PN108 PrepU Chapter 27
The nurse is caring for a 12-year-old boy. During a routine wellness examination, the mother tells the nurse that the boy's father has really been teasing him about his sexual development and the boy is very embarrassed. The mother asks for some guidance. How should the nurse respond?
"Advise your husband that good-natured teasing must be avoided at this age."
During a health maintenance visit, a 15-year-old girl mentions that she is not happy with being overweight. Which approach is best for the nurse to take?
"What specifically have you been noticing?"
Based on Erikson's developmental theory, what is the major developmental task of the adolescent?
Finding an identity
Which intervention would probably be most effective in preventing an adolescent from attempting suicide with an overdose again?
Helping him learn better problem solving
The school nurse is teaching parents risk factors for suicide in adolescents. What would the nurse discuss? Select all that apply.
Mental health changes History of previous suicide attempt Family disorganization Substance abuse
A 17-year-old girl has come to the clinic to get a rubella immunization that is required by the college she plans to attend. Before administering this immunization the child should have which of the following?
Pregnancy test
The nurse teaches parents of adolescents that adolescents need the support of parents and nurses to facilitate healthy lifestyles. What should be a priority focus of this guidance?
Reducing risk-taking behavior
The nurse knows that barriers to the adolescent's health and successful achievement of the tasks of adolescence exist. What is the major barrier to health for this population?
Socioeconomic
The nurse is admitting a 15-year-old to the pediatric unit. What does the nurse recognize as a priority for this child?
The child's need for privacy should be respected.
Jeff, a 13-year-old and his mother are in the office for a annual visit and his mother jokes openly in front of you about the changes in her son's voice and the fact that now he has hair under his armpits. What is an appropriate response for the nurse when she is talking with the mother?
"Remember, he is probably very self-conscious and may be embarrassed by your statements."
The nurse is teaching the parents of a 12-year-old boy about appropriate approaches when raising an adolescent. Which comment should be included in the discussion?
"Try to be open to his views."
A 15-year-old female adolescent is seen in the office. During the examination, the client asks the nurse about having sex. Her mother states that she has been asking questions lately regarding this topic. Which should be the nurse's response?`
"We can discuss that as well as other aspects of sexuality."
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 17-year-old girl needs to increase her iron intake but is concerned about weight gain. The nurse will suggest which foods?
Chicken, whole-wheat bread, watermelon
A nurse is attending to a group of boys at a school. The nurse is required to document the sexual development in boys on a regular basis. The nurse would anticipate which clients having the highest incidence of nocturnal emissions?
Clients who are showing pubertal changes
The school nurse is planning to teach a segment on smoking during the freshman health classes. The nurse is aware that this needs to be a forum rather than a lecture. Which of the following techniques will also help deliver a "don't smoke" message?
Listening to all comments nonjudgmentally
The nurse is promoting learning and school attendance to a 13-year-old girl. Which factor will affect the child's attitude most?
Peer group behaviors and attitudes
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.
T/F: Suicide is so common in adolescents it ranks as the third leading cause of death in the 10- to 24-year-old age group.
True
The nurse teaching safety to teens knows that which of these is the leading cause of death among adolescents?
Unintentional injuries
The period in which physical changes relating to sexual maturation take place is called:
puberty
The school nurse is discussing various topics with a group of adolescent girls. One of the girls states, "I just want to be pretty and to look like everyone else." The nurse recognizes that the girl's feelings about herself and her body relate to the development of:
self-esteem.
An adolescent is concerned that although he has pubic hair, he has no facial hair yet. He wishes facial hair would grow to cover acne lesions. You would advise him that facial hair
usually follows pubic hair growth.
Jenny is a 15 year old that is being seen today in the clinic accompanied by her mother. The mother states, "She ignores what we tell her and looks to her friends for answers and support. What should we do?" After talking with Jenny's mother, which statement by her mother indicates understanding of the basis for Jenny's behavior?
"Adolescents her age all do this and it will get better with time."
An adolescent shares with you that she wishes her breasts would grow larger. Which of the following would be the best response initially?
"Breast growth usually stops by the age of 16 years. What is the reason you were hoping yours would grow more?"
The nurse is planning to talk to a 12½-year-old boy who says, "I am too short! Girls are taller than I am. Guess I won't be playing basketball." What points of information will the nurse share? Select all that apply.
"Girls begin to grow rapidly at a younger age than boys do. Boys start later and grow longer." "There are a lot of size differences in your age group now because everyone enters puberty and grows at slightly different times than others." "You could add as much as 12 inches to your height before you stop growing."
A 19-year-old female adolescent comes to the clinic for a check-up. The nurse observes that she has a new tattoo. She tells the nurse, "I just got it 2 days ago." When reviewing the care of the tattoo with the adolescent, the nurse determines that the adolescent understands how to care for the tattoo when she states which of the following? Select all that apply.
"I wash it gently with a mild soap and warm water" "I let it air-dry for about 10 minutes after cleaning it." "I can put on some A&D ointment a couple of times a day for about 2 weeks.
A 14-year-old boy is far quieter than usual when he visits his physician's office. The nurse asks him if anything is wrong, and the boy replies that he did not make the cut for the football team. What would be most appropriate for the nurse to say?
"I'm really sorry; I know that must be a big disappointment."
An adolescent asks you what the term "puberty" means. What is your best response?
"It is the age at which one first becomes capable of sexual reproduction."
The mother of a 13-year-old boy confides to the pediatric nurse practitioner that her son has recently had a nocturnal seminal emission. The mother is concerned, and the nurse explains "wet dreams" and the other male traits of puberty to the mother. Which response indicates a need for further discussion?
"My son must be sexually active or having overly sexual thoughts to have a nocturnal emission."
Jerry and his mother have come to the office for a routine visit and his mother brings up to you in the hall away from Jerry that she is concerned because Jerry is playing games that the girls play and she has noticed that when he play any role-playing games that his character is very feminine. She tells you that she is worried about his sexual orientation. What is the best response to her concerns?
"This behavior may be exploratory or reflect peer pressure so avoid making assumptions about his sexual orientation."
A 16-year-old girl who has been confined to a wheelchair since early childhood has been acting rebellious and rude. Her parents ask you, "Are all adolescents like this?" What is your best response?
"Your daughter's behavior seems to be typical adolescent behavior. Let's talk more about it."
The adolescent continues to develop self-concept and self-esteem. What is most important to a teen's self-esteem?
Body image
Which of the following is accurate related to growth patterns in adolescent girls?
Growth slows after the beginning of menstruation.
A 13-year-old girl is struggling to accept the new changes that are occurring in her body as a result of puberty. After talking with this client, the nurse recalls that Erikson's primary developmental task of early and mid-adolescence is:
Identity versus role confusion.
According to Erikson, the adolescent develops their own sense of being independent people with their own thoughts and goals. This stage is referred to as:
Identity vs. role confusion
When assessing adolescents for health risks, the nurse must keep in mind the factors related to the prevalence of adolescent injuries. What accurately describes these factors? Select all that apply.
Increased physical growth Insufficient psychomotor coordination Peer pressure Inexperience
A 13-year-old girl has recently begun menstruating. She is active in sports at school. Increased intake of which of the following nutrients should the nurse recommend to the girl to prevent anemia associated with menstruation?
Iron
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?
The nurse is performing an assessment of the reproductive system of a 17-year-old girl. What would alert the nurse to a developmental delay in this girl?
Lack of occurrence of first menstrual period
What anticipatory guidance can the nurse provide the girl who has noted the development of breast buds?
Menarche should follow in about 2 years.
Based on the most frequent cause of death in adolescents, what preventive measure would the nurse most want to teach an adolescent?
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.
A nurse is preparing a class for a group of adolescents about sexuality and sexual activity. The nurse understands that which of the following are often the biggest influences on an adolescent's actions related to sexual activity? (Select all that apply.)
Peer pressure Self-esteem
The mother of a 15-year-old boy expresses sadness to the nurse that her son is "much more connected to his friends than his family." What understanding would benefit this parent? Select all that apply.
Peers are needed for emotional security while stepping away from family. Peers provide opportunity to learn and practice social roles. Peers can be positive or negative influences. Adolescents need parental support and guidance as they move toward greater peer involvement.
The mother of a 15-year-old boy confides in the nurse that she is concerned because her son is about to turn 16 and is pressuring her and her husband to buy him a motorcycle. Her husband is okay with the idea, but she is concerned about his safety. What information should the nurse mention to the mother regarding motorcycle safety? Select all that apply.
Require the son to wear a helmet. Require the son to wear long pants. Require the son to wear full body covering. Require the son to learn all relevant safety rules.
An adolescent with multiple tattoos and piercings comes to the health center at the child's school. The child is complaining of feeling hot. In collecting further data the nurse finds the child has a new piercing. The nurse recognizes the need for the adolescent to be given information related to personal health. Which topic would the nurse identify as the area that the child needs immediate information about?
Signs of infection
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 discussing nutrition with a group of caregivers of adolescents. One of the caregivers tells the group she is concerned because her daughter has decided to become a vegetarian. With further discussion the caregiver says her child won't eat any food of animal origin, including dairy products, eggs, fish, meat, and poultry. The vegetarian diet the caregiver is describing is which of the following?
Vegan
