Chapter 11: Adolescence

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A nurse is assessing a teenage client who had an accident in a car race. The client's father reveals that the client has also started drinking and using drugs. The nurse can best categorize the client in which developmental phase? a. Cognitive Adolescence b. Middle Adolescence c. Pyschosocial d.

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Parents of a son ask the nurse when they will know that their son has reached puberty. What is the best response by the nurse? a. "Puberty occurs when the person becomes able to reproduce sexually." b. "Puberty spans the ages between 11 and 20 years of age." c. "A rapid growth spurt occurs during puberty." d. "Emotional needs predominate the puberty period."

a. "Puberty occurs when the person becomes able to reproduce sexually." Puberty is the period when a person becomes able to reproduce sexually. Adolescence is the developmental period between puberty and maturity. It spans the ages between 11 and 20 years, after which a person enters early adulthood. Rapid growth spurt marks adolescence, by the end of which individuals achieve adult height. Although tremendous physical growth occurs, emotional needs predominate during this period; adolescents spend much of their time searching for meaning in life and for a sense of identity.

During the annual physical examination, a teenage client tells the nurse that she is anxious as well as frustrated because of the acne on her face. Which is the best response for the nurse? a. "This is one of the most common physical changes during adolescence." b. "It could be serious; seek consultation when your primary care physician examines you." c. "Most adolescents get acne during adolescence, don't worry." d. "You must be eating fried foods or sweets in large quantities."

a. "This is one of the most common physical changes during adolescence." It is important for the nurse to inform the client that acne is one of the physical changes that characterizes adolescence as a result of increased glandular activity. The client need not seek consultation with the primary care provider, because the condition is not serious. The client should not be reprimanded; the condition should be explained as a natural phase. The client's worries should not be trivialized or ignored either.

The student nurse is preparing a short oral report for postclinical discussion on adolescent stages of growth and development. Based on the information that adolescence can be divided into stages, what would be the best explanation of the main characteristics of the pubescence stage? a. Desire for independence b. Grapple with everyday issues c. Grapple with career choices d. Fluctuations in self-assurance

a. Desire for independence In early adolescence or the pubescence stage, the main characteristic is the desire for independence. In middle adolescence, the main characteristic is fluctuations in self-assurance, and the main characteristics of late adolescence is grappling with every day issues and career choices.

A nurse is taking care of a teenager who complains about involuntary discharge of semen while sleeping. The nurse observes that the client is confused and does not know about the pubertal changes that are taking place in his body. Based on this information, what is the highest priority area that should be reviewed with the client? a. Educate the client about the changes that occur during adolescence. b. Convince him that involuntary discharge of semen during sleeping needs the immediate attention of the primary care provider. c. Provide information about sex and sexuality. d. Review about sexually transmitted infections.

a. Educate the client about the changes that occur during adolescence. The highest priority areas of the nurse's teaching involves educating the client about the expected pubertal changes that take place in the body and convince him that the involuntary discharge of semen while sleeping is a normal part of reproductive health. Once he understands what is to be expected, the nurse can address sex education issues.

The father of a 15-year-old boy is worried because he wants to discipline his son in an age-appropriate manner. While the boy is being assessed for diabetes, the father reveals this concern to the nurse. How should the nurse best help the client? a. Explain the importance of adult respect toward adolescents. b. Explain the importance of good grades for adolescents. c. Discuss the challenges for families with children who are diabetics. d. Place stress on ensuring that the teenager is following family rules.

a. Explain the importance of adult respect toward adolescents. Adolescents are usually happiest when family relationships are based on mutual respect and affection. Therefore, helping the father understand the importance of displaying respect for his son is an appropriate nursing intervention. Talking about diabetes is not an appropriate response to the father's concerns. Emphasizing good grades and family rules is not helpful advice from a nurse.

According to Erikson's theory, at each stage of development, a significant person or group exerts a lasting influence on the ongoing development of the child. The student nurse is preparing a short report for a postclinical conference during the pediatric rotation. The student nurse is doing a case study report on the assigned child and family the nurse care for during the clinical experience. The family consists of an infant, school-age child, teenager, mother, and father. Which individual exerts the most lasting influence on the ongoing development of the adolescent? a. Peer Group b. School-Age Child c. Mother d. Father

a. Peer Group In each stage of development, a significant person or group exerts a lasting influence on the ongoing development of the child. The peer group, not parents or siblings, has the greatest influence on an adolescent.

When documenting the medical history of a young client with a mouth ulcer, the nurse finds that the client is homosexual and is scared of revealing this to his family. Which is the most appropriate nursing intervention when assessing this client? a. The nurse should inquire about the symptoms. b. The nurse should avoid physical contact with the client. c. The nurse should immediately inform the client's family. d. The nurse should provide extra attention to the client.

a. The nurse should inquire about the symptoms. The nurse should assess and inquire about the signs and symptoms experienced by the client as a result of the mouth ulcer; this will help allay the fear of rejection from the community. The nurse need not avoid physical contact with the client; it may further alienate the client. The nurse can inform the client's family about the client's homosexuality, but should take care to convince the family to accept the fact and behave normally with the client. The nurse need not provide extra attention to the client, because his condition is not serious.

A client tells the nurse that her 14-year-old daughter does not eat proper food and seems to be fond of eating at local fast food restaurants with her peers. Based on this information, what should the nurse tell the client about how eating disorders occur in adolescent girls? a. Very concerned about their appearance b. Fret continually about being thin c. Eating pattern of bulimia develops by eating minimal amounts of food. d. Eating pattern of anorexia develops by pattern of binge eating followed by induced vomiting.

a. Very concerned about their appearance Girls are often very concerned about their appearance. They may fret continually that they are fat. As a result, anorectic or bulimic patterns of eating may emerge during these years. Anorexia is marked by eating minimal amounts of food, whereas bulimia is characterized by a pattern of binge eating followed by induced vomiting or the use of laxatives.

During the annual physical examination of an adolescent girl, the adolescent reveals to the nurse that she is interested in having an intimate relationship with her boyfriend, but does not know much about sex. Why is it important that the nurse assist in providing sex education to teenagers? 1. Adolescents will seek answers elsewhere. 2. Unwholesome attitudes may develop from information from peers. 3. Repetition of correct beliefs that they receive from older adolescents is critical. 4. Premature and unsafe sexual activities could occur. a. 1,2,3 b. 1,2,4 c. 1,3,4 d. 2,3,4

b. 1,2,4 When parents, teachers, and counselors do not provide sex education, adolescents will seek answers elsewhere. Unwholesome attitudes or incorrect beliefs may develop from information they receive from peers and older adolescents who appear to know it all. The result may be premature and unsafe sexual activities. Hence, it is important to provide sex education to teenagers.

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 will have the highest incidence of experiencing nocturnal emissions? a. Clients who have reached adulthood b. Clients age group 12-20 years c. Clients who are showing pubertal changes d. Clients with strong, muscular appearance

b. Clients age group 12-20 years The nurse should know that boys in the age group of 12 to 20 years, experience various chemical and physical changes taking place within their body. The nurse should know that boys who are undergoing pubertal changes are more likely to experience nocturnal emissions. In late adolescence, which lasts from 18 to 20 years, the transition into adulthood is completed. A strong, muscular appearance does not indicate the presence of nocturnal emissions.

A teenage boy, while being assessed for fever, reveals to the nurse that he is interested in having an intimate relationship, but is afraid of sexually transmitted infections (STIs). How can the nurse best help this client? a. Advise the client to get sex education from his parents. b. Educate the client to use condoms. c. Educate the client on the various forms of birth control. d. Advise the client to avoid intimate relationships.

b. Educate the client to use condoms. The nurse should suggest that the use of condoms is the best way to prevent STIs. Sex education helps adolescents to know about sex, sexuality, and changes occurring in their bodies, whereas birth control methods help to prevent pregnancy; this knowledge will not help the client minimize the risk of STIs. The nurse should address the client's fears instead of asking him to refrain from sexual activity.

The student nurse is preparing a short oral report for postclinical discussion on adolescent stages of growth and development. Based on the information that adolescence can be divided into stages, what would be the best explanation of the main characteristics of late adolescence stage? a. Desire for independence b. Grapple with everyday issues c. Teeters between childish and mature ways of appearing and behaving d. Fluctuations in self-assurance

b. Grapple with everyday issues The main characteristic of late adolescence is grappling with every day issues and career choices. The main characteristic of late adolescence is grappling with every day issues and career choices. In early adolescence or the pubescence stage, the main characteristic is the desire for independence. It is sometimes referred to as an "awkward stage," as the person teeters between childish and mature ways of appearing, thinking, and behaving. In middle adolescence, the main characteristic is fluctuations in self-assurance.

A nurse is addressing a group of schoolteachers on the importance of sex education for children. What should the nurse emphasize as the highest primary source of sex education information for adolescents? a. Peers b. Parents c. Teachers d. Counselors

b. Parents The nurse should suggest that parents can provide information about sex and sexuality to their children with more sensitivity than teachers or counselors. The nurse may also warn that knowledge of sex provided by peers or older adolescents may not be accurate and can result in premature and unsafe sexual activities.

During the annual physical examination of an adolescent girl, the adolescent reveals to the nurse that she is interested in having an intimate relationship with her boyfriend, but does not know much about sex. Why does the nurse need to counsel this potentially sexually active adolescent? 1. Sexual activity at younger ages is increasing. 2. Young girls use birth control pills more when they are available. 3. Incidence of sexually transmitted infections is on the rise. 4. Condom use helps prevent sexually transmitted infections. a. 1,2,3 b. 1,2,4 c. 1,3,4 d. 2,3,4

c. 1,3,4 Sexual activity at younger ages is increasing. Even though birth control pills are available, many young people fail or refuse to use them. In addition, the incidence of sexually transmitted infections is on the rise. Hence, sexually active adolescents need counseling about the use of condoms to help prevent sexually transmitted infections and other forms of birth control to prevent pregnancy.

During the annual physical examination of an adolescent girl, the adolescent reveals to the nurse that she is interested in having an intimate relationship with her boyfriend but does not know much about sex. How can the nurse help this client form a healthy sexual attitude? 1. Tell her that she should have no questions about sexual preferences. 2. Review pubertal changes that occur in the body. 3. Provide information about sex. 4. Review that sexual activity at younger ages is decreasing. a. 1,2 b. 1,4 c. 2,3 d. 3,4

c. 1,4 The nurse can help the client by providing her information about sex, sexuality, and pubertal changes that occur in the body. Many adolescents have questions about sexual preferences and sexual activity at younger ages is increasing.

When discussing the growth and development of an adolescent, the nurse refers to various theories and phases of development. A nurse is discussing Erikson's theory of psychological development with an adolescent client. Based on Erikson's theory of psychosocial development, which should the nurse identify as the major priority challenge faced by adolescents? a. Developing trust b. Achieving independence from parental dominance c. Achieving their own identity d. Helping others achieve their goals

c. Achieving their own identity According to Erikson's theory of psychosocial development, the major challenge of adolescence is the achievement of identity. Achieving independence from parental domination is another task of adolescence, but not the ultimate one. Helping other adolescents achieve higher goals is not a part of Erikson's theory of psychosocial development.

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? a. Up to age 2, children learn by touching, tasting, and feeling. They learn to control body movement. b. Children from ages 2 to 7 years investigate and explore the environment and look at things from their own point of view. c. From ages 7 to 11 years, children internalize actions and can perform them in the mind. d. After age 12, children can think in the abstract including complex problem solving.

d. After age 12, children can think in the abstract including complex problem solving. At the formal operations level after the age 12 children can think in the abstract. Complex problem solving is included in this category. The nurse should explain that there are four levels of cognitive development in Piaget's theory. The sensorimotor level is up to age 2 where children learn by touching, tasting, and feeling. They learn to control body movement. Preoperational level is children from ages 2 to 7 years who investigate and explore the environment and look at things from their own point of view. At the concrete operations level from ages 7 to 11 years, children internalize actions and can perform them in the mind.

The student nurse is preparing a short oral report for postclinical discussion on adolescent stages of growth and development. Based on the information that adolescence can be divided into stages, what would be the best explanation of the main characteristics of middle adolescence stage? a. Desire for independence b. Grapple with everyday issues c. Grapple with career choices d. Fluctuations in self-assurance

d. Fluctuations in self-assurance In middle adolescence, the main characteristic is fluctuations in self-assurance. In early adolescence or the pubescence stage, the main characteristic is the desire for independence. The main characteristic of late adolescence is grappling with every day issues and career choices.

When discussing the growth and development of an adolescent, the nurse refers to various theories and phases of development. A nurse is discussing Erikson's theory of psychological development with an adolescent client. Based on this information, what is the best explanation of Erikson's theory of psychosocial development during the adolescence period? a. Cognitive development is cumulative; that is, what is learned is based on what has been known before. b. The adolescent thinks in the abstract and develops skills to participate in complex problem solving. c. The adolescent develops many skills during the teen ages, which help adolescents make educational and career choices. d. The adolescent faces many different decisions during the teen years concerning the future and the adult world.

d. The adolescent faces many different decisions during the teen years concerning the future and the adult world. The adolescent develops many skills during the teen ages, which help adolescents make educational and career choices. The main point of Erikson's theory on which the nurse should focus is that the adolescent faces many different decisions during the teen years concerning the future and the adult world. Piaget states that cognitive development is cumulative; that is, what is learned is based on what has been known before. The adolescent thinks in the abstract and develops skills to participate in complex problem solving.


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