NCLEX Quizzes-Adolescent

A client with chronic obstructive pulmonary disease (COPD) has oxygen at 2 L/min ordered and is dyspneic when the nurse arrives to administer medications. The client asks the nurse, "Why has my physician ordered such a low oxygen level? I obviously need more." What is the most appropriate response by the nurse?

"Your body is stimulated to breathe by low oxygen levels, so you don't want to increase the level of oxygen." This provides an explanation of the importance of low oxygen levels at a time when the client feels short of breath. This will also alert the client not to increase the oxygen without consulting someone.

A nurse is providing health teaching focusing on urinary tract infections to a group of adolescent girls. One of the girls tells the nurse that she has heard of a condition called honeymoon cystitis and wants to know what it is. Which statement by the nurse is the most appropriate response?

This condition results from irritation and inflammation from sexual activity." Honeymoon cystitis is a lower urinary tract infection seen in some young adolescent women after their first sexual intercourse experience. The urinary tract infections occur because of inflammation and local irritation caused by sexual activity.

An adolescent with type 1 diabetes is experiencing a growth spurt. Which treatment approach would be most effective?

Administering multiple doses of insulin. During an adolescent growth spurt, a regimen of multiple insulin doses achieves better control of the blood glucose level because it more closely simulates endogenous insulin release. A single daily dose of insulin wouldn't control his blood glucose level as effectively. Limiting dietary fat intake wouldn't help the body use glucose at the cellular level. An adolescent with type 1 diabetes doesn't produce insulin and therefore can't receive an oral antidiabetic agent instead of insulin.

Which assessment finding should alert the nurse to suspect appendicitis in a male adolescent reporting severe abdominal pain?

Bowel sounds are heard twice in 2 minutes. Manifestations of appendicitis include decreased or absent bowel sounds. Normally, bowel sounds are heard every 10 to 30 seconds. Therefore, bowel sounds heard twice in 2 minutes suggests appendicitis.

An 18-year-old tells the nurse, "Everyone does it, so it's all right," to justify rule-breaking behavior. The nurse realizes this is an example of which level or stage of moral reasoning development as described by Kohlberg?

Conventional. Level two, stage three behaviors of Kohlberg's conventional level of moral reasoning focus on the approval of others. Moral dilemmas are solved by the group standard, with an emphasis on conformity. Adolescents usually function at this level of moral development. Children up to age 2 years function at the preconventional level, which is characterized by avoiding punishment and obeying those who have power. Typically, adults function at the postconventional level, which is characterized by defining moral values and understanding that correct behavior is determined by society. The postconventional, or autonomous, stage of moral development is characterized by defining moral values and understanding that correct behavior is determined by use of ethical principles.

An adolescent is brought to the emergency department in a coma and is diagnosed with diabetic ketoacidosis. What is the priority action for the nurse?

Monitor for hypovolemic shock. Dehydration results from the osmotic diuresis associated with hyperglycemia and polyuria. The client is at risk for shock from dehydration.

A nurse is performing a psychosocial assessment on a 14-year-old adolescent. Which emotional response is typical during early adolescence?

Moodiness. Moodiness may occur often during early adolescence. Frequent anger and combativeness are more typical of middle adolescence. Cooperativeness typically occurs during late adolescence.

An adolescent is admitted to the pediatric unit for evaluation of abdominal pain. Which health professionals should collaborate in caring for this client? Select all that apply.

Nurse • Physician • Pharmacist • Social worker and • Client Collaboration of care involves all disciplines.

A client has been experiencing abdominal cramps, diarrhea, and concentrated urine for the past 2 days. Which of the following would be included in a focused assessment?

Signs of dehydration, including loss of weight; poor tissue turgor; and dry, cracked mucous membranes When a client has abdominal cramps and diarrhea, there is a loss of extra fluids from the body. Through a focused assessment, the nurse should assess for a fluid volume deficit. This would be indicated by signs of dehydration and weight loss. A focused assessment would usually indicate increased bowel sounds associated with the cramping.

After conducting a presentation to a group of adolescent parents on the topic of adolescent pregnancy, the nurse determines that one of the parents needs further instruction when the parent says that adolescents are at greater risk for which complication?

congenital anomalies. Additional teaching is needed when the parent says that adolescents are at greater risk for congenital anomalies. Although adolescents are at greater risk for denial of the pregnancy, lack of prenatal care, low-birth-weight infant, cephalopelvic disproportion, anemia, and nutritional deficits and have a higher maternal mortality rate, studies reveal that congenital anomalies are not more common in adolescent pregnancies

A 12-year-old with leukemia will be taking vincristine. The nurse should encourage the child to eat what kind of diet?

high-residue. Vincristine may cause constipation, so the client should be encouraged to eat a high-residue (fiber) diet.

A 15-year-old is a heavy user of marijuana and alcohol. When the nurse confronts the client about his drug and alcohol use, he admits previous heavy use in order to feel more comfortable around peers and achieve social acceptance. He says he has been trying to stay clean since his parents found out and had him seek treatment. When the nurse develops a plan of care with the client, what should be the highest priority to help him maintain sobriety?

Peer recognition that does not involve substance use. Peer acceptance and recognition is a very powerful force in the lives of adolescents, leading to positive or negative behavior depending on the child's peers. While the influence of parents remains strong, peer acceptance combined with the adolescent's desire for independence can lead to disobeying the parents. The sanctions provided at school and in the community by law enforcement will support those teens that have other support in their lives, but are generally not sufficient to prevent substance use in adolescents lacking support at home and with peers.