Chapter 27: Growth and Development of the Adolescent: 11 to 18 Years
A nurse is preparing a class for a group of adolescents about sexuality and sexual activity. The nurse understands that which of the following are often the biggest influences on an adolescent's actions related to sexual activity? Select all that apply. peer pressure self-esteem education scientific evidence parental concern
peer pressure self-esteem
A mother calls the school nurse and is concerned because her 13-year-old daughter's friends wear heavy makeup and black clothes. Which is the best advice for the mother? "This can lead to piercings and tattoos." "The teen years are a time for experimenting." "Encourage her to socialize with the kids at church." "Teen appearance might not accurately reflect their actual values."
"Teen appearance might not accurately reflect their actual values."
When interviewed by the school nurse, a 13-year-old adolescent female states she has a boyfriend and that her parents do not talk about sex with her. She says is confused about the facts and wants to know the truth. Which approach would best address this adolescent's concerns? Explain that a discussion about sex is best handled by her parents and she should go home and ask them. Offer to provide her some brochures to help her better understand how her body works. Sit down with her and openly discuss her concerns and questions in an honest, straightforward manner. Refer the adolescent to a local health department for sexual counseling and pregnancy prevention.
Sit down with her and openly discuss her concerns and questions in an honest, straightforward manner.
An adolescent female with anemia has been prescribed a diet high in iron. Selection of which meal indicates to the nurse that the client understands the prescribed diet? baked chicken, steamed cauliflower, garden salad fried chicken, carrots, and mashed potatoes cookies, candy, and crackers shrimp, corn on the cob with butter, and cookie
baked chicken, steamed cauliflower, garden salad
A runaway female adolescent has come to the community clinic because she is pregnant. When developing a plan of care, the nurse should identify which priority goal for this client? returning home to parents adequate nutrition monthly prenatal visits safe housing
safe housing
The nurse knows that barriers to the adolescent's health and successful achievement of the tasks of adolescence exist. What is the major barrier to health for this population? cultural socioeconomic marital status racial
socioeconomic
An 18-year-old client is planning to attend college in the fall. The health care nurse informs the adolescent that a visit with the primary care physician (PCP) will need to be scheduled before the start of college. What primary purpose does this PCP visit serve? to discuss diet to update immunizations to obtain birth control to assess for health problems
to update immunizations
The nurse is providing suggestions to a female adolescent about foods to help meet her nutritional requirements for iron. Which food would the nurse suggest as a good source of iron? broccoli yogurt peanut butter white beans
peanut butter
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? The adolescent's need for privacy should be respected. The adolescent should be encouraged to call friends often. The adolescent's need for parental support should be discussed. The adolescent should be given freedom to participate in unit activities as desired.
The adolescent's need for privacy should be respected.
Jenny is a 15-year-old who is being seen today in the clinic accompanied by her mother. The mother states, "She ignores what we tell her and looks to her friends for answers and support. What should we do?" After talking with Jenny's mother, which statement by her mother indicates understanding of the basis for Jenny's behavior? "Adolescents her age all do this and it will get better with time." "All of this is related to her raging hormones at this age." "I guess we'll just have to learn how to deal with her temperament." "She'll be alone all her life if she doesn't change her act."
"Adolescents her age all do this and it will get better with time."
An adolescent shares with you that she wishes her breasts would grow larger. Which initial nursing response is best? "It is unlikely that your breasts will grow any more. I wouldn't spend time thinking about it." "You look fine to me. Why would you want larger breasts?" "Breast growth usually stops by the age of 16 years. What is the reason you were hoping yours would grow more?" "Let's talk about your concern. You know that breast size has nothing to do with ability to reproduce."
"Breast growth usually stops by the age of 16 years. What is the reason you were hoping yours would grow more?"
The parent of a 14-year-old adolescent states to the nurse that the adolescent is moody, shuts oneself in the bedroom, and fights with a younger sibling. Which comment is most helpful to support the parent? "Calmly talk to your adolescent about your concerns." "This is normal for the age." "Take away all of the adolescent's privileges until your adolescent starts acting better." "Set some rules for family etiquette."
"Calmly talk to your adolescent about your concerns."
A nurse is educating a middle school class of male adolescents about sex education. The topic of multiple partners is discussed. Which of the following statements from the nurse would be the most effective? "Teens account for 25% of all sexually transmitted infections (STI) in the population." "Be careful, or you will end up being a teen parent." "Contraception is a responsibility of both parties involved." "Compared with male teens, female teens are more susceptible to STIs."
"Contraception is a responsibility of both parties involved."
A black adolescent male has been diagnosed with hypertension. Which statement made by the adolescent indicates to the nurse that additional teaching is needed? "My blood pressure should remain less than 130/90 mm Hg." "Playing baseball is good exercise for me." "Drinking sodas is not related to my blood pressure." "My dad has hypertension, so I have to be careful."
"Drinking sodas is not related to my blood pressure."
A 16-year-old female tells the school nurse she is worried her ex-boyfriend is stalking her. What would be most appropriate for the nurse to ask the adolescent? "How many times a day do you get texts from him?" "Have you had any difficulty when you see him at school?" "Did he ever try to hurt you when you were a couple?" "Does he tag you in pictures on his Facebook page?"
"How many times a day do you get texts from him?"
The health care provider has prescribed oral tetracycline for an adolescent girl to help clear acne. What statement about the medication made by the girl would require additional teaching from the nurse? "I will see improvement on my face after 4 weeks of therapy." "I need to take the medication with food every day." "It is important for me to check the expiration date on the bottle." "My periods will continue to be regular while on the medication."
"I need to take the medication with food every day."
A nurse in the teen clinic is using anticipatory guidance to educate parents about preventing suicide in teens. Which of the following responses by a parent would show the nurse that the teaching on suicide was effective? "I will check for signs of depression and a lack of peers." "I will watch for aggressive behavior." "I will become good friends with my child's peers." "I will monitor all electronic games and TV."
"I will check for signs of depression and a lack of peers."
An adolescent who is depressed states, "Nothing ever seems to be right in my life." Which would be the most appropriate response by the nurse? "Things will be better when you go off to college." "You are feeling sad right now. It's a hard time." "Try to look at the bright side of things." "Being a teenager is hard work."
"You are feeling sad right now. It's a hard time."
During a health check-up without the parents present, a 17-year-old adolescent tells the nurse about being gay. Which statement from the nurse is best? "Tell me what makes you think you are gay." "This puts you in an at-risk category." "We need to talk about safe sex." "You are not gay; you are confused."
"Tell me what makes you think you are gay."
The parents are concerned their 14-year-old child is always eating. The child weighs 54 kg and is 65 inches (165 cm) tall. What is the best explanation the nurse can give the parents? "He needs the calories because he participates in sports." "His calorie intake predisposes him to future obesity." "He is substituting food for unfilled needs." "The calories help his body increase muscle mass."
"The calories help his body increase muscle mass."
The nurse is teaching the parents of a 12-year-old boy about common approaches when raising an adolescent. Which instruction is most important? "Find out if his friends are worthy of him." "Try to be open to his views." "Maintain a firm set of rules." "Remind him that he is still your little boy."
"Try to be open to his views."
During a visit to the school nurse, an adolescent confides in recently having feelings of attraction to a member of the same gender. How should the nurse best respond to the adolescent? "How long have you been having these feelings?" "Would you like to talk about these feelings?" "These feelings are normal for your age." "Do these feelings make you feel bad about yourself?"
"Would you like to talk about these feelings?"
The school nurse is assessing a 15-year-old female client. The client states, "I just want to be pretty and to look like everyone else." Which response by the nurse is appropriate? "You seem concerned. Let's talk about your feelings." "I think you are beautiful just as you are." "Looking like everyone else is not what makes someone pretty." "Do you not think you are pretty now?"
"You seem concerned. Let's talk about your feelings."
A school nurse is assisting in Sports Physical Day with a 15-year-old teen who has a pierced navel. Which of the following statements by the nurse would be the best for health promotion? "I hope the equipment used in your piercing was clean." "You will need to clean the navel several times a day." "This piercing puts you at risk for hepatitis and tetanus." "This piercing is considered a wound and could get infected."
"You will need to clean the navel several times a day."
An adolescent client is concerned about the presence of facial acne. What should the nurse teach the client about the cause of this skin disorder? This is caused by thyroid gland secretions. This develops because of poor personal hygiene. This is caused by the activation of androgen hormones. This appears when there is a vitamin deficiency from an inadequate diet.
This is caused by the activation of androgen hormones.
The school nurse is preparing a program on sexuality and birth control for a class of 14- to 16-year-olds. Which behavior will have the most influence on how the information is presented? Teens are adjusting to new body images. Adolescents tend to take risks. Teenagers are able to think in the abstract. Adolescents understand that actions have consequences.
Adolescents tend to take risks.
A 15-year-old is hospitalized for acute appendicitis. Which activities would the nurse include in the client's plan of care? Select all that apply. Allow friends to visit during visiting hours. Include the parents when educating the client. Have the nurse control the patient's care as much as possible. Arrange care to provide for extra rest and sleep. Keep the client in hospital gowns for sanitary reasons.
Allow friends to visit during visiting hours. Include the parents when educating the client. Arrange care to provide for extra rest and sleep.
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. Allow the adolescent to choose the time for the dressing change. 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.
The nurse teaches a 14-year-old client's mother about the adolescent developmental task of identity versus role confusion. What is the best way for the mother to help her adolescent complete this task? Set limits and offer concrete choices. Set limits according to what other adolescents are allowed to do. Allow the adolescent to participate in decisions. Allow the adolescent to set his/her own limits.
Allow the adolescent to participate in decisions.
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
An adolescent with a new piercing comes to the health center at the school. The client reports feeling hot. Which action will the nurse complete first? Assess the client for signs of infection. Inquire about the piercing technique used. Determine when the client started feeling hot. Ask the client if any other piercings are present.
Assess the client for signs of infection.
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? Banding together with other girls and dressing like them Banding together with boys and girls but maintaining her own unique style Hanging out primarily with boys her own age Hanging out with girls but maintaining her own unique style
Banding together with other girls and dressing like them
The nurse is educating an adolescent's parents on the importance of self-esteem. Which factor will the nurse include as being most important to an adolescent's self-esteem? Strong authority figures Friends selected by the adolescent Morals and values Body image
Body image
A nurse is attending to a group of boys at a school. The nurse is required to document the sexual development in boys on a regular basis. The nurse would anticipate which clients having the highest incidence of nocturnal emissions? Clients who have reached adulthood Clients in the age group of 18 to 20 years Clients who are showing pubertal changes Clients with strong, muscular appearance
Clients who are showing pubertal changes
What anticipatory guidance can the nurse provide the girl who has noted the development of breast buds? Menarche should follow in about 2 years. The growth spurt will begin immediately with menarche. Breast development will be complete with 12 months. Adult height will be reached at the time of menarche.
Menarche should follow in about 2 years
The nurse is caring for a chronically ill adolescent client. What can the nurse do to maintain stimulation and support the client's sense of identity while hospitalized? Plan activities around scheduled rest periods. Explain food choices appropriate to the prescribed diet. Teach the name and indications for use of all medications. Encourage communicating with friends through social media.
Encourage communicating with friends through social media.
Which of the following is accurately related to growth patterns in adolescent girls? Growth slows after the beginning of menstruation. Girls grow in height about 2 in (5 cm) per year from age 14 to age 18. Growth spurts are common in girls after the age of 16. The girl's pelvic bones begin to broaden several years after menarche begins.
Growth slows after the beginning of menstruation.
A nurse is admitting a 16-year-old male to the floor for an appendectomy. How can the nurse prepare this client for hospitalization? Select all that apply. Encourage him to keep his cell phone nearby to communicate with his friends. Interview the adolescent separately from the parent to allow expression of information that he may not be comfortable sharing in front of the parent. Remind him that there are strict rules regarding meal times and when lights are turned out on the floor. Encourage parents to do as much as possible for the client, including ADLs and meal selection. Provide privacy when client is changing into the hospital gown or going to the bathroom.
Interview the adolescent separately from the parent to allow expression of information that he may not be comfortable sharing in front of the parent. Encourage him to keep his cell phone nearby to communicate with his friends. Provide privacy when client is changing into the hospital gown or going to the bathroom.
The nurse is talking with parents of a depressed 16-year-old boy. Which question is of the most importance? Is there a gun in your home? How is his personal hygiene? Have his sleeping and eating habits changed? Does he exercise?
Is there a gun in your home?
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? Offer to assist the girl in washing her hair and let her pick the shampoo. Allow the girl to wear her own clothes, despite hospital policy. Brush the girl's hair for her. Assist the girl with using the bed pan to urinate.
Offer to assist the girl in washing her hair and let her pick the shampoo.
The nurse is promoting learning and school attendance for a 13-year-old girl. Which factor will affect the child's attitude most? Her parents' values and desires The dramatic changes to her body Peer group behaviors and attitudes Desire for attention from boys
Peer group behaviors and attitudes
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? Permit peers to visit during open visitation hours. Provide video games for the client to play. Allow the client to touch equipment before procedures. Explain medical concepts by providing handouts and brochures.
Permit peers to visit during open visitation hours.
A female client tells the nurse about noticing an increase in weight and fat deposits during the past year. The nurse reviews the client's chart and recognizes that the client is most likely going through puberty. Which nursing action is most appropriate at this time? Provide reassurance that these are normal changes. Review dietary measures to assist in controlling weight gain. Encourage increased exercise to control weight gain. Share what foods can be eaten on a low-fat diet to prevent fat deposits.
Provide reassurance that these are normal changes.
The mother of a 15-year-old boy confides in the nurse that she is concerned because her son is about to turn 16 and is pressuring her and her husband to buy him a motorcycle. Her husband is okay with the idea, but she is concerned about his safety. What information should the nurse mention to the mother regarding motorcycle safety? Select all that apply. Require the son to wear a helmet. Require the son to wear long pants. Require the son to wear full body covering. Require the son to learn all relevant safety rules. Require the son to wear a seat belt. Insist on age and not emotional maturity as the qualification for obtaining a driver's license.
Require the son to wear long pants. Require the son to wear a helmet. Require the son to learn all relevant safety rules. Require the son to wear full body covering.
True adolescence is said to begin when what occurs? Sperm is produced in the male. The areola separate from the contour of the breasts in the female. The voice deepens in the male. The growth spurt in the female ends.
Sperm is produced in the male.
The school nurse is conducting a seminar for parents of adolescents on how to communicate with teenagers. Which guidelines might the nurse recommend? Select all that apply. Talk face to face and be aware of body language. Ask questions to see why he or she feels that way. Do not give praise unless the adolescent deserves it. Speak to your child as an authority figure, not an equal. Don't admit that you make mistakes. Don't pretend you know all the answers.
Talk face to face and be aware of body language. Ask questions to see why he or she feels that way. Don't pretend you know all the answers.
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
The nurse is helping the parents and their underweight adolescent collaborate on planning a healthy menu. The nurse should be aware of which nutritional requirement of adolescents? Teenagers have a need for increased calories, zinc, calcium, and iron for growth. Teenage girls who are active require about 1,800 calories per day. Teenage boys who are active require between 2,000 and 2,500 calories per day. Adolescents require about 1,000 to 1,200 mg of calcium each day.
Teenagers have a need for increased calories, zinc, calcium, and iron for growth.
The nurse is developing a teaching session on common adolescent injuries. What considerations lead the nurse to pertinent topics? Select all that apply. The adolescent's increased physical growth Common insufficient psychomotor coordination Adolescent comments of tiredness and lack of energy A lack of impulsivity in action and decision making Psychosocial concerns affected by peer pressure Inexperience
The adolescent's increased physical growth Common insufficient psychomotor coordination Psychosocial concerns affected by peer pressure Inexperience
During a physical assessment, a 15-year-old male expresses concern about being short in height. Which should the nurse respond to this client's concern? Most male adolescents stop growing by age 17 years. Maximum height is typically achieved by age 14 years. The epiphyseal lines of long bones close when signs of puberty occur. The epiphyseal lines of long bones close at about 18 to 20 years of age in males.
The epiphyseal lines of long bones close at about 18 to 20 years of age in males.
An adolescent comes into the emergency department with a foot wound. Upon assessment, the nurse learns that the client is a runaway and has been living on the streets. Which is the most appropriate care for the nurse to provide to the client at this time? Recommend returning to live with parents. Treat the wound and provide wound care supplies. Discuss the importance of a diet high in protein and vitamin C. Explain how the wound needs to be flushed with water every 4 hours.
Treat the wound and provide wound care supplies.
The school nurse is preparing an educational session for adolescents to address the 2020 National Health Goals for healthy habits. What should the nurse include in this presentation? Select all that apply. abstaining from alcohol avoidance of tobacco products maintaining a healthy body weight attending college preparation programs refusing to participate in substance abuse
abstaining from alcohol avoidance of tobacco products maintaining a healthy body weight refusing to participate in substance abuse
A nurse is examining a 17-year-old adolescent in the emergency room who is being disruptive in the waiting area. On assessment, the nurse finds dilated pupils, and the teen is talking very fast. Which of the following drugs does the nurse suspect the teen may be abusing? opiates marijuana amphetamines barbiturates
amphetamines
Nurses should provide anticipatory guidance to males to prepare them for what particular pubertal change in middle-to-late adolescence? nocturnal emissions lengthening of the penis reddening of the scrotum pubic hair growth
nocturnal emissions
An adolescent who admits to using cocaine frequently comes to the emergency center with symptoms of chest pain, is diaphoretic, and is hypertensive. When establishing care, what priority assessment data does the nurse need? heart rhythm temperature time of last cocaine use cardiac enzymes
heart rhythm
According to Erikson, the adolescent develops their own sense of being an independent person with individual thoughts and goals. This stage is referred to as: identity vs. role confusion. autonomy vs. doubt and shame. industry vs. inferiority. intimacy vs. isolation.
identity vs. role confusion.
The school nurse is planning to teach a segment on smoking during the freshman health classes. The nurse is aware that this needs to be a forum rather than a lecture. Which technique will also help deliver a "don't smoke" message? showing a command of the facts on smoking speaking with a tone of authority keeping your personal experiences out of it listening to all comments nonjudgmentally
listening to all comments nonjudgmentally
A 17-year-old girl has come to the clinic to get a rubella immunization that is required by the college she plans to attend. Before administering this immunization, the child should have which screening or test? pregnancy test screening for tuberculosis scoliosis screening HIV test
pregnancy test
The nurse is assessing an 11-year-old girl. Which assessment finding(s) should the nurse expect? Select all that apply. presence of pubic hair enlarged breast buds coarse pubic hair enlarged areolas increased genitalia pigmentation secondary mound formed of areola and nipple
presence of pubic hair enlarged breast buds enlarged areolas increased genitalia pigmentation
The nurse is caring for a 16-year-old adolescent who was arrested for driving while intoxicated. Which teaching method is most effective in changing the adolescent's behavior? scolding the client for such irresponsible behavior reviewing the long-term effects of alcohol on the liver teaching that alcohol eventually will lead to other drug abuse stressing that the driver's license can be lost if drinking continues
stressing that the driver's license can be lost if drinking continues
The nurse is caring for an adolescent who is physically challenged. Which activity should the nurse suggest that will foster the developmental task of adolescence? watching television deciding when to have a bath having a teacher bring school homework to the hospital talking to another adolescent who has a similar disorder
talking to another adolescent who has a similar disorder
Glycogen loading is practiced regularly by the local high school football team. What is most important for the nurse to monitor in these students? the amount of protein the student is eating how often the students engage in this practice the amount of carbohydrates the student is eating how many hours the student exercises each day
the amount of carbohydrates the student is eating
An adolescent is concerned that although he has pubic hair, he has no facial hair yet. He wishes facial hair would grow to cover acne lesions. The nurse would advise him that facial hair: usually grows before pubic hair. is rarely present before 20 years of age. is delayed in boys with acne. usually follows pubic hair growth.
usually follows pubic hair growth.
