Chapter 35 - the adolescent and family (evolve)

The nurse is caring for a 17-year-old obese adolescent who has a body mass index (BMI) more than 2 units above the 95th percentile for age. Which vitamins does the nurse expect to be included in the prescription along with orlistat (Alli)? Vitamin C Vitamin A Vitamin D Vitamin B 3 Vitamin K Vitamin E

Vitamin A Vitamin D Vitamin K Vitamin E

Parents report that their 13-year-old child is eating excessive amounts of food. What does the nurse suggest to the parents? "Give only fruit juices to the child for several days." "Give small amounts of food to the child frequently." "Encourage the child to have nutritious food regularly." "Encourage the child to skip breakfast and have brunch."

"Encourage the child to have nutritious food regularly."

An adolescent with hypertension reports having sudden enlargement of the breasts. Which statement given by the patient will help the nurse understand the reason for this? "I am on a low-salt diet for hypertension." "I am on a low-cheese diet for hypertension." "I am taking calcium channel blockers for hypertension." "I am doing physical exercise regularly for hypertension."

"I am taking calcium channel blockers for hypertension."

The nurse is preparing a written contract agreement from an adolescent who has been contemplating suicide. Which statement should be included in the written contract? "I will abide by the unit's behavior conduct code." "I will not communicate with anybody else in the unit." "I will not accept phone calls from my family members." "I will not accept phone calls from my friends who abuse drugs." "When I feel like hurting myself, I will notify the staff immediately."

"I will abide by the unit's behavior conduct code." "I will not accept phone calls from my friends who abuse drugs." "When I feel like hurting myself, I will notify the staff immediately."

The nurse observes that a 13-year-old male has gynecomastia (breast enlargement). What should the nurse explain that this is? A sign of too much body fat A sign of hormone imbalance A symptom of precocious puberty A normal occurrence during puberty

A normal occurrence during puberty

During assessment, the nurse finds that an adolescent has a swollen testis and a solid mass in the testis. What will the nurse do? Advise the adolescent to undergo direct biopsy immediately Advise the adolescent to have blood tests done immediately Refer the adolescent for biopsy after a few days of assessment Advise the adolescent to lie on the left side for 10 minutes periodically

Advise the adolescent to undergo direct biopsy immediately

An adolescent hospitalized after a suicide attempt states, "I have recovered, and I am able to sleep well. I have lot of things to do when I get home, and I don't need to stay in the hospital anymore." What question does the nurse ask to confirm the adolescent's statement? "Are you still having thoughts of suicide?" "Are you willing to sign a contract agreement?" "Have you ever thought about hurting yourself?" "How would you rate your mood on a scale of 1 to 10?"

Are you still having thoughts of suicide?"

The nurse is assessing a 16-year-old obese adolescent. The clinical reports indicate high serum triglyceride levels. The nurse advises the adolescent to undergo an electrocardiogram (ECG). The reason behind this is because the adolescent is at risk for what? Renal disorders Hepatic diseases Cardiac disorders Pulmonary diseases

Cardiac disorders

An adolescent female is admitted to the hospital with anorexia nervosa. What should the nurse monitor in this patient? Electrolyte levels in the blood Blood pressure in sitting position Accommodation reflex of the eyes Levels of ketones and protein in urine Blood pressure in sitting and standing position

Electrolyte levels in the blood Levels of ketones and protein in urine Blood pressure in sitting and standing position

The nurse is assessing an adolescent with anorexia nervosa. Which test should be done to detect inflammation? Renal function test Thyroid function test Complete blood count Erythrocyte sedimentation rate

Erythrocyte sedimentation rate

The nurse is teaching a group of adolescents about obesity. What information should the nurse include in the teaching plan? Excessive use of the Internet can lead to obesity in adolescents. Girls of lower socioeconomic groups have a greater prevalence of obesity. Increased risk of low blood pressure is a cause of mortality in adolescents. Diseases involving metabolic variations can lead to obesity in adolescents. Obesity in adolescents is not related to the presence of respiratory disorders.

Excessive use of the Internet can lead to obesity in adolescents. Girls of lower socioeconomic groups have a greater prevalence of obesity. Diseases involving metabolic variations can lead to obesity in adolescents.

Girls experience an increase in weight and fat deposition during puberty. What do nursing considerations related to these changes include? Encouraging low-fat diet to prevent fat deposition Giving reassurance that these changes are normal Suggesting dietary measures to control weight gain Recommending increased exercise to control weight gain

Giving reassurance that these changes are normal

When discussing pubertal growth changes with an adolescent male, what information should the nurse include? In girls, puberty occurs about 1 year before it appears in boys. In boys, puberty occurs about 1 year before it appears in girls. The onset of puberty is about the same in both boys and girls. In girls, puberty occurs about 3 years before it appears in boys.

In girls, puberty occurs about 1 year before it appears in boys.

What do nursing responsibilities in the management of adolescent obesity include? Planning a low-calorie, low-protein diet Using nutritious foods as a method of reward Incorporating favorite foods into the child's diet Encouraging diversional activities during mealtimes

Incorporating favorite foods into the child's diet

The community nurse is conducting a teaching session on good dietary habits to prevent obesity in adolescents for a group of parents and adolescents. What information does the nurse include in the teaching? Increase the portions sizes of food. Limit eating at fast food restaurants. Have frequent meals with other family members. Perform mild to moderate intensity exercises regularly. Limit television time to no more than half an hour per day.

Limit eating at fast food restaurants. Have frequent meals with other family members. Perform mild to moderate intensity exercises regularly.

The parents tell the nurse that they are having conflicts about independence with their child. The nurse infers from this that the child is which subphase? Early childhood subphase Late adolescence subphase Early adolescence subphase Middle adolescence subphase

Middle adolescence subphase

An adolescent arrives at the clinic with the parent for a routine examination. The parent reports to the nurse that the adolescent has irregular sleep patterns and watches television until late at night. What nursing intervention will the nurse perform next? Obtain a history of sleep patterns Provide reassurance to the parent Instruct the adolescent to go to bed early Inform the parent that irregular sleep patterns are common in adolescents

Obtain a history of sleep patterns

When discussing sex and sexual activities with adolescents, what should the nurse do? Use scientific terminology to convey content Present normal body functions in a straightforward manner Refer the adolescents to their parents for sexual information Defer giving information about pregnancy unless the adolescents are sexually active

Present normal body functions in a straightforward manner

The nurse is organizing a school-based antismoking program. Which goals should the nurse include in the antismoking program to motivate the youth against smoking? Promoting a smoke-free environment Encouraging the use of smokeless tobacco Discouraging students from starting to smoke Educating about the health hazards of smoking Encouraging students to participate in physical activities

Promoting a smoke-free environment Discouraging students from starting to smoke Educating about the health hazards of smoking

The nurse is caring for an adolescent with severe malnutrition. What will the nurse keep in mind when planning nutrition therapy for malnutrition? Nutrition therapy is not based on stage of puberty. Refeeding syndrome is avoided with slow refeeding. The goal is eventual intake of 2000 to 3000 kcal per week. The goal includes weight gain of 0.22 to 0.45 kg (0.5-1 pound) per day.

Refeeding syndrome is avoided with slow refeeding.

The school nurse is interacting with a school principal to implement measures to prevent smoking in their school. What instructions should the nurse give to the principal? Request for order of complete ban on smoking within the school premises Organize a peer-led program emphasizing social consequences of smoking Emphasize on long-term effects of smoking rather than on short-term effects Emphasize on short-term effects of smoking rather than on long-term effects Consider expanding school-based programs to include parents and mass media

Request for order of complete ban on smoking within the school premises Organize a peer-led program emphasizing social consequences of smoking Emphasize on short-term effects of smoking rather than on long-term effects Consider expanding school-based programs to include parents and mass media

An adolescent is admitted to the hospital with anorexia nervosa. What does the nurse monitor in this patient? Serum electrolyte levels Pupillary reaction to light Duration of blood clotting Levels of ketones and protein in the urine Blood pressure in the sitting and standing positions

Serum electrolyte levels Levels of ketones and protein in the urine Blood pressure in the sitting and standing positions

The nurse is teaching a group of school teachers about a smoking ban in schools. Which statements does the nurse include in the teaching? Smoking bans include the use of pharmacologic agents. Smoking bans explain the effects of smoke on the fetus. Smoking bans discourage students from starting to smoke. Smoking bans promote a smoke-free environment as the norm. Smoking bans reinforce knowledge of the health hazards of smoking

Smoking bans discourage students from starting to smoke. Smoking bans promote a smoke-free environment as the norm. Smoking bans reinforce knowledge of the health hazards of smoking.

An adolescent female is unusually preoccupied by her appearance. When the nurse asks the adolescent, "Do you make yourself sick because you feel uncomfortably full?" the adolescent replies no. The nurse asks her if she has lost control over how much she eats; the adolescent says no. The child says that she has lost more than 8 kg of weight in the last 3 months and she believes that she is fat, whereas her parents tell her that she is too thin. She does not think that food dominates her life. What can the nurse interpret about this girl? The child is normal and does not require any other treatment. The child may have depression and needs psychiatric referral. The child most likely has anorexia nervosa or bulimia nervosa. The child needs further assessment for the presence of cancer.

The child most likely has anorexia nervosa or bulimia nervosa.

The nurse is assessing an adolescent who lost 4.5 kg (10 lb) of weight suddenly. Which assessments are needed to identify the cause of weight loss? Vital signs Body weight Changes in behavior Patient characteristics Cardiac evaluation tests

Vital signs Changes in behavior Patient characteristics