pediatrics chapter 14 and 15

A 14-year-old adolescent male tells a nurse, "My trunk seems so short compared to my legs. Do I have any problem?" What is the nurse's best response? 1 "You are completely normal." 2 "You should do a lot of exercises." 3 "You require growth pills." 4 "You should have your testosterone levels checked."

1

What is the primary oral problem in children and adolescents? 1 Dental caries 2 Malocclusion 3 Dental injury 4 Periodontal disease

1

According to Freud, middle childhood is associated with an increase in relationships with: 1 Older children 2 Same-sex peers 3 Younger children 4 Opposite-sex peers

2

How long after the appearance of the first pubescent changes does the menarche, or the first menstruation, occur? 1 3 years 2 15 months 3 18 months 4 2 years

4

Why do peer relationships play a significant role during adolescence? 1 Adolescents dislike their parents. 2 Adolescents no longer need parental control. 3 Peer relationships promote a sense of individuality in adolescents. 4 Peer relationships provide adolescents with a source of social reinforcement.

4

A parent of a 6-year-old child is worried, because the child brings toys from a friend's house without asking and often cheats in a game to win. What does the nurse infer from the child's behavior? 1 The child has normal behavior. 2 The child lacks parental control. 3 The child has borderline personality disorder. 4 The child wants to grab the attention of parents

1

An adolescent is brought to the emergency department after sustaining a small clean cut to his right thumb. The nurse learns that the adolescent sustained injury with a clean, unused knife. On examination, the nurse finds that the cut measured 1 × 1 cm and is not contaminated. The adolescent has been immunized against tetanus in childhood but has never taken a booster dose. What should be the most appropriate step of the nurse? 1 Inform the parent that the adolescent requires tetanus booster dose. 2 Inform the parent that the adolescent requires tetanus immunoglobulin. 3 Inform the parent that tetanus injection is not needed for the adolescent. 4 Inform the parent that the adolescent requires hospital admission immediately

1

An adolescent tells the nurse "I grew up in a rural area and have recently moved to New York City. I don't feel like I fit in. I really find it difficult to make friends here." What suggestion should the nurse give to this adolescent? 1 "You join a club at school in your free time." 2 "You should go online to find friends." 3 "You should change schools." 4 "You should read up about the things that your peers talk about."

1

During a home visit, the nurse assesses the growth and development of a 7-year-old child. After the assessment, the nurse documents that the child's physical development is inadequate. Which physical characteristic did the nurse find in the child? 1 Decreased leg length in relation to height 2 Decreased head circumference in relation to height 3 Decreased waist circumference in relation to height 4 Increased arm length in relation to other parts of body

1

Girls experience an increase in weight and fat deposition during puberty. Nursing considerations related to this fact include what? 1 Giving reassurance that these changes are normal 2 Suggesting dietary measures to control weight gain 3 Encouraging a low-fat diet to prevent fat deposition 4 Recommending increased exercise to control weight gain

1

Moral development in late adolescence is best characterized by what? 1 Serious questioning of existing moral values 2 Acceptance of the decisions or point of view of parents 3 Adoption of their parents' set of moral values and beliefs 4 Basing of decisions on an externalized set of moral principles

1

The nurse is administering meningococcal vaccine (MCV) to a 12-year-old adolescent. What instruction does the nurse give to the patient? 1 "You will have to take a booster dose after 4 years." 2 "You need not take a booster dose of this vaccine." 3 "You need to take a booster dose on an annual basis." 4 "You can take the booster dose between 13 and 18 years of age

1

The nurse is administering meningococcal vaccine (MCV) to a 12-year-old adolescent. What instruction does the nurse give to the patient? 1 "You will have to take a booster dose after 4 years." 2 "You need not take a booster dose of this vaccine." 3 "You need to take a booster dose on an annual basis." 4 "You can take the booster dose between 13 and 18 years of age."

1

The nurse is assessing a female child according to Tanner's stages of development. Which physiologic developmental event should the nurse expect during the first of Tanner's stages of development? 1 Elevation of papillae 2 Enlargement of areolar diameter 3 Recession of areola into general contour to project papilla 4 Projection of areola and papilla to form a secondary mound

1

The nurse is assessing the immunization history of an adolescent. The nurse finds that the child has not received the tetanus booster dose. What is the likely recommendation for the adolescent? 1 Tdap (tetanus, diphtheria, acellular pertussis) vaccine 2 Meningococcal vaccine (MCV4) 3 Quadrivalent human papillomavirus (HPV) vaccine 4 Hepatitis B vaccine

1

The nurse is caring for a 7-year-old child. The nurse finds that the child is very curious about God and states that God is very loving towards children. Which statement appropriately describes spiritual development in the child? 1 The child assumes God to be a human. 2 The child feels illness to be due to God's anger. 3 The child does not believe in hell or heaven. 4 The child's beliefs are not influenced by culture.

1

The nurse is interviewing an adolescent in the hospital. Which nursing action indicates that the nurse is following the nursing care guidelines? 1 Showing concern for the adolescent's perspective 2 Judging the adolescent based on his or her answers 3 Offering a threatening explanation for the questions asked 4 Interviewing the adolescent in the presence of his or her parents

1

The nurse is teaching a community health promotion class to parents and school-age children related to bicycle safety. Issues to cover in the sessions include what? 1 Walking bicycles through busy intersections 2 Installing reflectors only on bicycles that are to be ridden at night 3 Wearing a bicycle helmet only if the child is planning to ride in traffic 4 Riding bicycles against, rather than with, traffic so the rider can see the cars

1

The nurse manager instructs a nurse to conduct a group activity for assessing physical and mental development in 6- to 12-year old children. Which suggestion given by the nurse manager is appropriate? 1 "Give grades and material rewards to all the children after performing the task." 2 "Compare the performance of one child with the other children based on grades." 3 "Do not allow the children to interact with each other while doing the task." 4 "A child who performs well in all the tasks can be considered as mentally fit."

1

The parent of an adolescent tells the nurse, "I am curious about why my child looks a little unusual. His hands and feet appear larger than before." What is the best response by the nurse? 1 "Hands and feet appear to be larger in adolescence." 2 "Everything will be alright in a few days." 3 "You must speak to the health care provider." 4 "This is unusual. Let me assess your child."

1

The parents of a 10-year-old child reveal to the nurse that after watching the news of a child-kidnapping case, their child is experiencing nightmares and bedwetting. The child has also stopped going out to play due to the fear of being kidnapped. Which priority intervention does the nurse employ for the child? 1 Teach relaxation techniques to the child. 2 Encourage the child to play indoor games. 3 Explain the reason for nightmares to the child. 4 Suggest that bedwetting is not a good habit.

1

The parents of a 7-year-old child want to know about growth and development in their child. Which tasks does the nurse mention as appropriate for the child? 1 The child combs his or own hair without help. 2 The child can take care of younger siblings. 3 The child can use a common tool such as a screwdriver. 4 The child can raise pets.

1

The registered nurse is teaching a group of student nurses about body art. Which information should the nurse include in the teaching plan? 1 Piercing may result in cyst or keloid formation. 2 Punching guns are useful for piercing the nose and ear lobes. 3 Sterilized needle usage may cause human immune deficiency virus (HIV) infection. 4 Contaminated tattoo ink may cause tuberculous skin infections.

1

What is an important consideration in the prevention of injuries during middle childhood? 1 Most injuries occur in or near school or home. 2 Peer pressure is not strong enough to affect risk-taking behavior. 3 Injuries from burns are the highest at this age because of fascination with fire. 4 Lack of muscle coordination and control results in an increased incidence of injuries.

1

Which statement is most descriptive of the spiritual development of the older adolescent? 1 Beliefs become more abstract. 2 Strict observance of religious customs is common. 3 Rituals and practices become increasingly important. 4 Emphasis is placed on external manifestations, such as whether a person goes to church.

1

Which tooth types usually erupt when the child is 6 years old? 1 First molar 2 Third molar 3 First bicuspid 4 Second molar

1

While assessing a child, the nurse fills two identical glasses with equal amounts of water and then pours the water from one of the two glasses into a third glass, which is wider in size. The child recognizes that the amount of water in the third glass is the same as before. What is the minimum age at which children should understand that the amount has not changed?? 1 6 years 2 8 years 3 10 years 4 12 years

1

While caring for hospitalized adolescents, the nurse observes that sometimes they are skeptical of their parents' religious beliefs and practices. What should the nurse recognize this as? 1 Normal in spiritual development 2 Abnormal in spiritual development 3 Related to illness and occurs only in times of crisis 4 Related to the parents' inability to adequately explain their beliefs and practices

1

While performing assessments of students at a grade school, the nurse learns that some are latchkey children. Which characteristics does the nurse find in the latchkey children? 1 The children spend most of their time at home. 2 The children are brave and free from illness. 3 The children have a large number of friends. 4 The children are frequently supervised by adults.

1

The primary health care provider asks a nurse to determine the stage of pubertal development in an adolescent female based on Tanner stages. What should the nurse assess? Select all that apply. 1 The distribution of pubic hair 2 The size of the vagina 3 The length of the clitoris 4 The development of breasts 5 The growth of body hair

1,4

Sexual maturation in girls occurs in a particular sequence. Arrange the maturational changes in the correct sequence.

1. Breast changes 2.Growth of pubic hair 3. Axillary hair 4. Menstruation

The nursing instructor is teaching a group of students about different stages of puberty. Which stages of puberty does the nurse mention? Select all that apply. 1 Prepubescence 2 Postpubescence 3 Adolescence 4 Early adolescence 5 Late Adolescence

12

An adolescent is accompanied by his mother for an annual physical examination. On which topic does the nurse, drawing on knowledge of this age group, avoid questioning the adolescent? Select all that apply. 1 Alcohol use 2 Sexual activity 3 Cigarette smoking 4 School performance 5 Use of car seat belts

123

The nurse is assessing the social factors that influence an adolescent. What factors does the nurse assess? Select all that apply. 1 Relationships with parents 2 Relationships with peers 3 Interests and activities 4 Sexual activity 5 Self-concept and body image

1234

The nurse recognizes that bullying is a common occurrence during the school-age years. How are the victims of bullies affected? Select all that apply. 1 Nightmares 2 Social isolation 3 Increased self-esteem 4 Psychologic distress 5 Increased self-harm behaviors

1245

What dimensions should be included in any consideration of an adolescent's sexual orientation? Select all that apply. 1 Attraction 2 Fantasy 3 Masturbation 4 Actual sexual behavior 5 Self-labeling or group affiliation

1245

What physiologic changes occur in children due to pubertal changes? Select all that apply. 1 Strength of the heart increases. 2 Systolic blood pressure increases. 3 Basal heat production increases. 4 Pulse rate decreases. 5 Respiratory volume increases.

1245

The school nurse is teaching a class on safety. Which activities require protective athletic gear? Select all that apply. 1 Football 2 Lacrosse 3 Swimming 4 Gymnastics 5 Skateboarding

125

What guidelines for interviewing adolescents do nurses need to follow? Select all that apply. 1 Ensure confidentiality and privacy. 2 Begin with the most sensitive issues to establish trust. 3 Use personal judgments and assumptions when indicated. 4 Offer a nonthreatening explanation for the questions you ask. 5 Restate and reflect back to the adolescent what he or she has said

145

A 6-year-old child's parent tells the nurse that the child has a loose tooth and is worried about it. Which appropriate response does the nurse give to the child's parent? 1 "The child has a chronic disease." 2 "It is a normal finding at this age." 3 "The child has calcium deficiency." 4 "It occurs due to vitamin A deficiency."

2

A child presents with toothache and inability to chew properly. Following a dental assessment, the nurse finds that the child has malocclusion. Which treatment strategy is included in the treatment plan to relieve the child from symptoms? 1 Flossing 2 Orthodontics 3 Tooth replacement 4 Fluoride supplements

2

A parent tells the nurse that her 8-year-old child throws a fit each night, refusing to go to bed. What interventions can the nurse suggest to the mother to help promote sleep in the school-age child? 1 Forcing the child to take a nap after school 2 Encouraging a quiet activity before bedtime 3 Having the child watch a movie before bedtime 4 Moving up the bedtime to encourage more sleep

2

A workshop is conducted for primary school teachers. In the workshop the nurse teaches cognitive development in middle childhood. Which statement made by the nurse indicates effective teaching? 1 "During middle childhood, children have a rigid and egocentric view." 2 "During middle childhood, children learn from their past experiences." 3 "During middle childhood, children cannot memorize symbols." 4 "During middle childhood, children have very low perceptual thinking."

2

According to Erikson's theory, what is the major developmental crisis of an adolescent that focuses on the development of a sense of identity? 1 Establishing a sense of idealism 2 Establishing a sense of autonomy 3 Developing logical reasoning and abstract thinking 4 Learning to make choices by questioning the existing moral values

2

Adolescence is the peak age for being either a victim or an offender in injuries involving what? 1 Falls 2 Firearms 3 Drowning 4 Motor vehicles

2

An adolescent boy tells the school nurse that he is gay. On what knowledge should the nurse's response be based? 1 The nurse should feel open in discussing his or her own beliefs about homosexuality. 2 It is important to provide a nonthreatening environment for him to discuss his feelings. 3 He is too young to have had enough sexual activity to determine his sexual orientation. 4 Homosexual adolescents do not have concerns that differ from those of heterosexual adolescents.

2

By what is the onset of puberty in boys characterized? 1 Voice changes 2 Testicular enlargement 3 Growth of dark pubic hair 4 Increased size of the penis

2

During assessment, the nurse observes that the child's new secondary teeth are appearing too large for the face. Which stage of child development is the child in? 1 Inferiority stage 2 Ugly duckling stage 3 Prepubescence stage 4 Accomplishment stage

2

The nurse is assessing a 10-year-old female and finds that the girl has reached puberty at an early age. What finding has led the nurse to conclude the child has reached actual puberty? 1 Hoarsening of the voice 2 Beginning of menstruation 3 Development of breasts 4 Development of axillary and pubic hair

2

The nurse is conducting a class on sex and sexual activities with adolescents. What is the most appropriate approach? 1 Using dolls to teach the content 2 Presenting normal body functions straightforwardly 3 Referring the adolescents to their parents for sexual information 4 Delaying giving information about pregnancy until the adolescents are sexually active

2

The nurse is performing an assessment of a 7-year-old child. The child's parents report to the nurse that instead of studying, the child spends most of his time collecting stickers of cars and bikes. What does the nurse infer from the parents' report? 1 The child has very few friends. 2 The child enjoys collecting the stickers. 3 The child is feeling inferior in class. 4 The child has obsessive-compulsive disorder

2

The registered nurse is teaching a group of student nurses about sexual maturation. Which statement made by the student nurse indicates the need for further teaching? 1 "Thelarche occurs in girls between 8 and 13 years of age." 2 "The initial indication of puberty is the growth of hair on the mons pubis." 3 "Testicular enlargement usually occurs in boys between 9½ and 14 years of age." 4 "Girls whose breast development has not occurred by 13 years of age have pubertal delay.

2

What is a normal occurrence during puberty for males? 1 Obesity 2 Gynecomastia 3 Growth rate decline 4 Loss of lean body mass

2

What is the greatest single cause of death among adolescents? 1 Fire injuries 2 Physical injuries 3 Chemical injuries 4 Drowning injuries

2

What is the most appropriate way for the nurse to obtain sexual information from an adolescent? 1 By asking questions that include scientific terminology 2 By presenting normal body functions in a straightforward manner 3 By consulting the adolescent's parent for sexual information about the teen 4 By deferring asking questions regarding sexual matters unless the adolescent is sexually active

2

Which statement is descriptive of the social development of school-age children? 1 Identification with peers is minimal. 2 Children frequently have "best friends." 3 Boys and girls play equally with one another. 4 Peer approval is not yet an influence toward conformity.

2

Which statement is true about physical growth? 1 The average boy gains 2 to 8 inches in height during the growth spurt period. 2 Growth in height typically ceases 2 to 2½ years after menarche in girls. 3 The growth spurt begins in girls usually between 10½ and 16 years of age. 4 The average girl gains 7 to 25 kg in weight during the fast growth spurt period.

2

Following the dental assessment of a child, the nurse finds that the child has gingivitis. Which symptoms associated with gingivitis are found in the child? Select all that apply. 1 Destruction of teeth 2 Deposition of plaque 3 Inflammation of gums 4 Bleeding from the gums 5 Disruptive tooth arrangement

234

The nurse is assessing the health status of an adolescent. What precautions does the nurse take during the assessment? Select all that apply. 1 Ask the parents to accompany their adolescent. 2 Show concern for the adolescent's perspective. 3 Offer a nonthreatening explanation for the questions. 4 Avoid assumptions, judgments, and lectures. 5 Use language that the adolescent understands

2345

The nurse is assessing the health status of an adolescent. What precautions does the nurse take during the assessment? Select all that apply. 1 Ask the parents to accompany their adolescent. 2 Show concern for the adolescent's perspective. 3 Offer a nonthreatening explanation for the questions. 4 Avoid assumptions, judgments, and lectures. 5 Use language that the adolescent understands.

2345

The nurse is teaching health promotion activities to a group of adolescents. What is included in the teaching? Select all that apply. 1 "Fat intake should only be about half of your diet." 2 "Use safety apparel while driving." 3 "Use adequate sunscreen." 4 "Avoid alcohol during water sports." 5 "Refuse to ride with reckless drivers.

2345

The nursing instructor is teaching a group of students about sexual maturation in boys. What is included in the teaching? Select all that apply. 1 Testicular enlargement is the last pubescent change in boys. 2 Pubescent changes occur between 9.5 and 14 years of age. 3 Early puberty can be identified with the initial appearance of pubic hair. 4 Increasing muscularity and voice changes are characteristics of puberty. 5 Sometimes there is temporary breast enlargement in midpuberty.

2345

A parent reports to the nurse that the child is stressed by having to take an examination. Which symptoms associated with stress does the nurse find in the child? Select all that apply. 1 Projectile vomiting 2 Headache 3 Neck pain 4 Slow heart rate 5 Abdominal pain

235

After speaking with a 10-year-old child, the nurse advises the child to participate in an anti-bullying program. Which behaviors of the child might have led the nurse to give this advice? Select all that apply. 1 The child readily joins in with peers. 2 The child withdraws from social activities. 3 The child shows high levels of enthusiasm. 4 The child has verbalized suicidal ideations. 5 The child has poor academic performance.

24

The nurse is assessing a 10-year-old child in a pediatric unit. Which changes does the nurse observe that indicate the child's degree of physical maturity? Select all that apply. 1 Body muscle functionally mature 2 Increase in leg length in relation to height 3 Decrease in body weight with respect to age-appropriate weight 4 Decrease in head circumference in relation to height 5 Decrease in waist circumference in relation to height

245

What nursing care guidelines should be used when the nurse is interviewing adolescents? Select all that apply. 1 Using adolescent slang 2 Ensuring confidentiality and privacy 3 Interviewing adolescents with their parents 4 Maintaining objectivity and avoiding judgments 5 Offering a nonthreatening explanation for the questions you ask

245

A 12-year-old girl asks her mother, "What are tampons? One of my friends in school said that she uses them every month, because she has bleeding." Which action should the nurse advise the mother to employ in this situation? 1 Explain to the child that tampons are anticoagulants. 2 Instruct the child not to discuss the topic in school. 3 Discuss the menstrual cycle and use of tampons. 4 Suggest that the child discuss it with science teacher.

3

A 6-year-old child is bullying another child. The bullying child perceives that bullying is good. What is the reason behind it? 1 The child has abnormal behavior. 2 The child has aggressive behavior. 3 The child is not punished for misdeeds. 4 Another child bullies this child.

3

A parent tells the nurse, "I'm worried about my 13-year-old son. He hasn't started puberty, but my daughter did when she was 11 years old." What is the most appropriate explanation by the nurse? 1 "This is unusual and requires further evaluation of your son." 2 "This is unusual because the onset of pubescence is usually the same in siblings." 3 "This is normal because the onset of pubescence is usually earlier in girls than it is in boys." 4 "This is abnormal because the onset of pubescence is usually earlier in boys than it is in girls."

3

According to Erikson, in what stage of psychosocial development is the adolescent? 1 Trust versus mistrust 2 Initiative versus guile 3 Identity versus identity confusion 4 Autonomy versus shame and doubt

3

At a primary health care center, the nurse is explaining preadolescence and prepubescence to the parents of children 8 to 12 years of age. Which statement made by the nurse indicates effective teaching? 1 "The first sign of puberty can be seen in girls before 8 years of age." 2 "The onset of pubescence can be seen in boys at 9 years of age." 3 "Rapid growth and development are seen in children during prepubescence." 4 "The preadolescence period starts at 9 years and ends when the child is 11 years old."

3

Parents of a 10-year-old child are concerned that their child has been recently showing signs of low self-esteem. What should the nurse consider when discussing this issue with the parents? 1 Changing self-esteem is difficult after about age 5 years. 2 Self-esteem is the objective judgment of one's worthiness. 3 Transitory periods of lowered self-esteem are expected developmentally. 4 High self-esteem develops when parents show adequate love for the child.

3

Play takes on new dimensions in the school years. What are some of the ways in which play helps school-age children develop? 1 They learn to not experience guilt when they misbehave. 2 They learn that misfortunes are punishment for misdeeds. 3 They acquire mastery over themselves, their environment, and others. 4 They begin to understand the rules and behaviors of social interaction and the reasons behind them.

3

The nurse is assessing the sexual development of a female child. The nurse finds that breast buds have started developing, but pubic hair is still not visible in the child. What can the nurse infer regarding the sexual development of the patient? 1 The child has attained menarche. 2 The child has attained puberty. 3 The child has attained thelarche. 4 The child has attained adrenarche.

3

The parent of a 6-year-old child is worried because the child frequently suffers from diarrhea and stomach upset. What does the nurse tell the child's parent? 1 "The immune system in 6-year-old children is not well developed." 2 "The digestive system in 6-year-old children is not well developed." 3 "Children tend to acquire infections during the first two years of schooling." 4 "Children at age 6 eat less due to reduced appetite."

3

The parents of 9-year-old twins tell the nurse, "They've filled up their bedroom with collections of rocks, shells, stamps, and cars." The nurse should recognize that this behavior is characteristic of what? 1 Giftedness 2 Typical "twin" behavior 3 Cognitive development at this age 4 Psychosocial development at this age

3

The parents of a 12-year-old child complain to the nurse that the child asks them about masturbation after watching a contraceptive advertisement. The parents are anxious about their child. Which response of the nurse helps relieve the parents' anxiety? 1 The child has a mental disorder. 2 The child has a hormonal disorder. 3 It is an age-associated behavior. 4 The child needs psychiatric treatment.

3

The parents of a 16-year-old adolescent tell the nurse "Our child is so well-mannered, always listens to us and does what we say. Our child always asks us first before making any decision. He also has a lot of friends." What does the nurse interpret from this? 1 The adolescent shows responsible and mature behavior. 2 The adolescent has a negative identity in the society. 3 The adolescent has a less developed sense of personal identity. 4 The adolescent does not have a well-developed sense of group identity.

3

The parents of an 8-year-old girl tell the nurse that their daughter wants to join a soccer team. What is the most appropriate recommendation, based in the nurse's knowledge of this age group? 1 Organized sports, such as soccer, are not appropriate at this age. 2 Competition is detrimental to the establishment of a positive self-image. 3 Sports participation is encouraged if the sport is appropriate to the child's abilities. 4 Girls should compete only against girls because at this age boys are larger and have more muscle mass.

3

The registered nurse is teaching the parents of adolescent children about guidance during hospitalization. Which behavior should the nurse exclude from the teaching plan? 1 Respecting the adolescent's privacy 2 Refraining from criticism about no-win topics 3 Comparing the adolescent's behavior to a sibling's behavior 4 Listening to the adolescent's views, even when he or she disagrees with your views

3

The school nurse is asked to speak with the parents of a 10-year-old boy who has been bullying other children. What knowledge should the nurse's response should be based on? 1 Bullying at this age is considered normal. 2 Children who bully others usually join gangs. 3 Bullying often manifests itself in children who witness violence or abuse at home. 4 Bullying is a short-term problem that is generally outgrown by the end of the school-age years.

3

The school nurse is discussing dental health with some children in first grade. Which teaching should be included? 1 Teaching how to floss teeth properly 2 Recommending nonfluoridated toothpaste 3 Emphasizing the importance of brushing before bedtime 4 Recommending a toothbrush with hard nylon bristles to get between the teeth

3

What has the most significant impact on the socialization of school-age children? 1 Parents 2 Teachers 3 Classmates 4 The child's self-concept

3

What is an important consideration for the school nurse planning a class on injury prevention for adolescents? 1 Adolescents are generally not risk takers. 2 Adolescents can anticipate the long-term consequences of serious injuries. 3 Adolescents need to discharge energy, often at the expense of logical thinking. 4 During adolescence, participation in sports should be limited to prevent permanent injuries.

3

What is the foundation for the process of developing a sexual identity in young adolescents? 1 Engaging in sexual activity 2 Abstaining from sexual activity 3 Forming close friendships with same-sex peers 4 Forming close friendships with opposite-sex peers

3

What should the nurse consider on encountering an adolescent girl whose breasts have not begun to develop by age 13 years? 1 That this is a normal finding 2 That the girl may be pregnant 3 That the girl is experiencing pubertal delay 4 That the girl has a genetic tendency to late development

3

Which behavior is most characteristic of the concrete operations stage of cognitive development? 1 Inability to put oneself in another's place 2 Progression from reflex to imitative behavior 3 Increasingly logical and coherent thought processes 4 Ability to think in abstract terms and draw logical conclusions

3

Which characteristic is observed in latchkey children? 1 They are brave. 2 They bully other children. 3 They prefer remaining isolated. 4 They have confidence.

3

Why is dental hygiene especially important during the school-age years? 1 Because many children eat diets that are low in sugar 2 Because children at this age do not need help brushing 3 Because the permanent teeth erupt during the school years 4 Because regular fluoride supplementation is not necessary at this age

3

he parents of an 8-year-old girl tell the nurse that their daughter wants to join a soccer team. What is the most appropriate recommendation, based in the nurse's knowledge of this age group? 1 Organized sports, such as soccer, are not appropriate at this age. 2 Competition is detrimental to the establishment of a positive self-image. 3 Sports participation is encouraged if the sport is appropriate to the child's abilities. 4 Girls should compete only against girls because at this age boys are larger and have more muscle mass.

3

What instructions should the nurse include when instructing the parents of school-age children in ways to reduce the risk of injury in sports? Select all that apply. 1 Encourage lots of competitive activities. 2 Discourage participation in sports at this age. 3 Encourage physical activity outside of sports. 4 Have children wear helmets and other protective equipment. 5 Have children compete against kids who are about the same size.

3,4,5

The nurse is teaching a group of parents about measures for the prevention of dental caries in their children. Which statements made by the parents indicate effective learning? Select all that apply. 1 "We should reduce fatty foods in our children's diet." 2 "We should not let the children sleep too much." 3 "We should teach the children the correct way to floss their teeth." 4 "We should reduce our children's intake of fermentable carbohydrates." 5 "We should make sure our children brush twice a day."

345

Which activities are typical adaptive behaviors for a 12-year-old child? Select all that apply. 1 The child spends a lot of time alone. 2 The child is less resistant and stubborn. 3 The child is able to do easy repair work. 4 The child counts backward from 20 to 1. 5 The child looks after his or her own needs and the needs of others.

35

A group of boys has formed a club that is open to other boys who like to play sports. How is this behavior best described? 1 Bullying 2 Promoting gang violence 3 Promoting isolation and exclusion 4 Normal social development of school-age children

4

A mother shouts at her 7-year-old child for doing wrong. Two days after this incident, the child develops fever. The child believes that fever is a punishment by God. What does the nurse interpret from this condition? 1 The child may require spiritual healing. 2 The child has a psychologic disorder. 3 The child is suffering from depression. 4 It is a normal behavior seen at this age

4

A mother shouts at her 7-year-old child for doing wrong. Two days after this incident, the child develops fever. The child believes that fever is a punishment by God. What does the nurse interpret from this condition? 1 The child may require spiritual healing. 2 The child has a psychologic disorder. 3 The child is suffering from depression. 4 It is a normal behavior seen at this age.

4

A nurse receives a call from a parent who says that her 12-year-old son just lost a permanent tooth while playing soccer. What instruction should the nurse give to the parent to increase the likelihood that the tooth can be re-implanted? 1 Do not rinse the tooth. 2 Hold the tooth by its root area. 3 Call the dentist first thing the next morning. 4 Place the avulsed tooth in cold milk for transport to the dentist.

4

According to statistics, which type of injury is the leading cause of unintentional injury and death in adolescence? 1 Homicide 2 Drownings 3 Drug overdoses 4 Motor vehicle crashes

4

After interacting with the parents of a 10-year-old child, the nurse understands that they are effectively following guidelines to help the child in getting good grades in school. Which statement made by the parents supports the nurse's conclusion? 1 "We discuss all our concerns with the teacher at the annual parent-teacher conference." 2 "We have arranged home tutoring sessions for our child twice a day." 3 "We are strict and allow our child to watch television only on achieving good grades." 4 "We help our child with homework by explaining the questions and avoiding giving answers."

4

After receiving the immunization history of a 12-year-old female, the nurse plans to administer the (human papilloma virus) HPV vaccine. What is the purpose of administering this vaccine? 1 To prevent meningitis 2 To prevent pertussis 3 To prevent genital warts 4 To prevent cervical cancers

4

Although puberty can begin in either sex after the age of 8 years, at what age does puberty generally begin for girls and boys? 1 8 years for girls, 10 years for boys 2 9 years for girls, 11 years for boys 3 12 years for girls, 10 years for boys 4 10 years for girls, 12 years for boys

4

During middle childhood, some children tend to tell stories to their parents by exaggerating events at school. What suggestion does the nurse give to the parents to manage this? 1 Consult to a child psychiatrist immediately. 2 Inform the child's teacher immediately. 3 Check with the peers and playmates of the child. 4 Teach the difference between reality and fantasy

4

Following the assessment of a 14-year-old adolescent female, the nurse documents that the female has pubertal delay. Which assessment finding has led the nurse to conclude this? 1 The girl has little axillary hair. 2 The girl is shorter than others at this age. 3 The girl has not had any menstrual flow. 4 The girl does not have complete breast development.

4

Following the assessment of a 15-year-old adolescent boy, the nurse documents that the boy has pubertal delay. Which assessment finding has led the nurse to conclude this? 1 The patient has less body hair. 2 The patient has a small penis. 3 The patient has a low-pitched voice. 4 The patient does not have an enlarged scrotum.

4

How does the onset of the pubertal growth spurt compare in girls and boys? 1 It is about the same in both boys and girls. 2 It occurs about 1 year earlier in boys than in girls. 3 It occurs about 3 years earlier in girls than in boys. 4 It occurs about 2 years earlier in girls than in boys.

4

In which of Tanner's stages of development does the scrotum begin to become darker and the voice begin to change? 1 Stage I 2 Stage II 3 Stage V 4 Stage IV

4

Nursing interventions to promote health during middle childhood should include what? 1 Instructing parents to defer questions about sex until the child reaches adolescence 2 Stressing the need for increased calorie intake to meet the increased demands on the body 3 Advising parents that the child will need decreasing amounts of rest toward the end of this period 4 Educating the child and parents about the need for effective dental hygiene because these are the years in which permanent teeth erupt

4

The mother of a prepubescent girl asks the nurse about the first signs of puberty. What is the best response by the nurse? 1 Menarche 2 An increase in height 3 The appearance of pubic hair 4 The appearance of breast buds

4

The nurse is performing an assessment of a 9-year-old child. The nurse finds that the child's mother is very concerned about the child's appearance because the child is very thin. What is the nurse's best response? 1 "Don't worry, many children are underweight during this age and this problem corrects itself as they become better eaters." 2 "Because your child is thin, you need to provide more fatty foods in the child's diet." 3 "Encourage your child to play indoor games so that too much exercise won't lead to additional weight loss." 4 "The child looks thinner now because of the reduction and redistribution of fat throughout the body. This is normal."

4

The nurse teaches progressive relaxation of muscle groups to a 12-year-old child who is under stress. Which sign of stress would the nurse have likely found in the child? 1 Calmness 2 Enthusiasm 3 Bradycardia 4 Facial redness

4

The registered nurse is teaching a group of student nurses about sexuality and psychological health of adolescents. What information should the nurse exclude from the teaching plan? 1 A child between 11 and 14 years of age shows wide mood swings. 2 A child between 11 and 14 years of age engages in intense daydreaming. 3 An individual between 18 and 20 years of age may publicly identify as gay, lesbian, or bisexual. 4 An individual between 15 and 17 years of age forms stable relationships and attachment to others.

4

The school nurse is teaching a class on injury prevention. What should be included in a discussion of firearms? 1 Adolescents are too young to use guns properly for hunting. 2 Carrying of guns is on the rise among adolescents, primarily inner-city youth. 3 Nonpowder guns (air rifles, BB guns) are relatively safe alternatives to powder guns. 4 Adolescence is the peak age for being either a victim or an offender in an injury involving a firearm.

4

What description characterizes normal cognition during the period of early adolescence (11 to 14 years)? 1 Development of capacity for abstract thinking 2 Ability to perceive and act on long-range options 3 Enjoyment of intellectual powers, often in idealistic terms 4 Exploration of new-found ability for limited abstract thought

4

What does Erikson describe in his theory of psychosocial development as the most important task for school-age children? 1 Sense of autonomy, in which children want to do things for themselves 2 Sense of trust, in which children form basic trust in the people around them 3 Sense of initiative, in which children explore their world with all their senses and powers 4 Sense of industry, in which children have access to tasks that need to be done and are able to complete them

4

What instruction should the nurse include when giving parents guidelines about helping their children in school? 1 Punish children who fail to perform adequately. 2 Help children as much as possible with their homework. 3 Accept responsibility for children's successes and failures. 4 Communicate with teachers if there appears to be a problem.

4

What is a characteristic of the psychosocial development of school-age children? 1 A developing sense of initiative is important. 2 Peer approval has not yet become a motivating factor. 3 Motivation comes from extrinsic rather than intrinsic sources. 4 Feelings of inferiority can be derived from children themselves or from the environment.

4

What is an important consideration related to childhood stress? 1 Children do not have coping strategies. 2 Children should be protected from stress. 3 Parents cannot prepare children for stress. 4 Children 7 to 12 years of age are capable of identifying physiologic stress responses.

4

What is the average age of second molar eruption in the child? 1 6-7 years 2 7-8 years 3 10-11 years 4 12-13 years

4

What is the most appropriate treatment plan for an adolescent who has not previously received two doses of hepatitis B vaccine and the varicella vaccine? 1 The varicella vaccine is enough to protect the adolescent against hepatitis B. 2 Two doses of hepatitis B are enough to warrant proper protection against the disease. 3 The adolescent should be given another varicella vaccine and another hepatitis B vaccine. 4 The adolescent should be vaccinated against hepatitis B virus with three doses of the vaccine.

4

What maturation of systems is associated with school-age children? 1 Bladder capacity is greater in boys than in girls. 2 The immune system becomes less competent in its ability to localize infections. 3 Bones cease to ossify and yield to pressure, and muscle tissue pulls more readily. 4 The heart grows more slowly during the middle years and is smaller in relation to the rest of the body.

4

What should the nurse understand about body image during the adolescent years? 1 Teenagers are not acutely aware of their appearance. 2 Most adolescents feel comfortable with their body image. 3 It does not seem to have a great impact on the teen's self-concept. 4 Body image established during adolescence is retained throughout life.

4

A nurse is performing an assessment of a 12-year-old child. After the assessment, the nurse documents that the child has impaired growth and development. Which personal and social traits has the nurse found in the child? Select all that apply. 1 The child is diplomatic. 2 The child has a few selective friends. 3 The child wants to please the mother. 4 The child spends most of his or her time alone. 5 The child plays only with the same sex group.

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