Growth and Development of the Adolescent

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The nurse is preparing to participate in a community discussion on the needs of the adolescents in the local school. The nurse should point out which goal is the primary concern for these young individuals as the committee makes plans? 1 Teens are busy developing their own personal identity. 2 They want to successfully complete activities. 3 Each child is learning to do things on his or her own. 4 They understand and respond to discipline.

1 According to Erikson, the central task of adolescence is to develop unique personality and identity. NOT 2 The developmental task for the school-age child is to develop a sense of industry, and completing activities builds that feeling of confidence. 3 Erikson's psychosocial developmental task for toddlers is to achieve autonomy (independence) and do things on their own. 4 Learning to speak and to understand and respond to discipline are not developmental tasks, according to Erikson

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? 1 "Do you take anabolic steroids?" 2 "Do you take human growth hormone?" 3 "Do you take amphetamines?" 4 "Do you take cocaine?"

1 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. NOT 2 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. 3 Amphetamines provide a sense of well-being, alertness, and self-esteem. They can produce paranoia and extreme restlessness. 4 Cocaine produces increased pulse and respirations, increased temperature, and blood pressure and decreased appetite.

While caring for a 16-year-old client expected to be hospitalized for several months, the nurse will perform which action to assist the client in meeting the current stage of psychosocial development? 1 Permit peers to visit during open visitation hours. 2 Provide video games for the client to play. 3 Allow the client to touch equipment before procedures. 4 Explain medical concepts by providing handouts and brochures.

1 In each stage of development, a significant person or group exerts a lasting influence on the ongoing development of the child. An adolescent striving for self-identity and increased independence spends more time with peers than with family. It is important for the hospitalized adolescent to still be able to visit with peers. NOT 2 Video games may be enjoyed by the adolescent and limit boredom; however, this action would not facilitate psychosocial development. 3 Allowing the client to touch equipment and to explain medical concepts/procedures are methods used to teach toddlers and preschoolers. 4 Providing handouts and brochures are not effective methods to explain medical concepts; the nurse would verbally explain using models, pictures, and diagrams. Handouts and brochures can be used as supplements to teaching.

A client has confided in a nurse that her 13-year-old daughter has recently changed dramatically in her social interactions with others. What is a social behavior most likely to be exhibited by a girl at this age? 1 Banding together with other girls and dressing like them 2 Banding together with boys and girls but maintaining her own unique style 3 Hanging out primarily with boys her own age 4 Hanging out with girls but maintaining her own unique style

1 In early adolescence, girls tend to band together with girls. They dress identically with other members of their group: jeans and sweatshirts, special jackets, or whatever the fashion may be. On the surface, this makes adolescents appear to be losing their identities rather than finding them.

The nurse is talking to a 13-year-old boy about choosing friends. Which function do peer groups provide that can have a negative result? 1 following role models 2 sharing problems 3 negotiating differences 4 developing stability

1 Peers serve as role models for social behaviors, so their impact on an adolescent can be negative if the group is using drugs, or the group leader is in trouble. NOT 2 Sharing problems with peers helps the adolescent work through conflicts with parents. 3.4. The desire to be part of the group teaches the child to negotiate differences and develop loyalties and stability.

A 17-year-old adolescent chats excitedly with the nurse about plans for college and a career. The adolescent states having checked out every college in the region and determined which one is the best fit and would give the adolescent the best career options. The nurse recognizes which developmental aspect in this client? 1 Formal operational thought 2 Socialization 3 Identification of identity 4 Sensorimotor

1 The final stage of cognitive development, the stage of formal operational thought, begins at age 12 or 13 years and grows in depth over the adolescent years, though it may not be complete until about age 25. This step involves the ability to think in abstract terms and use the scientific method (deductive reasoning) to arrive at conclusions. With the ability to use scientific reasoning, adolescents can plan their future. They can create a hypothesis (What if I go to college? What if I do not?) and think through the probable consequences (In the long run, I will earn more money; I could begin earning money immediately). This scenario does not pertain to socialization, role identification, or sensorimotor development.

The nurse is admitting a 15-year-old adolescent to the hospital pediatric unit. What does the nurse recognize as a priority for this adolescent? 1 The adolescent's need for privacy should be respected. 2 The adolescent should be encouraged to call friends often. 3 The adolescent's need for parental support should be discussed. 4 The adolescent should be given freedom to participate in unit activities as desired.

1 When an adolescent is ill or injured, it affects the body and body image. A hospitalized adolescent's primary concerns are pain and the loss of privacy. The adolescent is also anxious about being separated from friends and losing control of one's life. When an adolescent is hospitalized, it is very important the adolescent be given privacy. 4 The adolescent needs individualized attention, confidentiality, and the right to participate in decisions about one's own health care. 2 The adolescent should have contact with friends and be allowed in unit activities. Because the adolescent is under the age of 18, the parents should be involved and informed of the care. 3 The nurse can talk with the adolescent and parents about care decisions and the adolescent's need for support from family.

A 15-year-old girl is in the hospital for surgery and is confined to bed. The nurse can tell that the client is nervous about being in the hospital. She tells the nurse that she feels "gross" and "on display" in her hospital gown. What should the nurse do to encourage a sense of autonomy and dignity related to the girl's body image? 1 Offer to assist the girl in washing her hair and let her pick the shampoo. 2 Allow the girl to wear her own clothes, despite hospital policy. 3 Brush the girl's hair for her. 4 Assist the girl with using the bed pan to urinate.

1 When caring for hospitalized adolescents, providing time for self-care, such as shampooing hair, is important to include in an adolescent's nursing care plan. Offering to assist the client in washing her hair and letting her pick the shampoo both encourages a sense of autonomy to the client and offers her dignity related to her body image. NOT 3.4. Brushing the girl's hair for her and assisting her with using the bed pan for urination do not encourage a sense of autonomy. 2 If it is the hospital's policy to require clients to be dressed in a hospital gown while admitted, the nurse should not allow the girl to wear her own clothes.

The school nurse is preparing a presentation for a group of teachers about teen suicide. When discussing risk factors for this occurrence which should be included? (Select all that apply.) 1 Homosexuality 2 Substance use disorder 3 Family history of depression 4 History of mental illness 5 Sexual promiscuity

1.2.4. Suicide is the third leading cause of death in teens and young adults. There are identifiable risk factors that place a teen at an increased risk for suicide. These risk factors include substance use disorder, a history of mental illness, and homosexuality. NOT 3 A history of depression in the teen, not in family members, is considered a risk factor for suicide. 5 Sexual promiscuity (many sexual partners) is not considered an increased risk for suicide

The nurse is meeting with a group of adolescent athletes to discuss their nutritional needs. The nurse should encourage the adolescents to include which foods in the diet to increase iron intake? Select all that apply. 1 dried fruits 2 peanuts 3 milk shakes 4 grapes 5 hard-boiled eggs 6 cheese sticks

1.2.5. Dried fruits, peanuts, and eggs (especially the egg yolk) are high in iron. Milk shakes, grapes, and cheese sticks are low or have little iron content.

The nurse is planning to talk to a 12½-year-old boy who says, "I am too short! Girls are taller than I am. Guess I won't be playing basketball." What points of information will the nurse share? (Select all that apply.) 1 "Girls begin to grow rapidly at a younger age than boys do. Boys start later and grow longer." 2 "There are a lot of size differences in your age group now because everyone enters puberty and grows at slightly different times than others." 3 "You are at the age now when most boys begin their growth spurt and grow very rapidly." 4 "You can't control when and how much you will grow. Basketball can use some really fast guards." 5 "You could add as much as 12 in to your height before you stop growing." 6 "If you know how tall you were at age 3, you can double that and predict fairly well how tall you will get."

1.2.5. The information about girls growing faster than boys, about differences in size within his age group, and about his growth potential is accurate and addresses concerns implied in his comments to the nurse. NOT 3 Most boys' growth spurts begin near 14 years, not 12½. 6 Height should be doubled at 2 years to predict adult size. 4 The growth control and basketball remarks minimize his concerns and provide no information

The healthcare provider has made a notation in the medical record of a 17-year-old adolescent that the client is not demonstrating successful completion of the Erikson stage of development. What behavior would be consistent with this assessment? 1 The adolescent is anxious to move away from the parent's home. 2 The adolescent is uncertain and frequently unable to make decisions. 3 The adolescent is distrustful of others. 4 The adolescent is sexually promiscuous.

2 According to Erickson's stages of development the teen develops a sense of identity. Failure to successfully complete this stage will result in a lack of self-confidence and an inability to see oneself as an independent being. NOT 3 The establishment of the ability to trust is completed in an earlier stage of psychosocial development. 1 A desire to move away from the parental home is not uncommon and is not a sign of impaired navigation of this level of psychosocial development.

A 15-year-old adolescent is seen at a health care facility for facial acne. When counseling the teen, the nurse would teach that the basic cause of acne is: 1 lack of showering adequately after gym class. 2 activation of androgen hormones. 3 vitamin deficiency from an inadequate diet. 4 thyroid-gland secretions increasing with adolescence.

2 Acne occurs in adolescence as the result of hormone influence. With increased androgen production the sebaceous glands become more active. With increased testosterone production (in both boys and girls) increased sebum is produced. These increased hormone productions lead to the development of acne. NOT 1 Showering will certainly lead to cleaner skin and the removal of oils but the lack of showering does not cause acne. 3.4. Diet and thyroid hormones do not play a role in the development of acne.

A 15-year-old client's parent comments on the fact that the adolescent seems to always choose the opposite of what everyone else wants and that mood swings are a common occurrence. What statement shows the nurse that the client's parent understands these changes? 1 "I know that my adolescent is doing this because of all the hormones." 2 "This is common for this age group and it will get better with time." 3 "This is my adolescent's temperament, and we will have to learn how to deal with it." 4 "My adolescent will never find anyone to live with if the adolescent acts like this."

2 During middle adolescence, the adolescent spends more time ignoring adult authority and becomes more reliant on peer relationships. Adolescents might choose a stance directly opposite that of their parents and use peer support to back their ideas. NOT 3.4. Mood swings are a common occurrence during the adolescent period. They tend to smooth out and the adolescent will become more introspective. By late adolescence emotions become more consistent. Making statements such as "my adolescent will never find anyone to live with" or "we will have to learn to live with [my adolescent's temperament]" does not demonstrate the parent has a good idea of what is happening during the adolescent period.

The nurse is collecting data from an adolescent being seen for a well-child check-up. During the interview, the adolescent reports sleeping about 6 hours per night during the week but is able to sleep 8 to 9 hours per night on the weekend. What response by the nurse is most appropriate? 1 "I am glad to see you are getting the amount of rest you need." 2 "Let's talk about ways to increase the amount of rest you get during the week." 3 "You would benefit by trying to sleep a little less on the weekends." 4 "Sleeping during the weekend to catch up on missed rest is a good thing to do."

2 It is recommended that adolescents get 8 to 9.5 hours of sleep per night. Adolescents who do not get adequate rest during the week often sleep more hours on the weekend. The best practice would be to determine ways to improve daily rest patterns

The parent of a Black adolescent voices concern to the nurse because the child, "has gotten her period before all of her friends." How should the nurse respond? 1 "I will be sure to let the health care provider know this. We don't want to miss something that may be wrong." 2 "That must be difficult, but on average Black girls start their period earlier than other ethnicities." 3 "How old are most of her friends? Maybe that's the issue instead of it being a sign of something abnormal." 4 "Some girls just get their period earlier than others."

2 Menarche, the first menstrual period, usually begins between the ages of 9 and 15 years (average 12.8 years), but on average Black girls reach menarche earlier than girls of other ethnic groups. This response addresses the parent's concern. NOT 1.3.4. The other responses do not address the parent's concern or may lead the parent to think this is an abnormal occurrence.

A 15-year-old adolescent tells the nurse about a desire to get a tattoo. What response by the nurse is most appropriate? 1 "If you are determined to get a tattoo you need to get a small one so you can hide it if you want." 2 "Tattoos are invasive and there is the potential for disease with their application." 3 "You need to remember that a tattoo will be with you forever." 4 "You are too young to have a tattoo."

2 Piercings and tattoos are becoming increasingly common in teens. It is important to ensure that the teen and family understand the potential risk for disease with the application of the tattoo. NOT 4 The teen is young, but that does not change the fact he wants to get a tattoo. 3 Reminding the teen that it is a permanent alteration in the skin is important but not the most important response by the nurse.

The school nurse is monitoring a student athlete that experienced a concussion 2 weeks ago during a soccer game. The student reports having academic issues in a course in which the student previously had no difficulty. Which action should the nurse's take first? 1 Perform a neurologic assessment on the student to see if there are any changes in neurologic status 2 Ask the student to describe the academic issues the student is having in the class 3 Ask the student's teacher if the student is following the recommendations given to him or her for cognitive activity 4 Immediately notify the student's parents that their child should see the healthcare provider

2 Talking with the teacher and performing a neurologic assessment are actions that may be necessary, but the nurse must first determine if the student is following the recommended level of cognitive activity; this can be accomplished by asking the child to describe the issues he or she is having. Contacting the parents immediately would not be warranted until sufficient information is collected

What exercise recommendation should nurses give to adolescents? 1 Engage in at least one competitive sport during the school year. 2 Participate in 60 minutes of moderate to vigorous physical activity each day. 3 Engage in aerobic exercise for 30 minutes 3 days per week. 4 Participate in physical activities that cause sweating and hard breathing weekly.

2 The U.S. Department of Health and Human Services recommends that adolescents participate in 60 minutes of moderate to vigorous physical activity each day. NOT 3 Aerobic exercise for 30 minutes three times weekly is not the recommended amount of exercise. 1.4. The other recommendations lack adequate activity or specificity

The nurse is talking with parents of a depressed 16-year-old child. Which question is of the most importance? 1 Have your child's sleeping and eating habits changed? 2 Is there a gun in your home? 3 How is your child's personal hygiene? 4 Does your child exercise?

2 The child may be at risk for suicide. Firearm-related suicides have been responsible for a large number of the suicide deaths in 15- to 19-year-olds nationwide. NOT 1.3.4. All the other questions assess for depression and do not protect against suicide

Nurses should provide anticipatory guidance to males to prepare them for what particular pubertal change in late adolescence? 1 Lengthening of the penis 2 Nocturnal emissions 3 Reddening of the scrotum 4 Breast enlargement

2 This involuntary ejaculation during the night can be disturbing to the adolescent male who has little or no understanding of what is happening in his body. NOT 1.3. Lengthening of the penis begins to occur in early adolescence as does reddening of the scrotum. 4 Breast enlargement occurs in some males in middle adolescence and resolves in late adolescence.

The parent of a 14-year-old girl voices concerns that the child is likely to be not getting enough nutrients. How many calories should be ingested by the child daily? 1 At least 1,800 calories per day is recommended for an adolescent girl. 2 The range for caloric intake for an adolescent girl is 1,700--2,000 per day. 3 The adolescent girl who is active should consume about 2,000 calories per day. 4 The adolescent should not consume more than 2,500 calories per day.

3 Adolescent girls who are moderately active require about 2,000 calories per day. Teenage boys who are moderately active require between 2,200 and 2,800 calories per day The sedentary teen needs to consume approximately 1,600 calories each day.

A teen is suspected of having anovulatory menstrual cycles. This would be the result of which hormone? 1 estrogen 2 progesterone 3 luteinizing hormone 4 prolactin

3 Luteinizing hormone is responsible for ovulation. NOT 1.2. Estrogen and progesterone impact the menstrual cycle but do not control ovulation. 4 Prolactin is responsible for preparing the breasts for nursing.

What anticipatory guidance can the nurse provide the girl who has noted the development of breast buds? 1 Adult height will be reached at the time of menarche. 2 The growth spurt will begin immediately with menarche. 3 Menarche should follow in about 2 years. 4 Breast development will be complete with 12 months.

3 Menarche usually follows within 2 years of the first signs of breast development. NOT 2 Peak height velocity (PVH) in girls occurs 6 to 12 months following menarche. It does not follow immediately. 4 Breast development progresses through several stages and will not be complete until late puberty. 1 Adult height is not reached at the time of menarche but about 6 to 12 months following menarche.

The nurse is caring for an adolescent athlete who is being seen for a fractured arm. The adolescent's parent reports that this is the third sports injury in the past 2 years. The parent asks the nurse why the child who seems so healthy seems to continue to have injuries. What information should be included in the nurse's response? 1 These are accidents and random in occurrence. 2 Some children are accident prone. 3 The bones, joints and tendons of teens are vulnerable to injury due to their rapid state of growth. 4 There may be some underlying problems that the child should be evaluated for.

3 Rapidly growing bones, muscles, joints, and tendons are more vulnerable to unusual strains and fractures. NOT 2 While some people may seem to be accident prone, this is most likely the result of the stage of physical growth experienced during adolescence. 4 There is no evidence the child has any underlying medical conditions

A teacher refers a student to the school nurse because the student is frequently falling asleep during class. After talking with the student, the nurse is most concerned by which statement by the student? 1 "I guess I need to be more careful about my curfew on school nights." 2 "I get 7 hours of sleep every night so I don't know why I am so tired." 3 "I just can't seem to stay awake during that class because it's boring." 4 "My mom keeps telling me to turn off my television when I go to bed."

3 The average number of hours of sleep that teens require per night is 8.5 to 9.5 due to rapid growth that occurs during these years. Following a curfew and limiting distractions at bedtime can help provide the student with adequate hours of sleep each night

A 16-year-old female adolescent reports to the nurse that she is trying to improve her diet to loose weight. When assessing her dietary intake for adequacy which findings indicate the need for further education? (Select all that apply.) 1 Protein comprises approximately 30% of the daily dietary intake 2 Average caloric intake is 2,500 per day 3 1,000 mg calcium intake per day 4 Consumes 8--10 mg of iron each day 5 Fat comprises "about" 40% of the daily intake

3 The recommended calcium intake for teens is 1,300 mg/day. 2 The average caloric intake is approximately 2,000 (F). An intake of 2,500 calories per day is likely excessive and should be reduced. 4 Daily iron intake for teen girls should be approximately 15 mg per day. NOT 5 Fat intake should compose 25% to 35% of the daily diet.

A 16-year-old female adolescent reports to the nurse that she is trying to improve her diet to loose weight. When assessing her dietary intake for adequacy which findings indicate the need for further education? (Select all that apply.) 1 Consumes 8--10 mg of iron each day 2 Protein comprises approximately 30% of the daily dietary intake 3 1,000 mg calcium intake per day 4 Average caloric intake is 2,500 per day 5 Fat comprises about 40% of the daily intake

3 The recommended calcium intake for teens is 1,300 mg/day. 4 The average caloric intake is approximately 2,000. An intake of 2,500 calories per day is likely excessive and should be reduced. 1 Daily iron intake for teen girls should be approximately 15 mg per day 5 Fat intake should compose 25% to 35% of the daily diet.

The adolescent with sickle cell disease has been discharged from the hospital and has a need to increase fluid intake daily. What method of instruction would be most effective for the nurse to help the adolescent be compliant with increasing fluid intake? 1 Set the phone alarm as a reminder to drink. 2 Provide written instructions. 3 Establish a contract. 4 Begin each day with prefilled container.

3 When planning care with adolescents, respect the fact that they have a strong desire to exert independence or do things their own way. This means they are not likely to adhere to a plan of care that disrupts their lifestyle or makes them appear different from others their age. Because of this, including them in planning is essential so the plan will be agreeable and accepted. Establishing a contract may be the most effective means to reach a mutual understanding. NOT 1.2.4. Providing written instructions, having the phone set, or providing amounts of fluids needed for daily requirements does not include the adolescent in the planning of the care or any decision making.

A 16-year-old adolescent is talking with the nurse at a local health clinic about skin care. Which comments by the adolescent does the nurse determine require additional conversation? (Select all that apply.) 1 "My mom had melanoma so she always makes me wear a sunscreen with an SPF of 30." 2 "Our coach makes us wear sun-protective clothes when we practice outside on the weekends." 3 "My favorite time of day to be outside is the middle of the day, around noon." 4 "The more exposure and burns I get now will toughen my skin so I won't get skin cancer when I'm older." 5 "I only tan before going on spring break to get a base tan so I won't burn."

3.4.5. The nurse should further discuss comments that demonstrate incorrect information about sun exposure. Any exposure to tanning beds should be avoided to prevent skin cancer risks. Other risks for skin cancer include being in the sun between the times of 10:00 AM and 4:00 PM, and sun exposure and burns during childhood and adolescence. A minimum SPF of 15 should be used, so SPF 30 is good practice, as is wearing sun-protective clothing when outside during the day.

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? 1 Water sports injuries 2 Poison prevention 3 Drug and alcohol use prevention 4 Motor vehicle safety

4 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.

The nurse will monitor which adolescent client most closely for the risk of suicide? 1 a heterosexual client with a history of cocaine use whose best friend moved hours away last week 2 a gay client who is failing two high school courses and refusing prescribed medication 3 a heterosexual client diagnosed with multiple personality disorder requesting no visitors 4 a gay client requesting the nurse have the client's necklace and whose parents divorced last month

4 Being gay, giving away valued possessions, and a disorganized family are all risk factors for suicide in adolescents. Other risk factors include current substance use disorder, having no close friends/being a loner, poor school performance, and mental health illness or changes. Refusing to take medication or having visitors is not a risk factor.

A 17-year-old child needs to increase iron intake but is concerned about weight gain. The nurse will suggest which foods? 1 Raspberry yogurt, granola, apple 2 Cottage cheese, crackers, oranges 3 Egg white omelet, broccoli, pear 4 Chicken, whole-wheat bread, watermelon

4 Chicken, whole-wheat bread, and watermelon are all foods high in iron. The calorie content will not promote weight gain. NOT 1.2.3. All the other options do not include good sources of iron but are nutritious foods. Calorie content is also acceptable.

Parents comment that their child seemed more coordinated on the basketball floor at 12 years than now at 14. The nurse can include what information in the response? 1 It is more difficult to keep focused at 14 years than at 12. 2 This may be a reaction to adult authority. 3 Hand--eye coordination is affected negatively by puberty. 4 Rapid and uneven growth of early adolescence (11 to 14 years) can interfere with coordination.

4 Uneven growth of soft tissues and bones during growth spurts can cause decreased coordination for boys. The age of 14 years is usually the time of peak height velocity (PHV). NOT 1.2. Mental focus and reaction to adult authority are not causes of poor coordination. 3 Gains in hand-eye coordination are made during puberty and become precise by late adolescence

Break down of calories by percentages (carbs, protein, and fat):

45% to 65% should come from carbohydrates 10% to 30% from protein 25% to 35% from fat

Iron intake (mg):

Adolescent males require 11 mg of iron each day Females require 15 mg each day

Adolescents calcium requirement each day:

Adolescents require about 1,300 mg of calcium each day

A 17-year-old adolescent on the high school swim team tells the nurse diet changes during swim season that involve cutting the carbohydrates in the diet to 30% to improve swim times. What responses by the nurse are appropriate? (Select all that apply.) 1 "As long as you are taking in around 2,500 calories per day you should be just fine." 2 "Since you are so active, your carbohydrate intake should comprise 45% to 65% of your daily diet." 3 "Cutting carbohydrates is a good way to keep your weight down during swim season." 4 "Can you tell me the reason you feel the need to cut your carbohydrates when your activity level is high?" 5 "Twenty-five to thirty-five percent of your diet should be carbohydrates so you fall into the acceptable range."

Adolescents who are moderately active require between 2,200 and 2,800 calories per day and 45% to 65% should come from carbohydrates. Carbohydrates should not be cut, especially during an athletic season when energy use is increased. Asking the student why he or she are cutting carbohydrates is appropriate in order to help the nurse address the issue effectively.

The school nurse has just completed a presentation about normal adolescent physical growth to a group of adolescent students. Which comments by the adolescents indicate understanding of the nurse's presentation? (Select all that apply.) 1 "Our hormones are sure going to cause us to change a lot over our teenage years." 2 "It's strange how girls start getting taller before boys start getting taller." 3 "It doesn't seem fair that girls typically have more fat than boys." 4 "Since I'm a 15-year-old guy, I still have a chance to get taller over the next couple of years." 5 "Since I just had my first period and I am 14 years old, I probably haven't reached my peak height yet."

All of these statements demonstrate understanding of normal physical growth during adolescence. 1 The rapid growth during adolescence is secondary only to that of the infant years and is a direct result of the hormonal changes of puberty. 2.4. Boys' growth spurt occurs later than girls' and usually begins between the ages of 10½ and 16 years and ends sometime between the ages of 13½ and 17½ years. 5 Peak height velocity occurs at approximately 12 years of age in girls or at about 6 to 12 months after menarche. 3 Muscle mass increases in boys and fat deposits increase in girls.

For what reasons do nurses work to prevent tobacco use by teens? (Select all that apply.) 1 Teens who smoke are more likely to use alcohol and drugs. 2 Tobacco use is addicting (nicotine). 3 Smoking damages the respiratory system. 4 Smoking is associated with fighting and unprotected sex. 5 Smokeless tobacco damages gums and teeth.

All the options are true and represent reasons nurses work to help teens resist tobacco use.

The parent of a 15-year-old child expresses sadness to the nurse that the child is "much more connected to friends than family." What understanding would benefit this parent? (Select all that apply.) 1 Peers can be positive or negative influences. 2 Peers provide opportunity to learn and practice social roles. 3 Peers are needed for emotional security while stepping away from family. 4 Adolescents learn about negotiating differences by spending time with peers. 5 Adolescents need parental support and guidance as they move toward greater peer involvement.

All the statements are true regarding the role peers play in an adolescent's life. The parent may better understand the appeal of the peers.

Foods High in Iron:

Beef, chicken, seafood, liver Tofu Nuts and seeds lentils and legumes Eggs Dark leafy vegetables such as spinach Iron fortified cereals, whole-grain breads, and pastas

Calcium containing foods:

Fortified ready to eat cereals, cheese, yogurt, almond milk, white beans, and broccoli.

Peak height velocity (PHV)

Simply the period of time in which a child experiences their fastest upward growth in their stature - i.e. the time when they grow the fastest during their adolescent growth spurt


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