NURS360 HESI Adolescents level 2 (A's)
A nurse is caring for a client who is diagnosed with syphilis and has to administer a daily dose of the prescribed medication. Which medication is the nurse administering to the client?
Answer: 2. Penicillin G
A primary healthcare provider suspects that a client has a chlamydial infection and orders a highly sensitive diagnostic test. Which diagnostic test would be ordered?
Answer: 4. Nucleic acid amplification test
A nurse teaches a group of teenage girls about puberty. What information should the nurse refrain from providing?
Answer: 4. "Your body will gain height and weight disproportionately."
A 15-year-old adolescent is diagnosed with endometriosis. The client has severe, acute, and incapacitating symptoms. What would be the anticipated line of treatment?
surgical intervention
A 19-year old client is diagnosed with a heavy and palpable hard mass on the anterior aspect of the testis. Which treatment would be appropriate?
Answer: 4. Radical inguinal orchiectomy
After orthopedic surgery a 15-year-old adolescent reports pain and rates it a 5 on a scale of 0 to 10. A nurse administers the prescribed 5 mg of oxycodone every 3 hours as needed. Two hours after having been given this medication, the adolescent reports pain and rates it a 10 of 10. What action should the nurse take next?
Answer: 4. Request that the primary healthcare provider evaluate the need for additional medication.
A nurse is planning to discuss the importance of following the prescribed course of treatment with a group of adolescent clients. What is the nurse's priority consideration regarding these clients?
Answer: They are involved more with the present than with the future.
A female adolescent with comedonal acne has been prescribed tretinoin gel. What treatment-specific instructions should be given to the adolescent? Select all that apply.
Answers: 1. Apply the medication at night., 2. Use a scarf to avoid sun exposure on the face., 5. Apply a pea-sized dot of medication on the three main areas of the face and gently rub.
An 18-year-old adolescent reports irregularity in menses. Physical examination reveals decreased blood pressure. Her mother complains that her child often fears gaining weight and has a distorted self-image. What could be the reason for irregular menses?
Answer: 2. anorexia
An adolescent client is reported to have inflammatory acne lesions. Which medication would the primary healthcare provider prescribe?
Answer: 3. 5% dapsone gel + adapalene
A nurse is teaching a group of students about the characteristics of adolescence. Which statements made by the students indicate adequate learning? Select all that apply.
Answers: 1. Body fat distribution affects the adolescent's self-concept, 2. Accidents are the leading cause of death among adolescents, 3. A negative body image leads to suicidal thoughts in the adolescent.
A primary healthcare provider is reviewing the previous medical history of a client before prescribing danazol. Which conditions would cause a primary healthcare provider to not prescribe danazol to a client? Select all that apply.
Answers: 1. The client is in her first trimester of pregnancy, 5. The client is recently diagnosed with fatty liver
A nurse is counselling the parents of a 13-year-old child. Which of these behaviors will the nurse include in the discussion? Select all that apply.
Answers: 2. Egocentrism, 3. Logical reasoning, 5. Imaginary audience
A nursing instructor asks a nursing student about the development of adolescents according to Piaget's theory. Which statement made by the student indicates a need for further education? Select all that apply.
Answers: 4. "Adolescents emphasize using knowledge to achieve a goal.", 5. "Adolescents have the ability to recognize different answers for different situations."
A client currently taking medication for bacterial vaginosis complaints of an unpleasant metallic taste, nausea, and vomiting. Which medication would be responsible for this condition?
Metronidazole
A pregnant adolescent already diagnosed as HIV-positive with a viral load of more than 1,000 copies/mL is currently in her 38th week of gestation. Which is the best method of delivery in this situation?
Answer: 1. Cesarean section
A pregnant adolescent seeks treatment for blackheads. Which drug would be safe for the adolescent?
Answer: 4. Clindamycin
A nursing instructor asks a nursing student to outline the factors that predispose adolescents to substance use. Which of these statements outlined by the student are correct? Select all that apply.
Answers: 1. Adolescents believe that substance use makes them more mature, 3. Adolescents believe that using mood-altering substances creates a sense of well-being 4. Adolescents believe that using mood-altering substances creates a sense of well-being.
A primary healthcare provider suspects ectopic pregnancy in an adolescent and conducts further evaluation. Which signs and symptoms have led the provider to suspect ectopic pregnancy? Select all that apply.
Answers: 1. Hypotension, 2. Abdominal pain, 3. Vaginal bleeding
A nurse educates parents about how to communicate with their 14-year-old. Which statement should the nurse make?
Answer: 4. "You should look for the meaning behind your child's words or actions."
A registered nurse is teaching an adolescent female client with irregular menstruation about contraception. Which statements made by the client indicates the need for further education? Select all that apply.
Answer: 1. "The calendar method of oral contraception is best suitable for me.", 3. "Condoms do not offer protection against sexually transmitted infections.", 4. "Oral contraceptive pills offer protection from sexually transmitted diseases."
An adolescent sustains a sports-related fracture of the femur, and open reduction and internal fixation with a rod insertion is performed. After the surgery, a nurse notes that the adolescent is very upset. In light of the client's developmental level, what does the nurse conclude is the most likely explanation for this distress?
Answer: 2. The perception that the rod is a body intrusion
After an above-the-knee amputation for bone cancer, an adolescent boy is returned to his room. He is monitored closely because of the potential for hemorrhage from the residual limb. What should the nurse plan to keep at the bedside?
Answer: 2. narcotics
An adolescent with a BMI of 30 reports fatigue, frequent urination, and a tingling sensation on the feet. The adolescent is then diagnosed with type 2 diabetes mellitus. Which nursing interventions would be appropriate? Select all that apply.
Answers: 2. Physical activities, 4. Dietary counseling, 5. Behavior modification
A male adolescent going through puberty worries about breast enlargement. Which nursing interventions would benefit the adolescent? Select all that apply.
Answers: 2. Suggest that the client gets a medical evaluation, 3. Advise the adolescent to talk to his peers, 5. Assure the adolescent that the situation is temporary and benign
A nurse involved in a health promotional program educates a group of adolescents at school. Which of these measures is the nurse unlikely to adopt? Select all that apply.
Answers: 2. The nurse should treat the adolescents as small children, 3. The nurse should carry out an open discussion in a group
A physician orders a nucleic acid amplified test for an adolescent client who sustained a sexual assault. Which infections can be diagnosed with this test? Select all that apply.
Answers: 3. Chlamydia, 4. Gonorrhea
A nursing instructor asks a nursing student to explain the characteristics of substance abuse in adolescents. Which statements by the student indicate inadequate learning? Select all that apply.
Answer: 1. "Fifty percent of adolescents have used alcohol by the end of high school." 5. "Twenty-five percent of adolescents have tried smoking by the end of high school."
A nurse on the adolescent unit is planning to discuss smoking prevention. What is the most effective approach for the nurse to use?
Answer: 3. Presenting information on how smoking affects appearance and odor of the breath
An adolescent female suffering from severe cystic acne is placed on isotretinoin. What important facts should the nurse tell the client about isotretinoin? Select all that apply.
Answer: 2. Inform the client about the risk of teratogenicity. 3. Inform the client that skin improvement may take time.
An unmarried female adolescent arrives at a hospital with her parents. She complains of a delay in her regular menstrual cycle and wants to confirm her health status. Which strategies should be employed while interviewing the adolescent? Select all that apply.
Answers: 1. Gaining the client's trust, 3. Explaining the limits of confidentiality
A young adolescent couple asks a community health nurse about using condoms as a method of contraception. Arrange the steps of using a condom in sequential order.
Answer: 1. Open the package to remove the condom and check for breaks or holes, 2. Contraceptive jelly is squeezed onto the tip of the condom, 3. Condom is unrolled on the erected penis, 4. Leave 0.5 inch of space at the tip of the condom, 5. Hold the rim of the condom in place when withdrawing, 6. Throw the condom away.
According to Tanner stages, which figure indicates the pubertal stage in males?
Answer: 3
A 16-year-old girl has been admitted to the pediatric eating disorders unit with a diagnosis of anorexia and is undergoing behavioral therapy. Unit privileges are based on weight gain and have been explained to the client. What is the most appropriate intervention for the nurse to use when taking the lunch tray to the client's room?
Answer: 1. Setting the tray down and saying nothing
An adolescent having premenstrual syndrome displays pelvic fullness, irritability, depression, fatigue, and backaches. What instructions should the nurse provide to the adolescent to help obtain relief? Select all that apply.
Answers: 1. Do aerobics 3 to 4 times a week., 2. Follow stress reduction techniques, 3. Take NSAIDs or progesterone, 5. Eat food rich in complex carbohydrates and fiber in three small portions.
An adolescent reports fever and headache. The nurse observes several maculopapular rashes on the palms and soles and broad, pinkish gray, wart-like lesions on the genitals. What does the nurse infer from these findings?
Answer: 3. The adolescent has secondary syphilis
A nursing instructor asks a nursing student to explain the teaching methods to be used for adolescents. Which statement by the student indicates a need for further teaching? Select all that apply.
Answers: 1. Keep teaching sessions short, 4. Encourage them to learn together, using pictures and short stories
A nurse educates a group of parents about the psychosocial changes of adolescents. Which statement made by parents indicates inadequate learning?
Answer: 3. "Adolescents love their parents in every situation."
A 15-year-old is grounded for 2 weeks by her parents for smoking in school. The adolescent tells the school nurse, "It's not fair that I get punished when my friends get away with doing the same thing." What is the best response by the nurse?
Answer: 3. "When errors in judgment are made, people must be prepared to take the consequences for their actions."
An adolescent comes to the school nurse complaining of a 2-day history of low-grade fever, exhaustion, and lack of energy and appetite. He has been tardy to school twice in the past week. Which assessment should the nurse use to identify the possible origin of the problem?
Answer: 3. Checking for lymphadenopathy
According to Erikson's theory, which behaviors will a nurse notice in 13-year-old students? Select all that apply.
Answers: 1. Such students want to know "Who am I?", 5. Such students show a marked preoccupation with body appearance.
A nursing instructor asks a nursing student to describe teaching methods that are effective for adolescents. Which statement by the student indicates a need of further teaching?
Answer: 4. "Encourage adolescents to learn together through pictures and short stories."
A nurse provides instructions to a group of adolescents about ways to prevent obesity. Which statements made by an adolescent indicates a need for further learning? Select all that apply.
Answer: 4. "I should make a decision about the health and health promotion of an adolescent."
A nurse educates a group of teenagers about the physical changes they will experience. What statement made by the teenager shows inadequate learning?
Answer: 4. "My bones will grow at a decreased rate."
A nursing instructor asks a nursing student about the warning signs that may be seen in an adolescent one month before suicide is attempted. What statement indicates a need for further education?
Answer: 4. A suicidal adolescent may avoid speaking about suicidal thoughts
A nurse in the clinic is taking the health history of a 16-year-old. When the nurse asks questions concerning sexual activity, the adolescent begins to perspire and hyperventilate. As her anxiety increases, she indicates that she feels dizzy and short of breath and that her heart is racing. What condition does the nurse identify?
Answer: 4. Hyperventilation syndrome
An adolescent who works out 6 hours a day reports not eating well, weight loss, and an absence of menses for the past few months. Which nursing intervention is most appropriate?
Answer: 4. Modify the adolescent's diet to incorporate more nutrients.
A nursing instructor asks a nursing student about the health risks faced by adolescents. Which statements by the student indicate inadequate learning? Select all that apply.
Answers: 2. "Eating disorders are more common in teen boys than girls." 3. "The incidence of substance abuse among adolescents in high school is low."
An adolescent reports pain in the scrotum and is having dysuria and pyuria. The nurse observes redness and swelling in the scrotal part. What penile abnormality does the nurse infer from these findings?
Answer: 2. Epididymitis
An eighth-grade teacher reports to a school nurse that a student has suddenly dropped out of activities, has been receiving bad grades, has a flat affect, and cries for no specific reason. Which familial factors should be investigated to identify the cause of this behavior? Select all that apply.
Answer: 2. Parental loss, 3. Unavailable parents, 5. Child abuse or neglect
A 17-year-old adolescent with a history of asthma is brought to the emergency department in respiratory distress. A nurse immediately places the client in a bed with the head of the bed elevated and administers oxygen with a facemask. The primary healthcare provider performs a physical assessment and admits the adolescent to the pediatric unit. What is the priority nursing intervention in regard to the primary healthcare provider's prescriptions?
Answer: 1. Administering the nebulizer treatment to facilitate breathing
A nursing instructor asks a nursing student about the formal operations stage of Piaget's theory of cognitive development. Which of these statements by the student indicate a need for further teaching? Select all that apply.
Answer: 2. During this stage, there's an absence of egocentric thought, 3. During this stage, reversibility in thought is the primary characteristic.
A nurse is assessing the impact of pregnancy on the social aspect of an adolescent girl's life. Which statement by the adolescent indicates that the pregnancy is affecting the social aspect of her life directly?
Answer: 1. "I am having a lot of trouble in school."
A 16-year-old male asks the nurse about the use of condoms. He states, "I've used condoms in the past, but I'm not sure I'm using them correctly." What should be included as part of the teaching plan about condoms?
Answer: 2. The condom must be positioned after an erection has occurred.
A 19-year-old primigravida in the first trimester of pregnancy is diagnosed with gonorrhea. What dosage of ceftriaxone is recommended to prevent the transmission of gonorrhea?
Answer: 250 mg started immediately
A young adolescent who reports abdominal bloating, pelvic fullness, edema of the lower extremities, and breast tenderness is diagnosed as premenstrual syndrome. What is the primary responsibility of the nurse?
Answer: 1. Client education
After an assessment, a nurse suspects that an adolescent has anorexia nervosa. Which characteristics may have been observed in the adolescent? Select all that apply.
Answer: 1. Denying illness, 4. Dismissing food, 5. Maintaining rigid body control
An adolescent is found to have type 1 diabetes. The nurse plans to teach the adolescent that dietary control and exercise can help regulate the disorder. What additional information should the nurse include in the teaching plan? Select all that apply.
Answer: 1. Insulin therapy, 3. Blood glucose monitoring, 5. adherence to the treatment regimen
After an assessment, an adolescent is diagnosed with a perceived inability to ingest food. Which nursing interventions would be appropriate for identifying hyponatremia? Select all that apply.
Answer: 1. Monitor vital signs, 2. Monitor fluid and electrolyte status
An adolescent client presents to the clinic with complaints of absence of menses for two months. What should the nurse do next?
Answer: 1. The nurse should ask the adolescent to take a pregnancy test.
A nursing instructor asks a nursing student to provide information about adolescents. Which statement made by the student indicates the need of further teaching?
Answer: 2. "Adolescents accept their society and its values."
A nurse is educating a group of teenage girls about dietary sources of iron. Which statement by one of the teenagers indicates to the nurse the need for more instruction?
Answer: 2. "We need 8 mg of iron each day."
An HIV-infected pregnant adolescent does not want a cesarean birth. Which finding would indicate the increased risk of perinatal transmission via vaginal birth?
Answer: 2. A viral load of 1,200 copies/mL
A nurse is conducting a health class for adolescents. What modifiable risk factor, most closely associated with the development of coronary heart disease (CHD) in both men and women, should the nurse discuss?
Answer: 2. Cigarette smoking
A pregnant adolescent reports genital warts. What interventions would reduce the discomfort? Select all that apply.
Answer: 2. Consider cryotherapy, 3. Bathe with an oatmeal solution, 4. Wear loose-fitting cotton clothes
An adolescent on gonadotropin-releasing hormone agonist therapy reports hot flashes and an absence of menses. Which treatment would be most appropriate?
Answer: 2. Counseling
An adolescent with type 1 diabetes is brought to the emergency department in ketoacidosis. The adolescent admits to not adhering to the diabetic regimen. What can the nurse do to help the adolescent become more accepting of the diabetic regimen?
Answer: 2. Encourage the adolescent to express feelings about having diabetes.
After an assessment, a nurse observes a feeling of an altered perception of body appearance in an adolescent. Which nursing interventions would be beneficial in this situation? Select all that apply.
Answer: 3. Providing a therapeutic discussion of personal attributes perceived as positive. 4. Encouraging a discussion of maladaptive behaviors surrounding food and fluid intake. 5. Involving the adolescent in activities designed to promote a positive image of self-worth and accomplishment
A primary healthcare provider recommends that an adolescent with the diagnosis of osteogenic sarcoma have the affected leg amputated and then be treated with chemotherapy. The parents are concerned about what to tell their child and ask the nurse for advice. What should the nurse suggest they discuss?
Answer: 3. The amputation and information about chemotherapy
A girl comes to the physician's office for her 14-year-old check-up. What is the most important anticipatory guidance that can be offered to the client?
Answer: 3. Ways to prevent accidents
A woman visits a primary healthcare provider and reports chills, severe abdominal pain, and increased vaginal discharge. Which infection does the nurse suspect the woman to have?
Answer: 4. Pelvic inflammatory disease
A nurse explains the physical sensation that a 13-year-old client will feel when a needle punctures the skin to draw blood. What instructional method would the nurse use?
Answer: 4. Preparatory instruction
A client with recurrent episodes of nausea, vomiting, and abdominal pain arrives at the hospital. Assessments by the primary healthcare provider reveal that the cremasteric reflex is absent, and emergency surgery is performed. What is the likely diagnosis?
Answer: 4. Testicular torsion
A nurse needs to explain a procedure to an adolescent with the use of the analogy instructional method. Which of these actions should the nurse take? Select all that apply.
Answer: 4. Using images to describe the procedure to the client, 5. Asking the client about previous experience with the procedure
An adolescent has pinpoint pupils, respiratory depression, and cyanosis. Upon assessment, the school nurse observes needle marks on arms and legs. Which drug is the adolescent probably abusing?
Answer: narcotics
A registered nurse is teaching a client with dysmenorrhea about how to reduce the menstrual discomfort. Which statements made by the client indicate the need for further teaching? Select all that apply.
Answers: 1. "I will take a cold water bath.", 5. "I should not rub my abdomen because it will worsen the pain."
A nurse is working in a school health promotion program for adolescents. Which of these actions should be included in the assessment process? Select all that apply.
Answers: 1. The nurse should conduct a school violence assessment, 3. The nurse should try identifying individuals at risk for substance abuse, 5. The nurse should enquire about the presence of guns in the home to reduce the incidence of homicide.
A registered nurse is teaching a nursing student about sexual assault in teenagers. Which statement made by the nursing student indicates a need for further education? Select all that apply.
Answers: 2. "A sexual assault committed on a person above the age of consent is called statutory rape.", 4. "A rape that occurs when the assailant is 18 years of age or older is referred to as acquaintance rape."
A client visits a primary healthcare provider because of painful urination. The primary healthcare provider confirms that the client has candidiasis. Which medications would be prescribed? Select all that apply.
Answers: 2. Miconazole, 3. Clotrimazole
A client's body mass index (BMI) is 31. This client has a history of hyperinsulinemia caused by an intracranial tumor. Which treatment strategies would be beneficial? Select all that apply.
Answers: 3. Octreotide, 4. Metformin