Peds exam 3
A 14-year-old boy is of normal weight, and his parents are concerned about bilateral breast enlargement. The nurse's discussion of this should be based on what?
Ans: Most likely part of normal pubertal development
An adolescent girl asks the school nurse for advice because she has dysmenorrhea. She says that a friend recommended she try an over-the-counter nonsteroidal anti-inflammatory drug (NSAID). The nurse's response should be based on what?
Ans: NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity.
An adolescent girl is brought to the hospital emergency department by her parents after being raped. The girl is calm and controlled throughout the interview and examination. The nurse should recognize this behavior is what?
Ans: One of a variety of behaviors normally seen in rape victims
The nurse is caring for an adolescent male with gynecomastia. What groups of drugs can induce gynecomastia in male adolescents? (Select all that apply.)
Ans: Oral ketoconazoles Ans: Calcium channel blockers Ans: Histamine 2 receptor blockers Ans: Cancer chemotherapeutic agents
The nurse is teaching a class on obesity prevention to parents in the community. What is a contributing factor to childhood obesity?
Ans: Parental overweight
The nurse is teaching an adolescent female with primary dysmenorrhea foods that are natural diuretics. What foods should the nurse include in the teaching plan? (Select all that apply.)
Ans: Peaches Ans: Asparagus Ans: Watermelon
What strategy is considered one of the best for preventing smoking in teenagers?
Ans: Peer-led programs emphasizing the social consequences of smoking
Descriptions of young people with anorexia nervosa (AN) often include which criteria?
Ans: Perfectionist
An adolescent girl calls the nurse at the clinic because she had unprotected sex the night before and does not want to be pregnant. What should the nurse explain?
Ans: Postcoital contraception is available to prevent implantation and therefore pregnancy.
What is a priority goal in the postpartum care of an adolescent mother?
Ans: Prevention of subsequent pregnancies
Many adolescents use alcohol for self-medication. How does an adolescent view the benefit of alcohol?
Ans: Provides a defense against depression
The nurse's role in facilitating successful childrearing in unmarried teenage mothers includes what?
Ans: Providing information and feedback about positive parenting skills
A 13-year-old boy comes to the school nurse complaining of sudden and severe scrotal pain. He denies any trauma to the scrotum. What is the most appropriate nursing action?
Ans: Refer him for immediate medical evaluation
A 15-year-old girl tells the school nurse that she has not started to menstruate yet. Onset of secondary sexual characteristics was about 2 1/2 years ago. The nurse should take which action?
Ans: Refer the adolescent for an evaluation.
The school nurse suspects a testicular torsion in a young adolescent student. What action should the nurse take?
Ans: Refer the adolescent for immediate medical evaluation
What statement is true about smoking in college students?
Ans: Regular cigar use is becoming more common
What do nursing responsibilities regarding weight gain for an adolescent with anorexia nervosa include?
Ans: Restore body weight to within 10% of the adolescent's ideal weight
During a well-child visit, the nurse practitioner provides guidance about promoting healthy eating in a child who is overweight. What does the nurse advise?
Ans: Slow down eating meals
What is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats?
Ans: Social isolation
The nurse has determined that an adolescent's body mass index (BMI) is in the 90th percentile. What information should the nurse convey to the adolescent?
Ans: The adolescent is at risk for becoming overweight.
What best describes central nervous system (CNS) stimulants?
Ans: They can result in strong psychologic dependence
A pregnant 15-year-old adolescent tells the nurse that she did not use any form of contraception because she was afraid her parents would find out. The nurse should recognize what?
Ans: This is a frequent reason given by adolescents
During a well-child visit, the nurse plots the child's BMI on the health record. What is the purpose of the BMI?
Ans: To provide a consistent measure of obesity
What statement is true about gonorrhea?
Ans: Treatment of all sexual contacts is essential
What conditions are physical complications of obesity? (Select all that apply.)
Ans: Type 2 DM Ans: Fatty liver disease Ans: Abnormal growth acceleration
What factor is most likely to increase the likelihood that an adolescent will misuse alcohol?
Ans: Unconventional behavior
The school nurse is teaching a group of adolescent females which measures to take to prevent genital tract infections. What should the nurse include in the teaching session? (Select all that apply.)
Ans: Use condoms Ans: Avoid tight-fitting clothing Ans: Limit exposure to bubble baths Ans: Avoid colored and scented toilet tissue
A sexually active adolescent asks the school nurse about prevention of sexually transmitted infections (STIs). What should the nurse recommend?
Ans: Use of condoms
An important distinction in understanding substance abuse is that drug misuse, abuse, and addiction are considered what?
Ans: Voluntary behaviors based on psychosocial needs
The middle school nurse is planning a behavior modification program for overweight children. What is the most important goal for participants of the program?
Ans: Identify and eliminate inappropriate eating habits
What are risk factors of testicular cancer? (Select all that apply.)
Ans: Infertility Ans: Tobacco use Ans: Family history
The nurse is preparing to administer danazol (Danocrine) to a patient with endometriosis. What are the side effects of this medication? (Select all that apply.)
Ans: Insomnia Ans: Hot flashes Ans: Amenorrhea
What is true about pelvic inflammatory disease (PID)?
Ans: It may have devastating effects on the reproductive tract of affected adolescents
The nurse is teaching an adolescent with premenstrual syndrome (PMS) dietary measures to relieve the symptoms of PMS. What should the nurse include in the teaching session? (Select all that apply.)
Ans: Limit salt in the diet Ans: Include whole grains in the diet Ans: Limit consumption of refined sugar
An adolescent patient has been diagnosed with a vulvovaginal candidiasis (yeast infection). The nurse expects the health care provider to recommend which vaginal cream?
Ans: Miconazole (Monistat)
The nurse is caring for an adolescent brought to the hospital with acute drug toxicity. Cocaine is believed to be the drug involved. Data collection by the nurse should include what information?
Ans: Mode of administration
The nurse is teaching an adolescent girl strategies to relieve dysmenorrhea. What should the nurse include in the teaching session? (Select all that apply.)
Ans: Effleurage Ans: Use of a heating pad Ans: Massaging the lower back
During the physical examination of an adolescent with significant weight loss, what finding may indicate an eating disorder?
Ans: Erosion of tooth enamel
What is a major physical risk for young adolescents during pregnancy?
Ans: Fetopelvic disproportion is a common problem
What method is the most commonly used in completed suicides?
Ans: Firearms
What statement is true concerning adolescent suicide?
Ans: Gay and lesbian adolescents are at a particularly high risk for suicide.
What is the usual presenting symptom for testicular cancer?
Ans: Hard, painless mass
What behavior is the nurse most likely to assess in an adolescent with anorexia nervosa (AN)?
Ans: Has a marked preoccupation with food
The nurse is teaching an adolescent female about the symptoms of premenstrual syndrome (PMS). What symptoms should the nurse include in the teaching session? (Select all that apply.)
Ans: Headaches Ans: Fluid retention Ans: Emotional changes Ans: Premenstrual cravings
The nurse is presenting an educational program to a group of parents about differences between anorexia nervosa (AN) and bulimia nervosa (BN) at a community outreach program. What statement by a parent would indicate a need for additional teaching?
Ans: "A child with AN is usually sexually active and seeks intimacy, but a child with BN avoids intimacy and is usually not sexually active."
The nurse is teaching an adolescent about acne care. What statement by the adolescent indicates a need for further teaching?
Ans: "I will use my antibacterial soap to cleanse my face."
The clinic nurse is evaluating a patient with a vaginal infection. The nurse knows that the normal vaginal pH is in which range?
Ans: 4.0 to 5.0
The clinic nurse is evaluating an adolescent with menses that have stopped occurring. The nurse understands that which minimum amount of time should the menses be absent after a period of menstruation to be diagnosed as secondary amenorrhea?
Ans: 6 months
After a treatment plan for acne has been initiated, which time period should the nurse explain to an adolescent before improvement will be seen?
Ans: 6 to 8 weeks
What menstrual disorders are indications for a pelvic examination? (Select all that apply.)
Ans: Amenorrhea Ans: Irregular uterine or vaginal bleeding Ans: Dysmenorrhea unresponsive to therapy
An adolescent girl tells the nurse that she is very suicidal. The nurse asks her if she has a specific plan. How should asking about a specific plan be viewed?
Ans: An appropriate part of the assessment
Tretinoin (Retin-A) is a commonly used topical agent for the treatment of acne. What do nursing considerations with this drug include?
Ans: Applying of the medication occurs at least 20 to 30 minutes after washing.
The nurse is teaching an adolescent about the use of tretinoin (Retin-A). What should the nurse include in the teaching session? (Select all that apply.)
Ans: Begin with a pea-sized dot of medication Ans: Use sunscreen daily and avoid the sun when possible Ans: Divide the medication into the three main areas of the face
What statement regarding chlamydial infections is correct?
Ans: Both men and women may have asymptomatic infections
The clinic nurse is assessing an adolescent on a topical antibacterial agent. The nurse should assess for which side effects that can be seen with topical antibacterial agents? (Select all that apply.)
Ans: Burning Ans: Dryness Ans: Erythema
It is important that women with anogenital warts caused by the human papillomavirus (HPV) receive adequate treatment because this sexually transmitted infection increases the risk of what?
Ans: Cervical cancer
What goal is most important when caring for a child with anorexia nervosa (AN)?
Ans: Correct malnutrition