Peds CH 19 ?'s

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 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 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

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.

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

A 14-year-old male seems to be always eating, although his weight is appropriate for his height. The parents ask the nurse if they should be concerned about this behavior. Which response by the nurse is best? a. This is normal because of increase in body mass during this time. b. This is abnormal and suggestive of possible future obesity. c. His caloric intake would have to be excessive for him to gain weight. d. He is substituting food for unfilled needs.

ANS: A In adolescence, nutritional needs are closely related to the increase in body mass. The peak requirements occur in the years of maximal growth. The caloric and protein requirements are higher than at almost any other time of life. It is not suggestive of possible future obesity or unmet psychosocial needs. It may be true that the teen would need to eat an enormous amount of food in order to gain weight, but that does not give the parents the information they are requesting.

A nurse is teaching adolescent boys about pubertal changes. Which is the first sign of pubertal change seen with boys? a. Testicular enlargement b. Facial hair c. Scrotal enlargement d. Voice deepens

ANS: A The first sign of pubertal changes in boys is testicular enlargement in response to testosterone secretion, which usually occurs in Tanner stage 2. Slight pubic hair is present and the smooth skin texture of the scrotum is somewhat altered. As testosterone secretion increases, the penis, testes, and scrotum enlarge. During Tanner stages 4 and 5, rising levels of testosterone cause the voice to deepen and facial hair appears at the corners of the upper lip and chin.

Which is most descriptive of the spiritual development of the older adolescent? a. The beliefs become more abstract. b. Strict observance of religious customs is common. c. Rituals and practices become increasingly important. d. Emphasis is placed on external manifestations, such as whether a person goes to church.

ANS: A Because of their abstract thinking abilities, adolescents are able to interpret analogies and symbols. Strict observance of religious customs, rituals, and practices become less important as the adolescent questions values and ideals of families. Adolescents question external manifestations when not supported by adherence to supportive behaviors.

A student nurse learns that according to Piaget, the adolescent is in the fourth stage of cognitive development, or period of what? a. Formal operations b. Concrete operations c. Conventional thought d. Postconventional thought

ANS: A Cognitive thinking culminates with capacity for abstract thinking. This stage, the period of formal operations, is Piaget's fourth and last stage. Concrete operations usually develops between ages 7 and 11 years. Conventional and postconventional thought refer to Kohlberg's stages of moral development.

A sexually active adolescent asks the school nurse about prevention of sexually transmitted diseases (STDs). What is the most appropriate recommendation by the nurse? a. Use condoms. b. Abstain from sex. c. Any type of contraception method will prevent STDs. d. The withdrawal method of contraception will prevent STDs.

ANS: A Condoms provide the best available barrier to the organisms that cause STDs. Complete protection from pregnancy and STDs is achievable only through sexual abstinence. However, the adolescent is sexually active and the nurse needs to be open, forthright, and respectful of the decisions she made about sexual activity.

The school nurse overhears a group of adolescent girls talking about gaining weight and getting fat deposits during puberty. What anticipatory advice would be appropriate for the nurse to give to the girls? a. Provide reassurance that these changes are normal. b. Suggest dietary measures to control weight gain. c. Encourage a low-fat diet to prevent fat deposition. d. Recommend increased exercise to control weight gain.

ANS: A Muscle mass increases in boys, and fat deposits increase in girls. Ultimately, diet, exercise, and hereditary factors influence adolescents' height, weight, and body build. A healthy balance must be achieved between expected healthy weight gain and obesity. Dietary measures to control weight gain or a recommendation for increased exercise would not be given unless weight gain was excessive.

The school nurse is evaluating the school's athletic programs for safety. What factors should the nurse assess? (Select all that apply.) a. Students get adequate rest periods. b. Equipment is in good condition. c. Practices are appropriate for students. d. Post-game concussion assessment if needed e. Adequate fluids are available at all times.

ANS: A, B, C, E A safe athletic program has several features including adequate rest periods, good quality equipment, appropriate practice schedules and regimes, and adequate fluids. Concussion testing if warranted, should occur immediately as the student is withdrawn from the game, and not wait until after the game is over

Which factors contribute to early adolescents engaging in risk-taking behaviors? (Select all that apply.) a. Peer pressure b. A desire to master their environment c. Trying to separate from their parents d. A belief that they are invulnerable e. Impulsivity

ANS: A, D, E Peer pressure (including impressing peers) is a factor contributing to adolescent injuries. During early to middle adolescence, children feel that they are exempt from the consequences of risk-taking behaviors; they believe that negative consequences only happen to others. Feelings of invulnerability ("It can't happen to me") are evident in adolescence. Impulsivity places adolescents in unsafe situations. Mastering the environment is the task of young school-age children. Emancipation is a major issue for the older adolescent. The process is accomplished as the teenager gains an education or vocational training

Which statement is the most appropriate advice to give parents of a 16-year-old teenager who is rebellious? a. You need to be stricter so that your teenager feels more secure b. You need to allow your teenager to make realistic choices while using consistent and structured discipline. c. Increasing your teens involvement with his peers will improve his self-esteem. d. Allow your teenager to choose the type of discipline that is used in your home.

ANS: B Allowing teenagers to choose between realistic options and offering consistent and structured discipline typically enhances cooperation and decreases rebelliousness. Setting stricter limits typically does not decrease rebelliousness or increase feelings of security. Increasing peer involvement does not typically increase self-esteem. Allowing teenagers to choose the method of discipline is not realistic and typically does not reduce rebelliousness.

Which behavior suggests appropriate psychosocial development in the adolescent? a. The adolescent seeks validation for socially acceptable behavior from older adults. b. The adolescent is self-absorbed and self-centered and has sudden mood swings. c. Adolescents move from peers and enjoy spending time with family members. d. Conformity with the peer group increases in late adolescence.

ANS: B During adolescence, energy is focused within. Adolescents concentrate on themselves in an effort to determine who they are or who they will be. Adolescents are likely to be impulsive and impatient. Parents often describe their teenager as being "self-centered or lazy." The peer group validates acceptable behavior during adolescence. Adolescents move from family and enjoy spending time with peers. Adolescents also spend time alone; they need this time to think and concentrate on themselves. Conformity becomes less important in late adolescence

Which behavior suggests appropriate psychosocial development in the adolescent? a. The adolescent seeks validation for socially acceptable behavior from older adults. b. The adolescent is self-absorbed and self-centered and has sudden mood swings. c. Adolescents move from peers and enjoy spending time with family members. d. Conformity with the peer group increases in late adolescence

ANS: B During adolescence, energy is focused within. Adolescents concentrate on themselves in an effort to determine who they are or who they will be. Adolescents are likely to be impulsive and impatient. The peer group validates acceptable behavior during adolescence. Adolescents move from family and enjoy spending time with peers. Adolescents also spend time alone; they need this time to think and concentrate on themselves. Conformity becomes less important in late adolescence

A 17-year-old adolescent tells the nurse that he is not having sex because it would make his parents very angry. This response indicates that the adolescent has a developmental lag in which area? a. Cognitive development b. Moral development c. Psychosocial development d. Psychosexual development

ANS: B The appropriate moral development for a 17-year-old adolescent would include evidence that the teenager has internalized a value system and does not depend on parents to determine right and wrong behaviors. Cognitive development is related to moral development, but it is not the pivotal point in determining right and wrong behaviors. Identity formation is the psychosocial development task. Energy is focused within the adolescent, who exhibits behavior that is self- absorbed and egocentric. Although a task during adolescence is the development of a sexual identity, the teenagers dependence on the parents sanctioning of right or wrong behavior is more appropriately related to moral development.

Which statement is the most appropriate advice to give parents of a 16-year-old who is rebellious? a. "You need to be stricter so that your teen stops trying to test the limits." b. "Try to collaborate to set limits that are perceived as being reasonable." c. "Increasing your teen's involvement with her peers will improve her behavior." d. "Allow your teenager to choose the type of discipline that is used in your home."

ANS: B Allowing teenagers to choose between realistic options and offering consistent and structured discipline typically enhances cooperation and decreases rebelliousness. Structure helps adolescents to feel more secure and assists them in the decision-making process. Setting stricter limits typically does not decrease rebelliousness or decrease testing of parental limits. Increasing peer involvement does not typically improve behavior. Allowing teenagers to choose the method of discipline is not realistic and typically does not reduce rebelliousness.

What does the nurse learn that predisposes the adolescent to feel an increased need for sleep? a. An inadequate diet b. Rapid physical growth c. Decreased activity d. Typical lack of ambition

ANS: B Rapid physical growth, the tendency toward overexertion, and the overall increased activity of this age contributes to fatigue in this population. It is not due to dietary factors, decreased activity, or lack of ambition.

Which is assessed with Tanner staging? a. Hormone levels b. Secondary sex characteristics c. Growth hormone secretion d. Hyperthyroidism

ANS: B Tanner stages are used to assess staging of secondary sex characteristics at puberty. Hormone levels are assessed by their concentration in the blood. Growth hormone secretion tests are not associated with Tanner staging. Tanner stages are not associated with hyperthyroidism.

A 17-year-old tells the nurse that he is not having sex because it would make his parents very angry. This response indicates that the adolescent has a developmental lag in which area? a. Cognitive development b. Moral development c. Psychosocial development d. Psychosexual development

ANS: B The appropriate moral development for a 17-year-old would include evidence that the teenager has internalized a value system and does not depend on parents to determine right and wrong behaviors. Adolescents who remain concrete thinkers may never advance beyond conformity to please others and avoid punishment. Cognitive development is related to moral development, but it is not the pivotal point in determining right and wrong behaviors. Identity formation is the psychosocial development task. Energy is focused within the adolescent, who exhibits behavior that is self-absorbed and egocentric. Although a task during adolescence is the development of a sexual identity, the teenager's dependence on the parents' sanctioning of right or wrong behavior is more appropriately related to moral development.

A student nurse learns that according to Erikson, the psychosocial task of adolescence is to develop a. intimacy. b. identity. c. initiative. d. independence.

ANS: B Traditional psychosocial theory holds that the developmental crises of adolescence lead to the formation of a sense of identity. Intimacy is the developmental stage for early adulthood. Initiative is the developmental stage for early childhood. Independence is not one of Erikson's developmental stages.

Which statement by the nurse is most appropriate to a 15-year-old adolescent whose friend has mentioned suicide? a. Tell your friend to come to the clinic immediately. b. You need to gather details about your friends suicide plan. c. Your friends threat needs to be taken seriously and immediate help for your friend is important. d. If your friend mentions suicide a second time, you will want to get your friend some help

ANS: C Suicide is the third most common cause of death among American adolescents. A suicide threat from an adolescent serves as a dramatic message to others and should be taken seriously. Adolescents at risk should be targeted for supportive guidance and counseling before a crisis occurs. Instructing a 15-year-old adolescent to tell a friend to come to the clinic immediately provides the teen with limited information and does not address the concern. It is important to determine whether a person threatening suicide has a plan of action; however, the best information for the 15-year-old adolescent to have is that all threats of suicide should be taken seriously and immediate help is important. It is imperative that help is provided immediately for a teenager who is talking about suicide. Waiting until the teen discusses it a second time may be too late

A nurse is teaching an adolescent about Tanner stages. Which statement best describes Tanner staging? a. Predictable stages of puberty that are based on chronological age b. Staging of puberty based on the initiation of menarche and nocturnal emissions c. Predictable stages of puberty that are based on primary and secondary sexual characteristics d. Staging of puberty based on the initiation of primary sexual charactericts

ANS: C Tanner sexual-maturing ratings are based on the development of stages of primary and secondary sexual characteristics. They are not based on chronological age. The age at which an adolescent enters puberty is variable. The puberty stage in girls begins with breast development. The puberty stage in boys begins with genital enlargement. Primary sexual characteristics are not the basis of Tanner staging

10. In an interview with the nurse, a mother states that she is concerned that her 14-year-old teen is critical and finding fault with her. The nurse counsels the mother that: a. the family needs to change its value system to meet the teenagers changing needs. b. the parentteen relationship is important for the teenager and conflicts are to be expected. c. teenagers create psychological distance from the parent to separate from the parent. d. parents need to relinquish their relationship with their teenager to the teens peers

ANS: C The teenager uses critical and fault-finding behavior as a mechanism to separate from the parent and become independent. Changing the familys value system to meet the teenagers needs is not realistic and will result only in the teenagers being critical of the new system. The parentteen relationship is not as important to the teenager as it was in earlier years. Friends and peers become more important. Parents should not relinquish their relationship with their teenager to the teens peers. Maintaining a consistent parental relationship with the adolescent is important

A parent tells the nurse, "I am worried about my 13-year-old son. He hasn't started puberty, and my daughter did when she was 11 years of age." How can the nurse explain the difference to the parent? a. That this is unusual and requires further evaluation of the son. b. This is unusual because the onset of pubescence is usually the same in siblings. c. This is normal because the onset of pubescence is usually earlier in girls than it is in boys. d. This is abnormal because the onset of pubescence is usually earlier in boys than it is in girls.

ANS: C Girls begin puberty an average of approximately 2 years before boys. The average age of onset for puberty in boys is 12 years. In boys, puberty is considered delayed if testicular enlargement or pubic hair development has not occurred by age 14 years.

3. The parents of a 14-year-old girl are concerned that their adolescent spends too much time looking in the mirror. Which statement is the most appropriate for the nurse to make? a. Your teenager needs clearer and stricter limits about her behavior. b. Your teenager needs more responsibility at home. c. During adolescence, this behavior is not unusual. d. The behavior is abnormal and needs further investigation

ANS: C Narcissistic behavior is normal during this period of development. The teenager is seeking a personal identity. Stricter limits are not an appropriate response for a behavior that is part of normal development. More responsibility at home is not an appropriate response for this situation

A student nurse asks the faculty why peer relationships become more important during adolescence. Which of the following is the nurse's best response? a. Adolescents dislike their parents. b. Adolescents no longer need parental control. c. They provide adolescents with a feeling of belonging. d. They promote a sense of individuality in adolescents.

ANS: C The peer group serves as a strong support to teenagers, providing them with a sense of belonging (versus individuality) and a sense of strength and power. During adolescence, the parent/child relationship changes from one of protection-dependency to one of mutual affection and quality. This does not mean teens do not like their parents who continue to play an important role in their personal and health-related decisions.

Which factor contributes to early adolescents engaging in risk-taking behaviors? a. Peer pressure b. A desire to master their environment c. Engagement in the process of separation from their parents d. A belief that they are invulnerable

ANS: D During early to middle adolescence, children feel that they are exempt from the consequences of risk-taking behaviors: they believe negative consequences happen only to others. Impressing peers is more typically the factor influencing behavior of older school-age children. Mastering the environment is the task of young school-age children. Emancipation is a major issue for the older adolescent. The process is accomplished as the teenager gains an education or vocational training

The best response a nurse can make to a 15-year-old girl who has verbalized a desire to have a baby is: a. Have you talked with your parents about this? b. Do you have plans to continue school? c. Will you be able to support the baby? d. Can you tell me how your life will change if you have an infant?

ANS: D Having the teenager describe how the infant will affect her life will allow the teen to think more realistically. Her description will allow the nurse to assess the teens perception and reality orientation. Asking the teenager if she has talked to her parents is not particularly helpful to the teen or the nurse and may terminate the communication. A direct question about continuing school and how the teenager will support the child will not facilitate communication. Open- ended questions encourage communication

When planning care for adolescents, the nurse should: a. teach parents first, and they, in turn, will teach the teenager. b. provide information for their long-term health needs because teenagers respond best to long-range planning. c. maintain the parents role by providing explanations for treatment and procedures to the parents only. d. give information privately to adolescents about how they can manage the specific problems that they identify

ANS: D Problems that teenagers identify and are interested in are typically the problems that they are the most willing to address. Confidentiality is important to adolescents. Adolescents prefer to confer privately (without parents) with the nurse and healthcare provider. Teenagers are socially and cognitively at the developmental stage where the healthcare provider can teach them and can receive explanations about healthcare directly from the nurse. Teenagers are more interested in immediate healthcare needs than in long-term needs

What is the best response a nurse can make to a 15-year-old girl who has verbalized a desire to have a baby? a. "Have you talked with your parents about this?" b. "Do you have plans to continue school?" c. "Will you be able to support the baby?" d. "Can you tell me how your life will be if you have an infant?"

ANS: D Having the teenager describe how the infant will affect her life will allow the teen to think more realistically. Her description will allow the nurse to assess the teen's perception and reality orientation. Asking the teenager whether she has talked to her parents is not particularly helpful to the teen or the nurse and may terminate the communication. A direct question about continuing school will not facilitate communication. Open-ended questions encourage communication. Asking the teenager about how she will support the child will not facilitate communication. Open-ended questions encourage communication.

In girls, the initial indication of puberty is a. menarche. b. growth spurt. c. growth of pubic hair. d. breast development.

ANS: D In most girls, the initial indication of puberty is the appearance of breast buds, an event known as thelarche. The usual sequence of secondary sexual characteristic development in girls is breast changes, rapid increase in height and weight, growth of pubic hair, appearance of axillary hair, menstruation, and abrupt deceleration of linear growth.

When planning care for adolescents, the nurse should a. teach parents first, and they, in turn, will teach the teenager. b. provide information for long-term health needs. c. provide explanations for treatment and procedures to the parents only. d. give information privately to adolescents on specific problems that they identify.

ANS: D Problems that teenagers identify and are interested in are typically the problems that they are the most willing to address. Confidentiality is important to adolescents. Adolescents prefer to confer privately (without parents) with the nurse and health care provider. Teenagers are socially and cognitively at the developmental stage where the health care provider can teach them. Teenagers are more interested in immediate health care needs than in long-term needs. Teenagers are at the developmental level that allows them to receive explanations about health care directly from the nurse.

Place in order the signs of female sexual maturity beginning with the first sign and ending with the last. Use the following format for your answers: A, B, C, D a. Growth of pubic hair b. Menarche c. Appearance of breast buds d. Ovulation is established

ANS:C, A, B, D Sexual maturation in girls begins with the appearance of breast buds (thelarche), which is the first sign of ovarian function. Thelarche occurs at approximately age 8 to 11 years and is followed by the growth of pubic hair. Linear growth slows, and menarche begins approximately 1 year after the peak height velocity (PHV). Ovulation occurs with menarche but may or may not accompany the first 2 years of menarche so it is not established till later

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.

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

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.

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. Forming 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.

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.

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.