after menarche in girls Rationale: Growth in height typically ceases 2 to 2½ years after menarche in girls; in boys, growth ceases between 18 and 20 years of age. The average boy gains 10 to 30 cm (4 to 12 inches) in height during the growth spurt period. The growth spurt usually begins in girls between 9½ and 14½ years of age. The average girl gains 7 to 25 kg in weight during slower growth spurt periods.

What is a normal occurrence during puberty for males? A. Obesity B. Gynecomastia C. Growth rate decline D. Loss of lean body mass

B. Gynecomastia Rationale: Gynecomastia, or temporary breast enlargement and tenderness, is common during male puberty; it is reported by up to one third of boys. Obesity is not a part of male puberty. Growth rate increases rather than declines during male puberty. There is growth, not a loss, of lean body mass in boys.

During the adolescence period, what role does the school environment take on? A. It is the only site for their continuing education. B. It forms the basis for their social life.. C. It provides a consistent structure based on peer group assignment. D. It allows for development of autonomy as a transition from only being in the home environment.

B. It forms the basis for their social life Rationale: The school environment becomes the focus of the adolescent's social life. While the school environment provides a site for education, the adolescent may also be receiving instruction at other areas or venues. The school environment is not based on peer group assignment and peer groups provide the transitional structure for adolescent's emerging autonomy

Joanna, a 19 year-old pregnant female, is at the clinic for her first prenatal care visit. She is in her first trimester. Joanna has been recently diagnoses with HIV and is concerned about the health of her unborn fetus. The nurse counsel Joanna that treatments are available to prevent of minimize perinatal transmission of HIV. The current EB recommendations to prevent perinatal transmissions of HIV are to: A. Administer IV zidovudine 24 hours before delivery B. Start a combination of antiviral drugs as soon as possible C. Avoid giving antiretroviral drugs until the 28th week of gestation D. Wait until the infant is born because perinatal transmission before delivery if very rare.

B. Start a combination of antiviral drugs as soon as possible

An adolescent teen has confided to the school nurse that he is bisexual and asks the school nurse for advice in "coming out" top his peers. What would be the best response to the student's request? A. Call the parents of the child directly and tell them before the child "comes out" to his peers. B. Suggest that the individual have form a safety plan first before disclosing information. C. Suggest to the student that he tell his parents before he tells anyone else D. Let the student know that you are supportive but that he is the only person that knows when the time is right to "come out."

B. Suggest that the individual have form a safety plan first before discolsin information Rationale: is important to have a safety plan in place first before "coming out" as individuals may not be able to cope with the information and as such the adolescent teen maybe exposed to potential rejection, violence or misunderstanding. The nurse has no legal authority to violate confidentiality by notifying the teen's parents without his consent. And although it may be best to tell one's parents first, the priority is to have a safety plan in place prior to disclosure of this type of information. Similarly, the teen is the best person to determine when the time is right but safety and support are a priority.

In planning sex education and contraceptive teaching for adolescents, what should the nurse consider? A. Both sexual activity and contraception require planning. B. Teenagers need contraception education in both oral and written form. C. Most teenagers today are knowledgeable about reproductive anatomy and physiology. D. Most teenagers who become pregnant do so as an act of hostility, especially toward the parents.

B. Teenagers need contraception education in both oral and written form. Rationale: Sex education and contraceptive information need to be concrete and concise. Oral explanations with demonstrations and written explanations with diagrams should be provided. Sex education and contraceptive teaching are independent of adolescents' knowledge of reproductive anatomy and physiology. Contraception requires planning. Most adolescents are sexually active for 6 months to 1 year before seeking contraceptive information. Most adolescent sexual activity is unplanned. There are no data to indicate that most teenage pregnancies occur as acts of hostility toward parents.

The onset of puberty in boys is characterized by A. Voice changes B. Testicular enlargement C.growth of dark pubic hair D. Increases size of the penis

B. Testicular enlargment Rationale: This is the first change that signals puberty in boys during Tanner stage 2 of sexual development. Voice changes occur between Tanner stages 3 and 4 of sexual development. Fine pubic hair may occur at the base of the penis early in puberty, but darker hair occurs during Tanner stage 3 of sexual development. The penis enlarges during Tanner stage 3 of sexual development.

An adolescent boy tells the school nurse that he is gay. The nurse's response should be based on knowledge that A. he is too young to have had enough sexual activity to determine his sexual orientation at this time. B. it is important to provide a nonthreatening environment for him to discuss his feelings. C. the nurse should feel open in discussing his or her own beliefs about homosexuality. D. homosexual adolescents do not have concerns that differ from those of heterosexual adolescents.

B. it is important to provide a nonthreatening environment for him to discuss his feelings. Rationale: The nurse needs to be open and nonjudgmental in interactions with adolescents who have questions about their sexual orientation. This will allow a safe environment for the adolescents to speak and receive guidance from a health care professional as warranted. Adolescence is when sexual identity develops; therefore, questions about sexual orientation often surface at this time. The nurse's own beliefs should not bias the interaction with this student and, therefore, are irrelevant. Homosexual adolescents have different challenges to growing up and their sexual identity than heterosexual adolescents, often related to societal, cultural, religious, and spiritual influences.

A 13-year-old boy is concerned about bilateral breast enlargement. The most appropriate explanation by the nurse is based on knowing that this is A. A sign of too much body fat B. A sign of hormonal imbalance C. A normal occurrence during puberty D. an indication of precocious puberty

C. A normal occurence during puberty Rationale:Gynecomastia, or enlargement of the breast tissue, is common during midpuberty in about one third of boys. For most boys, the breast enlargement disappears within 2 years. Although overweight boys may have excess body weight in the breast area, in boys of normal body weight, gynecomastia is a normal occurrence during puberty. If gynecomastia persists beyond 2 years, then a hormonal cause may need to be investigated. Precocious puberty is the early onset of puberty, before age 9 years in boys, and is not related to the gynecomastia.

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

C. Adolescents need to discharge energy, often at the expense of logical thinking. Rationale: The physical, sensory, and psychomotor development of adolescents provides a sense of strength and confidence. There is also an increase in energy coupled with risk taking that puts them at risk, because they often ignore logical thinking. Adolescents tend to be risk takers because of their feelings of indestructibility. The feelings of indestructibility that accompany adolescence interfere with understanding the consequences of their behavior, thus increasing their potential for injuries. Sports can be a useful way to discharge energy and should not be limited. Care must be taken to avoid overuse injuries and to use appropriate protective equipment.

What is the foundation for the process of developing a sexual identity in young adolescents? A. Engaging in sexual activity B. Abstaining from sexual activity C. Forming close friendships with same-sex peers D. Forming close friendships with opposite-sex peers

C. Formin close friendships with same-sex peers Rationale:For young adolescents, the process of sexual identity development usually involves forming close friendships with same-sex peers, with whom they may experiment sexually, often to satisfy curiosity. Engaging in sexual activity and abstaining from sexual activity is not the foundation for the process of developing a sexual identity for young adolescents. Forming close friendships with opposite-sex peers is not common for adolescents.

According to Erikson, in what stage of psychosocial development is the adolescent? A, Trust versus mistrust B.Initiative versus guile C. Identity versus identity confusion D. Autonomy versus shame and doubt

C. Identity versus identity confusion Rationale: According to Erikson the adolescent has the task of developing a sense of identity. The infant has the task of developing trust. The toddler has the task of developing autonomy. The school-age child has the task of developing initiative.

Which observation if noted by the school nurse would pose a priority concern? A. Teenager is using her mobile phone while walking in the hallway to class. B. Student is using the computer in a classroom to post a picture of herself taken in class on Facebook. C. Student is looking at a risqué image of another student on her phone while seated at the cafeteria table. D. Student is texting her parents that she will be home later than expected.

C. Student is looking at a risque image of another student on her phone while seated at the cafeteria table Rationale: This observation would be an example of sexting which is illegal and associated with risky sexual actions according to recent evidenced based practice. The use of social media within the school setting to post a picture of a student taken in class while not the best practice would not cause a concern unless the image was provocative or offensive. Texting information to advise parents that a student would be late would be considered to be appropriate. Use of mobile phones in the school setting may not pose a problem unless that activity is restricted by school policy.

The parents of an adolescent tell the nurse "We are fed up with our child. We have no idea where the child goes or spends time. We hardly see our child at home. What should we do?" What is the most appropriate response by the nurse? A. "This behavior is normal and will pass with time." B. "Don't allow your child to go out without your permission." C. "Know who your child's friends are and where your child goes." D. "Explain clearly that you must know where the child is going."

D. "Explain clearly that you must know where the child is going" Rationale: The adolescent's parents should be guided toward an authoritative style of parenting. They should give clear messages about the behavior that is expected and also allow developmentally appropriate levels of freedom. In this situation, the nurse should advise the parents to insist on knowing where the adolescent goes. The adolescent is showing signs of struggling for independence, and this behavior is normal. The nurse should not advise the parents to prevent the adolescent from going out, because this would impose a severe degree of restriction on the child. The nurse should not ask the parents to follow their child, because this would make the adolescent lose trust in them.

How long after the appearance of the first pubescent changes does the menarche, or the first menstruation, occur? A. 3 years B. 15 months C. 18 months D. 2 years

D. 2 years. Rationale: Initial menstruation, or menarche, occurs about 2 years after the appearance of the first pubescent changes. Three years is too long and 15 or 18 months is not long enough.

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

D. Adolescence is the peak age for being either a victim or an offender in an injury involving a firearm. Rationale: Gun carrying among adolescents is on the rise. The increase in gun availability is linked to increased gun injuries and deaths among children. Adolescents can be taught to safely use and store guns for hunting. Gun carrying is on the rise in adolescents and is not limited to stereotypical inner-city youth. Nonpowder guns, such as air rifles and BB guns, cause almost as many injuries as powder guns.

The registered nurse is teaching a group of student nurses about sexuality and psychological health of adolescents. What information should the nurse exclude from the teaching plan? A. A child between 11 and 14 years of age shows wide mood swings. B. A child between 11 and 14 years of age engages in intense daydreaming. C. An individual between 18 and 20 years of age may publicly identify as gay, lesbian, or bisexual. D. An individual between 15 and 17 years of age forms stable relationships and attachment to others.

D. An individual between 15 and 17 years of age forms stable relationships and attachment to others. Rationale: The age range of the middle adolescence period is 15 to 17 years. During this period, an individual forms plural relationships, but not stable relationships. The early adolescence period of the child ranges from 11 years to 14 years. During this period, the child shows wide mood swings and intense daydreaming. The age range of the late adolescent period is 18 to 20 years. During this period, the individual may publicly identify as gay, lesbian, or bisexual.

What should the nurse understand about body image during the adolescent years? A. Teenagers are not acutely aware of their appearance. B. Most adolescents feel comfortable with their body image. C. It does not seem to have a great impact on the teen's self-concept. D, Body image established during adolescence is retained throughout life.

D. Body image established during adolescence is retained throughout life Rationale:Experts have found that the body image established during adolescence is one that individuals retain throughout life. Teenagers are acutely aware of their appearance, rather than not acutely aware of their appearance. Most adolescents feel uncomfortable with the changes their bodies are going through rather than feeling comfortable. Body image during adolescence does seem to have a great impact on the child's self-concept.

What description characterizes normal cognition during the period of early adolescence (11 to 14 years)? A. Development of capacity for abstract thinking B. Ability to perceive and act on long-range options C. Enjoyment of intellectual powers, often in idealistic terms D. Exploration of new-found ability for limited abstract thought

D. Exploration of new-found ability for limited abstract Rationale: During the period of early adolescence (11 to 14 years), normal cognition is characterized by exploration of new-found ability to engage in limited abstract thought. Development of capacity for abstract thinking does not occur until middle adolescence (15 to 17 years). Perception and action on long-range options does not occur until late adolescence (18 to 20 years). Enjoyment of intellectual powers, often in idealistic terms, does not occur until middle adolescence (15 to 17 years).

How does the onset of the pubertal growth spurt compare in girls and boys? A. It is about the same in both boys and girls. B. It occurs about 1 year earlier in boys than in girls. C. It occurs about 3 years earlier in girls than in boys. D. It occurs about 2 years earlier in girls than in boys.

D. It occurs about 2 years earlier in girls than in boys Rationale: The average age of onset for puberty is 12 years in girls and 14 years in boys.

Why do peer relationships play a significant role during adolescence? A. Adolescents dislike their parents. B. Adolescents no longer need parental control. C. Peer relationships promote a sense of individuality in adolescents. D. Peer relationships provide adolescents with a source of social reinforcement.

D. Peer relationships provide adolescents with a source of social reinforcement Rationale: The peer group serves as a credible source of information, role model for new social behaviors, a source of social reinforcement, and a bridge to alternative lifestyles. During adolescence the parent-child relationship changes from one of protection-dependency to one of mutual affection and equality. Parents continue to play an important role in personal and health-related decisions. The peer group forms the transitional world between dependence and autonomy.

Following the assessment of a 14-year-old adolescent female, the nurse documents that the female has pubertal delay. Which assessment finding has led the nurse to conclude this? A. The girl has little axillary hair. B. The girl is shorter than others at this age. C. The girl has not had any menstrual flow. D. The girl does not have complete breast development.

D. The girl does not have complete breast development Rationale: Pubertal delay occurs if the breasts are not developed by the age of 13 or if menarche has not occurred within 4 years of the onset of breast development. In most white females, breast development usually begins at the age of 10 years. The amount of axillary hair is variable in females. If the female has less axillary hair, it does not mean that the female has pubertal delay. Similarly, height varies from person to person, and decreased height does not indicate that the female has pubertal delay. Menstrual flow usually begins within 4 years of breast development. If a 14-year-old female has not started menses, the nurse cannot conclude that the female has pubertal delay.

What is true about the trend in adolescent pregnancy in the United States? A. The rate has doubled since 1990. B. The rate has been on the rise since 1990. C. The rate has been holding steady since 1990. D. The rate has been on a downward trend since 1990.

D. The rate has been on a downward trend since 1990. Rationale: The teen pregnancy rate has been on an overall downward trend for all races since the peak of 117 per 1000 in 1990. The rate has not doubled, or increased, since 1990. The rate has not held steady but instead declined since 1990.

After receiving the immunization history of a 12-year-old female, the nurse plans to administer the (human papilloma virus) HPV vaccine. What is the purpose of administering this vaccine? A. To prevent meningitis B. To prevent pertussis C. To prevent genital warts D. To prevent cervical cancers

D. To prevent cervical cancers Rationale: Human papilloma virus vaccine is used for the prevention of cervical cancers in females. HPV does not prevent meningitis or pertussis. The meningococcal vaccine (MCV) is given for the prevention of meningitis. The Tdap (tetanus, diphtheria, acellular pertussis) vaccine is used for the prevention of pertussis. HPV vaccine is used to reduce the likelihood of genital warts in males.

Following the assessment of a 15-year-old adolescent boy, the nurse documents that the boy has pubertal delay. Which assessment finding has led the nurse to conclude this? A. The patient has less body hair. B. The patient has a small penis. C. The patient has a low-pitched voice. D. The patient does not have an enlarged scrotum.

D. the patient does no have an enlarged scrotum Rationale: If a male does not have a developed scrotum by the age of 13 to 14, the male is diagnosed with pubertal delay. Body hair does not determine pubertal development in males. Therefore, having less body hair does not indicate that the male has pubertal delay. Lengthening and widening of the penis usually occurs in the late puberty phase. Therefore, a small penis size does not indicate that the patient has pubertal delay. Hoarsening or having a low-pitched voice is a manifestation of sexual development in males.

The nurse is assessing the health status of an adolescent. What precautions does the nurse take during the assessment? Select all that apply. 1 Ask the parents to accompany their adolescent. Correct 2 Show concern for the adolescent's perspective. Correct 3 Offer a nonthreatening explanation for the questions. Correct 4 Avoid assumptions, judgments, and lectures. Correct 5 Use language that the adolescent understands.

The nurse shows concern for the adolescent's perspective to build trust. The nurse offers a nonthreatening explanation for the questions that are asked so that the adolescent is not anxious and understands the purpose of the interview. The nurse avoids assumptions, judgments, and lectures to maintain objectivity. The nurse uses language that the adolescent understands to reduce confusion and obtain concise answers. The nurse interviews the adolescent without the parents to ensure confidentiality and privacy.