Chapter 7: Growth and Development of the Adolescent - ML6

during the assessment of a 15-year-old female, the nurse notes a new body piercing in the navel. Which statements by the nurse would be appropriate in regard to this new piercing? Select all that apply.

"I notice you have a new piercing. Be sure to clean it twice a day so you don't get an infection." "Did they tell you when you got your piercing how important cleaning it is? Infections can take up to a year to heal in a naval piercing."

The parent of a Black adolescent voices concern to the nurse because the daughter, "has gotten her period before all of her friends." How should the nurse respond?

"On average Black girls start their period earlier than other ethnicities."

An adolescent's parent states not knowing what to do with the adolescent. The parent reports the teenager is taking two or three showers a day when not that long ago the parent could barely get the teen to take a shower at all. What should the nurse's reply be to the parent?

"Reinforce the family rules but also allow the adolescent to develop one's own routine."

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?

"The calories help his body increase muscle mass."

A male adolescent comes to the clinic for a routine health care follow-up accompanied by the parents. During the visit, the parents tell the nurse, "Our son just doesn't seem to listen to us anymore. It's like he's tuning us out. Is there anything we can do to get him to hear what we're saying to him?" Which suggestions would be appropriate for the nurse to offer? Select all that apply.

"When you talk to him, speak to him face to face and be careful of your body language." "Don't be afraid to ask him questions about why he feels a certain way." "Choose words carefully to make sure that he understands you." "Talk to you son as an equal and don't talk down to him."

An adolescent who is depressed states, "Nothing ever seems to be right in my life." How should the nurse respond?

"You are feeling sad right now. It is a hard time."

A nurse is taking care of a teenager who reports involuntary discharge of semen while sleeping. The nurse observes that the client is confused and does not know about the pubertal changes that are taking place in his body. Based on this information, what is the highest priority area that should be reviewed with the client?

Educate the client about the changes that occur during adolescence.

An 18-year-old adolescent reveals the presence of nipple ring and is looking to get a tattoo in the next few months. What is the most important thing that the nurse can teach the adolescent at this time?

Tattooing carries risks such as infection, disease, and nerve damage.

Computer use at home and at school has increased adolescents' comfort in gaining access to and using the Internet. This has expanded their exposure to risks. What potential risks are there for an adolescent to be exposed to?

Teens can be exposed to inappropriate materials, harassment, threats, and potential for molestation.

The nurse is educating a 17-year-old adolescent after a new diagnosis of diabetes. What does the nurse understand about teaching an adolescent?

The adolescent will likely have the greatest influence on one's own decisions.

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 father of a 15-year-old daughter is concerned she is not getting adequate nutrition to play high school basketball. Her games are on Friday nights. Which suggestion should the nurse point out will best suit the needs of this adolescent?

Three daily meals that include choices from each of the food groups; Friday's lunch eaten around 2 p.m. with a small amount of fat and a somewhat larger than usual portion of complex carbohydrates.

The nurse is performing a health surveillance visit with a 12-year-old boy. Which characteristic suggests the boy has entered adolescence?

experiences frequent mood changes

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?

motor vehicle safety

The nurse is promoting nutrition to a teen who is going through a growth spurt. Which food should the nurse recommended for its high iron content?

whole grain bread

The nurse is assessing an adolescent's risk for harm from guns being present in the home. What question would be best to ask during the assessment?

"Are the guns in your home locked in a safe?"

A 17-year-old male adolescent on the high school swim team tells the nurse that during swim season he cuts the carbohydrates in his diet to 30% to help his swim times. What responses by the nurse are appropriate? Select all that apply.

"Can you tell me the reason you feel the need to cut your carbohydrates when your activity level is high?" "Since you are so active, your carbohydrate intake should comprise 45% to 65% of your daily diet."

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?

"I get 7 hours of sleep every night so I don't know why I am so tired."

The nurse is providing anticipatory guidance to the parents of a 15-year-old who voice concerns with their teenager's sleep habits. They state, "Left to her own devices, I'm sure she'd stay up until 3:00 in the morning on the weekends and sleep until after lunchtime." Which should the nurse explain to the parents?

"That must be hard for you to manage. Perhaps we can explore some strategies with her to establish more predictable sleep patterns."

During an examination, an adolescent client tells the nurse about being anxious and frustrated because of the facial acne. Which nursing response is appropriate?

"This is one of the most common physical changes during adolescence."

The clinic nurse is assessing a 14-year-old client. The client states "I am worried I have a brain tumor. I am so clumsy when I play sports now that it is totally embarrassing." Which response by the nurse is appropriate?

"You are experiencing rapid and uneven growth now which can interfere with coordination."

During a well-child visit, the parents of an adolescent ask the nurse about how much physical activity their adolescent should engage in each day. The nurse would instruct the parents to encourage how many minutes of physical activity each day?

60

A nurse is explaining cognitive development in children to a client, with the help of Piaget's theory of cognitive development. What would be the best explanation by the nurse about the formal operations level of cognitive development?

After age 12 children can think in the abstract, including complex problem solving.

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?

Allow the adolescent to choose the time for the dressing change.

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.

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

The nurse is preparing a presentation for a local health fair depicting the differences in maturity between preadolescents. Which differing factor should the nurse prioritize in the presentation?

Boys grow at a slower, steadier rate than do girls.

To help prevent obesity, which intervention would the nurse include in an adolescent's plan of care?

Describe a normal serving size.

The nurse is caring for a 16-year-old client. The client confides in the nurse that they use marijuana daily. Which action by the nurse is appropriate?

Discuss adverse side effects with the client.

A 15-year-old adolescent shows a pattern of gaining weight, not a large amount but a little more each visit. The adolescent is not active in any sports and eats out frequently with parents. What is the best way for the nurse to assess the adolescent's eating pattern?

Have the adolescent keep a food diary for 1 week.

The school nurse is developing a school wellness program to promote healthy eating habits and regular physical activity. What is the most important element to emphasize to maximize compliance, healthy habits, and long-term change?

Include both parents and children in the wellness program.

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?

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.

A 16-year-old client has been hospitalized 100 miles from home for 1 week to repair a fractured patella suffered in a skateboarding accident. She was cheerful and chatty when she first arrived, but the nurse notes in recent days she has become increasingly quiet and seems lonely. Which nursing intervention should the nurse prioritize for this client?

Take her to the teen lounge so she can meet and interact with other teens.

The nurse is caring for an adolescent athlete who is being seen for a fractured arm. The parent reports that this is the third sports injury in the past 2 years. The parent asks the nurse why the adolescent—who is healthy overall— continues to have injuries. How should the nurse respond?

The bones, joints, and tendons of adolescents are vulnerable to injury due to their rapid state of growth.

The physician has made a notation in the medical record of a 17-year-old that the teen is not demonstrating successful completion of Erikson's stages of development. What behavior would be consistent with this assessment?

The teen is uncertain and frequently unable to make decisions.

The school nurse is assessing a 16-year-old girl who was removed from class because of disruptive behavior. She arrives in the nurse's office with dilated pupils and is talking rapidly. Which drug might she be using?

amphetamines

Nurses should provide anticipatory guidance to males to prepare them for what particular pubertal change in middle-to-late adolescence?

nocturnal emissions

The nurse is counseling an overweight, sedentary 15-year-old girl. The nurse is assisting her to make appropriate menu choices. Which statement indicates the adolescent understands how to make appropriate dietary selections?

"I need to eat plenty of fruit each day."

A 16-year-old adolescent is talking with the nurse at a local health clinic about skin care. Which comments by the teen does the nurse determine require additional conversation? Select all that apply.

"I only tan before going on spring break to get a base tan so I won't burn." "My favorite time of day to be outside is the middle of the day, around noon." "The more exposure and burns I get now will toughen my skin so I won't get skin cancer when I'm older."

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. Arrange care to provide for extra rest and sleep.

What anticipatory guidance can the nurse provide the girl who has noted the development of breast buds?

Menarche should follow in about 2 years.

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.

The nurse is assessing the psychosocial development of an adolescent. The nurse determines that the client is in the middle post-conventional phase with which observation?

The adolescent tells the nurse, "I'm starting to think that some of my friends care a lot more about what other people think of them than what I do."

A 16-year-old girl has arrived for her sports physical with a new piercing in her navel. Which response by the nurse is best?

"Be sure to clean the navel several times a day."

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?

"Do you take anabolic steroids?"

The mother of a 9-year-old female voices concern to the nurse about her daughter developing breasts "at such a young age." How should the nurse respond?

"I understand your concern, but girls typically enter puberty around the age of 9 or 10."

The nurse is educating an adolescent female who needs to increase dietary iron but has expressed concern about weight gain. What dietary choices would the nurse recommend?

chicken, whole-wheat bread, watermelon

The parent of an adolescent diagnosed with iron-deficient anemia asks the nurse for help with incorporating more iron into the adolescent's diet when packing lunches and snacks for school. Which foods would be good sources of iron that could be easily incorporated into the diet when taking lunches and snacks to school? Select all that apply.

peanut butter eggs strawberries nuts

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?

Formal operational thought

The parents of a 16-year-old male are worried about recent changes in his behavior, ignoring his schoolwork and sports, and spending almost all of his free time interacting with his girlfriend. Which suggestion should the nurse point out would best address this situation?

He has developed his own identity by now; being able to establish close relationships with girls is important preparation for all of his adult relationships. They should honor his need to be with, or talk to, his girlfriend as long as he has completed his schoolwork for the day.

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?

Teens are busy developing their own personal identity.

The parents of a 16-year-old are fearful that their child may be using illegal drugs. They report to the nurse that they have noticed recently that their child seems much more focused when doing homework or chores, is losing weight, displays a high level of energy, and becomes agitated easily. The nurse is aware that the teen is displaying symptoms of which type of drug use?

methamphetamine

The nurse is assessing a teenage client and notes his lower front teeth are slightly crossed over. The nurse points out to his caregiver that he should see an orthodontist about this to prevent which potential situation?

Even slight malocclusions make chewing and jaw function less efficient.

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?

following role models

A teenage boy tells the nurse that his parents embarrass him in front of his friends when they kiss him goodbye. The nurse is aware that this teenager is revisiting which stage of development identified by Erikson?

autonomy

A teenage girl and her mother are in the office. When the teen uses the restroom, her mother asks the nurse about the changes that Linda is going through. She would like to talk to her about sexuality and its changes but she is unsure of how to do this. What reminders should the nurse give to the mother for when she discusses sex?

Promote open lines of communication; listen instead of lecture; and share family values.

During the assessment of a 15-year-old female, the nurse notes a new body piercing in the navel. Which statements by the nurse would be appropriate in regard to this new piercing? Select all that apply.

"I notice you have a new piercing. Be sure to clean it twice a day so you don't get an infection." "Did they tell you when you got your piercing how important cleaning it is? Infections can take up to a year to heal in a naval piercing."