Adolescent- prep U- W&C

A nurse is reinforcing education about type 1 diabetes with an adolescent. Which instruction by the nurse about how to prevent hypoglycemia would be most appropriate for the adolescent?

"Carry crackers or fruit to eat before or during periods of increased activity."

A 15-year-old client comes to the clinic requesting a test for human immunodeficiency virus (HIV) exposure. The adolescent is concerned that her parents might be notified of her test results. Which response by the nurse is best?

"HIV testing is confidential; after we get the test results we'll discuss your options."

The nurse completes discharge teaching with an adolescent client related to a sexually transmitted infection. Which statement made by the client best indicates that discharge instructions were understood?

"I will notify my sex partners about this infection and explain the need for treatment."

The nurse assisted in the education of a group of adolescent females about eating disorders. Which comments made by some of the teenagers would indicate to the nurse that the teaching was effective? Select all that apply.

"You can develop vitamin deficiency with anorexia." "Purging may cause tooth decay."

An intradermal skin test to detect tuberculosis infection is administered to a high-risk adolescent client. How long after the test is administered should the nurse wait to evaluate the results?

48 to 72 hours

A nurse is preparing to reinforce education with a 13-year-old child with asthma on how to administer breathing treatments. Which principle should the nurse keep in mind when planning the education session?

Adolescents are worried about appearing different from their peers.

The nurse is working with the Quality Improvement Committee on a project to improve the satisfaction ratings of adolescent clients who experience long-term hospitalization. Which evidence-based suggestions does the nurse make to the committee? Select all that apply.

Avoid admitting adolescents to units with adults or younger-aged pediatric clients. Provide an area where schoolwork can be done with educational supports available Design specified areas on the units where adolescent clients can socialize with each other.

A nurse is caring for an adolescent who underwent surgery for a perforated appendix. What should the nurse keep in mind regarding the main life-stage task for the adolescent when providing care?

Developing identity and independence is the objective.

The nurse is caring for an adolescent with cancer who is well informed about the medical condition and treatment. The adolescent refused the morning medications and states intentions of refusing all future medications. What is the best action by the nurse?

Document the adolescent's choice and offer to discuss feelings about the medication.

An adolescent presents to a community clinic for treatment of vulvar lesions associated with type 2 herpes simplex. Which intervention is appropriate to do at this time? Select all that apply.

Escort the adolescent to a private examination room. Provide the adolescent with literature about type 2 herpes simplex.

A 16-year-old client comes to the physician's office for a physical examination that's required to play sports. The mother reports that her son is unusually tired during the day. She explains that he works at a part-time job, is socially active, and gets about 7 hours of sleep each night. Physical examination reveals that the client grew 3" during the past year. Which intervention by the nurse is most appropriate?

Explaining that his sleep requirements have increased related to the increased metabolic demands of growth

The parents of an adolescent girl have recently learned that their daughter has a terminal illness. At first, as they try to cope, they display avoidance behaviors. Then they demonstrate behaviors that indicate possible acceptance of the diagnosis. Which of the following behaviors would indicate acceptance?

Expression of feelings, such as sorrow and anger, about the child's condition

An adolescent female arrives in the emergency department after a physical assault. How could the male nurse best protect the client's rights during the physical examination?

Have a female health care worker present.

The nurse is planning sex and contraceptive education for adolescents. Which factor should the nurse consider?

Most teenagers are open about contraception, but inconsistently use birth control.

The nurse cares for an older adolescent client. The nurse observes a visitor wearing a gun and gun holster. Which action does the nurse take?

Notify security personnel of the observation and location.

An adolescent client is brought to the hospital after a house fire. What is the nurse's priority intervention for this client?

Observe nares and vocal quality.

When planning a program to educate adolescents about acquired immunodeficiency syndrome (AIDS), which action might lead to better acceptance of the program?

Obtain peer educators to provide information about AIDS.

A teenager is brought to the facility by friends after accidentally ingesting gasoline while siphoning it from a car. Based on the nurse's knowledge of petroleum distillates, which system would be most affected?

Respiratory system

According to Erikson, the psychosocial task of adolescence is the development of a sense of identity. The nurse can best promote the development of a hospitalized adolescent by:

encouraging peer visitation.

The nurse is caring for an adolescent with syphilis. What factor must the nurse determine before the client can be treated?

existence of medication allergies

An adolescent typically achieves formal operational thought, Piaget's final stage of cognitive development. Which cognitive abilities are achieved during this stage? Select all that apply.

flexibility complex deductive reasoning abstract thinking

An adolescent is diagnosed with iron deficiency anemia. After emphasizing the importance of consuming dietary iron, the nurse asks the child to select iron-rich breakfast items from a sample menu. Which selection demonstrates knowledge of dietary iron sources?

ham and eggs

The nurse is caring for a 14-year-old child in skeletal traction for treatment of a fractured femur. The child is expected to be hospitalized for several weeks. When planning care, the nurse should take into account the client's need to achieve what developmental milestone?

identity

The school nurse is gathering data related to the diabetic status of a 15-year-old athlete. Which physiologic change should the nurse anticipate as a diabetic teenager becomes more physically active during the day?

increased need for food

The nurse is reinforcing education on how to change a sterile dressing. The client is an older adolescent. During the education session, the nurse observes redness, swelling, and induration at the incision site. What does this indicate to the nurse?

infection

A 13-year-old boy visits the school nurse because he's experiencing back pain, fatigue, and dyspnea. The nurse suspects that the child may have scoliosis. The nurse should first:

inspect the child for uneven shoulder height or uneven hip height.

An adolescent client with diabetes checks the blood glucose at 9:00 p.m. before going to bed. It has been 4 hours since dinner and the regular insulin dose. The current blood glucose is 60 mg/dl (3.3 mmol/L). The client feels a little "shaky." Which action does the nurse take?

provide the client with a snack

A female adolescent client refuses to allow male nurses to care for her while she's hospitalized. Which of these health care rights is this adolescent exerting?

right to privacy

A child, age 14, is diagnosed with scoliosis and scheduled for brace application. The mother asks the nurse how long her child will have to wear the brace. What is the nurse's best response?

"About 4 to 7 years."

The nurse is caring for a 14-year-old with type 1 diabetes who has been admitted with ketoacidosis for the second time in 3 months. The parent states, "I don't know why this keeps happening." Which response by the nurse is the most appropriate?

"Adolescents sometimes become overwhelmed by having to adhere to dietary restrictions and taking medications."

The nurse is teaching a group of high school students about obesity. Which information will the nurse provide when discussing this topic?

"Calculating body mass index is preferred to weighing yourself on a scale."

A 15-year-old girl visits the neighborhood clinic seeking information on "how to keep from getting pregnant." What should the nurse say in response to her request?

"Can you tell me about the precautions you're taking now?"

A nurse is caring for a 14-year-old client who was admitted with cellulitis and has been ordered warm compresses. The nurse delegates the treatment to the unlicensed assistive personnel (UAP). The compress causes a first-degree burn to the area. Which actions should the nurse initiate? Select all that apply.

Complete an incident report regarding the event. Notify the healthcare provider of the injury.

An emancipated adolescent is pregnant and plans to raise her child. She has no income or health insurance. Which recommendation should the nurse make to help the client with her health care expenses?

Completing a Medicaid application

During chemotherapy for lymphoma, a child, age 15, is at risk for stomatitis. Which statement by the child supports a nursing diagnosis of Deficient knowledge related to mouth care?

"I remove white patches on my tongue and cheeks with my toothbrush."

The nurse is teaching a 16-year old client who has menstruated for more than a year. Which client statement will the nurse respond to as the priority?

"I was having regular periods before but haven't had one for a couple of months."

A school nurse is planning a program on skin cancer prevention for a group of teenagers. Which instruction should the nurse emphasize during the program?

"Examine your skin once per month, looking for suspicious lesions or changes in moles."

A 15-year-old adolescent confides in the nurse that the adolescent has been contemplating suicide. The adolescent has developed a specific plan to carry it out and pleads with the nurse not to tell anyone. What is the nurse's best response?

"For your protection, I can't keep this secret. After I notify the physician, we will need to involve your family. We want you to be safe."

A nurse is conducting a health class at the local middle school about testicular self-examination. What statement by a student would indicate a need for further teaching?

"I do not need to perform testicular self-exams until I become sexually active."

Which statement by a female adolescent reveals an early indicator of anorexia nervosa?

"I jog three times per day for a total of 5 hours per day."

The nurse is working with adolescents. Which developmental rationale explains risk-taking behavior?

Belief in their own invulnerability persuades adolescents that they can take risks safely.

The parent of a 16-year-old child calls the emergency department, suspecting their child's abdominal pain may be appendicitis. In addition to pain, the child has a fever of 100° F (37.8° C) and has vomited twice. What would be appropriate advice for the nurse to give the parent?

"Immediately bring your child into the emergency department."

The nurse is teaching a group of adolescent clients about personal hygiene. Which client statement indicates the need for further teaching?

"It's unsafe to swim during your period."

A 13-year-old client tells the nurse, "I have not yet started my period, but all my friends have." Which nursing response is appropriate?

"Some individuals do not start menstruating until age 15 or 16."

An adolescent who is sexually active seeks counseling from the school nurse about the prevention of sexually transmitted infections (STIs). Which suggestion does the nurse make?

"Use condoms each time you have sexual intercourse."

An adolescent client was offered a babysitting job after school. The nurse coaches the parents to make which response to the client?

"What thought have you given as to how you'll manage your responsibilities?"

The nurse is reinforcing education to an adolescent about sexually transmitted infection (STI). What statement made by the client indicates that further education is required?

"You always know when you have gonorrhea."

The nurse is teaching a group of adolescents about automobile safety. Which is the most effective teaching method for this age-group?

Coordinating a panel of peers who were involved in motor vehicle accidents

The nurse is caring for an adolescent client after surgery for a perforated appendix. Which life stage task is important to this client's care?

Develop independence.

An adolescent with diabetes tells the community nurse they recently started drinking alcohol on the weekends. Which action would be most appropriate for the nurse to take?

Educate the adolescent about the effects of alcohol on diabetes.

A 15-year-old client who sustained a spinal cord injury is on bedrest. Which intervention by the nurse might best help the adolescent cope with the prolonged bedrest?

Encouraging visitation by his friends

The nurse is caring for an adolescent client with borderline personality disorder admitted to the acute inpatient psychiatric unit. The client also has a history of type 1 diabetes mellitus (T1DM) and nonadherence to treatment recommendations. The healthcare provider has given permission for the client to monitor blood glucose levels and administer insulin using the client's own equipment. Which actions should the nurse take to ensure safe diabetes management? Select all that apply.

Establish a contract with the client stating nurses will review the client's glucometer to record blood glucose readings. Keep the control solutions used to calibrate the glucometer at the nurse's station instead of in the client's room.

A 17-year-old client visits the family planning clinic to discuss with a nurse regarding safe sex practices. In instructing the client on how to correctly use a condom, which information should be stressed? Select all that apply.

Leave a ½ inch space at the end of the condom. Never reuse a condom. The condom should be applied on an erect penis. Condoms should be stored in a cool, dry place to prevent damage.

An adolescent, age 17, with acute lymphoblastic leukemia is discharged with written information about chemotherapy administration and the outpatient appointment schedule. The child now is in the maintenance phase of chemotherapy but has missed clinic appointments for blood work and admits to omitting some chemotherapy doses. To improve the client's compliance, the nurse should include which intervention in the plan of care?

Letting the client participate in the planning and scheduling of treatments

An adolescent client is admitted for a sickle cell crisis. Which intervention is most important for the nurse to implement?

Manage pain aggressively and continually.

The nursing staff is developing a care plan for a client who's receiving palliative care for end-stage leukemia. The client is experiencing breakthrough pain, rated as a 5 on a pain scale of 1 to 10. Which action by the nurse should be included in the client's care plan?

Meeting with the pain management team to devise a more effective pain control plan

A girl, age 15, is 7 months pregnant. When teaching parenting skills to an adolescent, the nurse knows that which teaching strategy is most effective?

Providing a one-on-one demonstration and requesting a return demonstration, using a live infant model

An adolescent presents to a community clinic for treatment of vulvar lesions associated with Type 2 herpes simplex. Which action does the nurse take?

Show the adolescent to a private examination room for further assessment.

A 16-year-old client is admitted to the emergency department following an accident. The client sustained a head injury, is unconscious, and has compound fractures of the right tibia and fibula. No family members accompanied the client and none can be reached by phone. The surgeon instructs the nurse to take the client to the operating room immediately. Which of the following actions should the nurse take regarding informed consent?

Take the client to the operating room for surgery without informed consent.

A physician needs to obtain written informed consent for a surgical procedure on an adolescent. Which situation allows the physician to obtain written informed consent from the adolescent rather than the parents?

The adolescent is estranged from the parents and lives independently.

The nurse is working with a group of adolescents reviewing information regarding the human immunodeficiency virus (HIV). What fact is important for the nurse to include in the review?

The virus can be spread through many routes, including sexual contact.

An overweight girl, age 15, has lost 12 lb (5.4 kg) in 8 weeks by dieting. Now, after reaching a weight plateau, she has become discouraged. She and the nurse decide she should keep a food diary. What is the primary purpose of keeping such a diary?

To help the nurse and client analyze the amount of food the client is eating and determine when food intake occurs

The nurse is reinforcing education with an adolescent about gonorrhea. Which information should be included?

Treatment of sexual partners is an essential part of treatment.

Which situation violates a hospitalized adolescent's right to confidentiality?

Two nurses talk about the adolescent on an elevator on their way to lunch.

The nurse is caring for a teenage client involved in a motor vehicle accident. The client has a chest tube in place. If the chest tube is accidentally removed, the nurse should immediately:

cover the opening with sterile petroleum gauze.

The nurse is providing anticipatory guidance to a well 16-year-old female client. Which topics would be included in the discussion? Select all that apply.

driving responsibilities protection from sexually transmitted infections anxiety related to career choices

The nurse is collecting data from an adolescent with pelvic inflammatory disease (PID). What symptoms are anticipated when reviewing data?

lower abdominal pain and urinary tract symptoms

The nurse has conducted a vision assessment for an adolescent client. Which term will the nurse use to document the finding of the client's nearsightedness?

myopia

The nurse is helping the adolescent deal with diabetes. What characteristic of adolescence should be considered?

need to be like peers