Growth and Development of Adolescents

A 15-year-old client's mother comments on the fact that her daughter seems to always choose the opposite of what everyone else wants and that her mood swings are a common occurrence. What statement shows the nurse that the client's mom understands these changes?

"This is common for this age group and it will get better with time."

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?

"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 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 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

According to Erikson, the adolescent develops his or her own sense of being an independent person with individual thoughts and goals. This stage is referred to as:

identity vs. role confusion.

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 mother of an African-American adolescent voices concern to the nurse because her daughter, "has gotten her period before all of her friends." How should the nurse respond?

"That must be difficult, but on average African-American girls start their period earlier than other ethnicities."

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?

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

The nurse is performing an admission assessment of an adolescent with the teen and the parents. During the assessment the nurse suspects that the teen may be pregnant. What is the best way for the nurse to address this situation?

Ask the parents to wait in the family lounge while finishing the assessment, then ask the teen during the assessment

The nursing instructor is leading a class discussion on the various aspects of adolescents. The instructors determines the class is successful after the students correctly choose which milestone as the beginning of adolescence?

The beginning of puberty

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?"

An adolescent boy of African American descent has been diagnosed with hypertension. Which statement made by the boy indicates to the nurse that additional teaching is needed?

"Drinking sodas is not related to my blood pressure."

A male nurse is meeting with a group of 12-year-old boys to discuss expected bodily changes. After one of the boy's says, "My older brother told me my bed might be wet and that means I had a wet dream. Is that true?" What is the best response from the nurse?

"Having wet dreams indicates that your body is going through a process of maturing."

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 have 4 servings of fruit each day."

A 17-year-old female is meeting with the nurse for an annual well-visit and is asking the nurse questions about how to know when one is in love. The nurse should point out which factor to help decide if both individuals have reached a mutual agreement and are ready for an intimate relationship?

A sense of trust and identity

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.

A 17-year-old boy chats excitedly with the nurse about his plans for college and a career. He says he has checked out every college in the region and determined which one is the best fit for him and would give him the best career options. The nurse recognizes which developmental aspect in this young man?

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 family reports to the nurse that their adolescent always wants to argue, will not participate in family functions, and has poor school grades. What recommendation should the nurse make for an adolescent client who presents with these symptoms?

Make an appointment with the health care provider.

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 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

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

Nocturnal emissions

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.

An 18-year-old reveals that she has a 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 her at this time?

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

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.

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 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 adolescent comes to the clinic seeking information about sexuality concerns. The clinic nurse assures the adolescent that confidentiality and privacy will be maintained unless a life-threatening situation occurs. Maintaining confidentiality demonstrates which nursing goal? Select all that apply.

development of a trusting relationship compliance with existing laws an environment where adolescents can be truthful

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."

The nurse is caring for a 13-year-old girl. The child has been identified as overweight with no underlying psychological or secondary causes. The nurse is reviewing the child's weight-loss progress and nutrition at a follow-up visit. What finding indicates a need for further discussion and teaching?

"Her goal is to be a size smaller by our vacation in two weeks."

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 need to take the medication with food every day"

A 13-year-old girl has grown rapidly in height over the past 2 years and is taller than most of the boys in her class. She wonders when she will stop growing. What should the nurse tell her as a general guideline for the ages at which most girls stop growing?

16 to 17 years old

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.

The nurse is meeting with a group of caregivers of adolescents. Which example should the nurse point out is most effective for the caregiver to support the adolescent?

Let them choose their hairstyle, even though it may not look the best for them

A client tells the nurse that she has noticed an increase in her weight and fat deposits during the last 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 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 activity that would best foster the developmental task of an adolescent who is physically challenged would be:

talking to another adolescent who has a similar disorder

The nurse is caring for an 11-year-old girl. The girl's mother reports that the girl does not want to play team sports like soccer or volleyball anymore. Her daughter insists she does not enjoy them. The mother is concerned that her daughter will not get enough physical activity and asks the nurse for guidance. How should the nurse respond?

"Give her some options; it's important to find something she enjoys."

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."

Which intervention would probably be most effective in preventing an adolescent from attempting suicide with an overdose again?

Helping him learn better problem solving