ch29: teens
The nurse is preparing a presentation for a local health fair depicting the differences in maturity between preadolescents. Which differing factor should the nurse prioritize in the presentation? Boys grow at a slower, steadier rate than do girls. Girls grow at a slower, steadier rate than do boys. Boys grow at a rapid, sporadic rate. Boys and girls grow at the same rate.
Boys grow at a slower, steadier rate than do girls. Preadolescent boys grow generally at a slower, steadier rate than do girls. Girls grow more rapidly during preadolescence and then their growth rate slows dramatically after menarche.
The nurse is educating an adolescent female who needs to increase dietary iron but has expressed concern about weight gain. What dietary choices would the nurse recommend? raspberry yogurt, granola, apple pasta, broccoli, pear cottage cheese, crackers, oranges chicken, whole-wheat bread, watermelon
chicken, whole-wheat bread, watermelon Chicken, whole-wheat bread, and watermelon are all foods high in iron. The calorie content will not promote weight gain. All the other options do not include good sources of iron but are nutritious foods. The calorie content is also acceptable.
Nurses should provide anticipatory guidance to males to prepare them for what particular pubertal change in middle-to-late adolescence? reddening of the scrotum lengthening of the penis nocturnal emissions pubic hair growth
nocturnal emissions Involuntary ejaculation during the night can be disturbing to the adolescent male who has little or no understanding of what is happening in the body. Lengthening of the penis begins to occur in early adolescence as does reddening of the scrotum and emergence of pubic hair.
The mother of a 15-year-old boy expresses sadness to the nurse that her son is "much more connected to his friends than his family." What understanding would benefit this parent? Select all that apply. Peers are needed for emotional security while stepping away from family. Peers provide opportunity to learn and practice social roles. Peers can be positive or negative influences. Adolescents need parental support and guidance as they move toward greater peer involvement. Parents should wait until the adolescent introduces them to their peers.
Peers are needed for emotional security while stepping away from family. Peers provide opportunity to learn and practice social roles. Peers can be positive or negative influences. Adolescents need parental support and guidance as they move toward greater peer involvement. The parent should understand that at this stage of development, it is normal for peers to have a large role in the adolescent's life. The adolescent is finding his/her place outside the home and is filling a need for emotional security, an opportunity to learn and practice societal roles. It is true that peers can have a positive influence or a negative influence over the adolescent. Adolescents still need their parents' involvement in their life with support and guidance. The parents should take a proactive approach at getting to know their adolescent's peers.
What activity would best foster the developmental task of an adolescent who uses a wheelchair to ambulate? Allowing the adolescent to decide when to bathe Watching television on the set in the adolescent's room Talking to another adolescent who has a similar situation Having a teacher bring school work to the adolescent
Talking to another adolescent who has a similar situation A sense of identity is developed by "trying on" roles and discussing values and goals with others. A sense of trust develops when an adolescent is able to find out whom (and what ideas) to have faith in. The adolescent period is also a time where past stages of development are revisited. The sense of autonomy is where the adolescent seeks ways to express individuality. The stage of initiative is where the adolescent develops vision of what he or she might become. Talking with another adolescent who also uses a wheelchair to ambulate will help the adolescent see possibilities and reassurances. Making decisions or having assistance from someone else does not allow the adolescent to "try out" roles.
A teen is brought to the clinic by his mother after getting a tattoo without permission earlier that day. The family is requesting information about how to care for the tattoo. What information should be included? Select all that apply. When showering, allow warm water to rinse the tattoo starting today. Use an antibiotic ointment on the tattoo. Keep the tattoo bandaged for the next 48 hours. After the first 24 hours wash the tattoo with warm soap and water. Protect the tattoo from the sun.
Use an antibiotic ointment on the tattoo. After the first 24 hours wash the tattoo with warm soap and water. Protect the tattoo from the sun. Tattoos are open wounds and put the individual at risk for infection. The tattoo should be covered with a bandage for the first 24 hours. After that time the site should be washed with warm soap and water. Protect the tattoo from the sun. Use antibiotic ointment or fragrance free lotion. Avoid pools or hot tubs.
The school nurse is preparing health promotion presentations regarding unintentional injuries for a high school health fair. On which topic should the nurse place as the priority when preparing the presentation? water sports injuries drug and alcohol use prevention poison prevention motor vehicle safety
motor vehicle safety All options should be included in the presentation, but motor vehicle safety has the highest priority because motor vehicle accidents are the leading cause of injury and death, followed by poisoning (which includes prescription drug overdose).
A chronically ill adolescent is readmitted to the hospital with an infected wound requiring long-term dressing changes. What is the best way the nurse can encourage independence for this client? Have the school provide homework. Have the adolescent go to the teen room every day. Teach the parents to perform dressing changes at home. Allow the adolescent to choose the time for the dressing change.
Allow the adolescent to choose the time for the dressing change. Achieving a sense of identity may be difficult for adolescents who have a chronic illness. Some of the nursing actions which encourage identity in the chronically ill adolescent include the following: respecting food preferences; allowing the adolescent to choose the time for the dressing changes; teaching the name, actions, and possible side effects of medication; and respecting modesty. The school can provide homework so the adolescent does not get further behind in school work, and the teen can go to the teen room each day. These provide a good emotional outlet, but they do not promote independence. Teaching the parents to do the dressing changes makes the adolescent dependent on the parents. If the dressings are at a location the adolescent can reach and dexterity is not limited, then the adolescent should be allowed self-care.
Which nursing action will best assist a 15-year-old client accomplish the developmental task according to Erikson? Permit the client to make decision regarding one's care Praise the client for correctly performing self-care Allow the client's friends to visit while the client is hospitalized Provide the client with crafts and puzzles to complete independently
Allow the client's friends to visit while the client is hospitalized The developmental task of adolescence is to develop a sense of identity, or deciding who and what kind of person one is. Friends and peers are important to facilitating the adolescent in determining one's identity. Permitting the client to make decisions assists in developing autonomy, which is a toddler task. Praising facilitates initiative, which is a preschool task. Independently performing tasks assists in developing industry, which is a school-age task.
During the assessment of a 15-year-old female, the nurse notes a new body piercing in the navel. Which statements by the nurse would be appropriate in regard to this new piercing? Select all that apply. "You are very young to have a navel piercing. Do your parents know you have this?" "I really like your belly ring. Where did you get it?" "I notice you have a new piercing. Be sure to clean it twice a day so you don't get an infection." "Did they tell you when you got your piercing how important cleaning it is? Infections can take up to a year to heal in a naval piercing." "A navel piercing is a lot better than a tattoo. At least the piercing doesn't have to be permanent if you don't want it to be."
"I notice you have a new piercing. Be sure to clean it twice a day so you don't get an infection." "Did they tell you when you got your piercing how important cleaning it is? Infections can take up to a year to heal in a naval piercing." Informing the client about infection risks and prevention are appropriate responses by the nurse when noticing a new body piercing. Judgmental responses and personal responses are not appropriate from the nurse.
To help prevent obesity, which intervention would the nurse include in an adolescent's plan of care? Plan a diet of 2,000 calories per day. Plan a diet of 1,500 calories per day. Describe sources of low calorie proteins. Describe a normal serving size.
Describe a normal serving size. Some adolescents may be unaware that their food intake is excessive because they have been told they need excess nutrients for healthy adolescent growth and everyone in their family eats large portions. Health teaching with these adolescents may need to begin with a discussion of "normal" weight and standard food portions. If adolescents eat a diet too low in protein for any length of time, they can develop a negative nitrogen balance, which can lead to seriously impaired growth. Therefore, a diet of fewer than 1,400 to 1,600 calories a day can rarely be tolerated by adolescents. They generally will do better and will stick closer to 1,800 calories per day. A diet of 2,000 calories a day will provide excess amounts of food and may lead to obesity.
While speaking to the caregiver of a 13-year-old girl, the nurse learns the client is struggling to accept the changes occurring to her body as a result of puberty. Which statement will the nurse include while responding to the client's caregiver? "Adolescents are often uncomfortable with their new body images and must learn to accept it." "Once puberty ends, your daughter will feel more confident in her body changes." "Be sure to tell your daughter she is beautiful often to promote a positive self-image." "These are feelings all adolescent girls experience. Have your daughter talk to her peers."
"Adolescents are often uncomfortable with their new body images and must learn to accept it." According to Erikson, the developmental task in early and mid-adolescence is to form a sense of identity versus role confusion. Adjustment to changes in body image is part of forming this sense of identity. The nurse would let the caregiver know this is a normal finding. Adolescents must learn to accept the changes; it is not an immediate acceptance at the end of puberty. Promoting a positive self-image is important; however, telling the child she is beautiful does not address the caregiver's concern. Encouraging the client to speak with peers does not address the caregiver's concern.
A high school athlete comes to the emergency department with hypertension, aggressiveness, and psychosis. What question would be important for the nurse to ask the client? "Do you take cocaine?" "Do you take anabolic steroids?" "Do you take human growth hormone?" "Do you take amphetamines?"
"Do you take anabolic steroids?" Anabolic steroids are used by adolescents who play sports. They are used to enhance the adolescent's athletic ability. They produce euphoria and lessened fatigue. Unfortunately, steroid use can also lead to early closure of the epiphyseal plate, acne, elevated triglyceride levels, hypertension, aggressiveness, and possibly psychosis. Human growth hormone is also used to enhance athletic performance. The side effects of it are joint pain and swelling and the development of diabetes. Amphetamines provide a sense of well-being, alertness, and self-esteem. They can produce paranoia and extreme restlessness. Cocaine produces increased pulse and respirations, increased temperature, and blood pressure and decreased appetite.
The nurse is providing anticipatory guidance to the parents of a 15-year-old who voice concerns with their teenager's sleep habits. They state, "Left to her own devices, I'm sure she'd stay up until 3:00 in the morning on the weekends and sleep until after lunchtime." Which should the nurse explain to the parents? "I can hear that this is exasperating for you, but know that children do grow out of this in time, with no ill effects." "That must be hard for you to manage. Perhaps we can explore some strategies with her to establish more predictable sleep patterns." "This is expected at this stage of development. Are there any ways that you could adjust your family routines to accommodate this?" "It's very important that you communicate to your daughter that this is unacceptable because it can have a negative effect on her health."
"That must be hard for you to manage. Perhaps we can explore some strategies with her to establish more predictable sleep patterns."
A 15-year-old client tells the nurse he has been having wet dreams and is ashamed and afraid he will get into trouble because he believes his parents think he is too young to understand or know about sex. To which statement would be the most appropriate for the nurse to respond? "Since your parents feel you are not ready to talk about sex, you need to honor their wishes and not bother them with this." "Don't worry, it is perfectly normal for 15-year-olds to have the kinds of fantasies that lead to wet dreams. You should tell your parents about this." "Wet dreams are not the result of anything you are doing but are simply the body's way of ridding itself of excess semen." "You don't need to feel ashamed. I will speak to your parents about the importance of allowing you to experiment with and feel good about your sexuality."
"Wet dreams are not the result of anything you are doing but are simply the body's way of ridding itself of excess semen." Boys who are unprepared for nocturnal emissions may feel guilty, believing that they have caused these "wet dreams" by sexual fantasies or masturbation. They need to understand that this is a normal occurrence and is simply the body's method of getting rid of surplus semen. The other suggestions do not address the situation in a professional manner.
