Chapter 29: Adolescent NCLEX style

The nurse is talking to a 13-year-old boy about choosing friends. Which function do peer groups provide that can have a negative result? a) Negotiating differences b) Sharing problems c) Following role models d) Developing loyalties

Following role models

The period in which physical changes relating to sexual maturation take place is called: a) Role confusion. b) Identity diffusion. c) Adolescent turmoil. d) Puberty.

Puberty

An adolescent asks you what the term "puberty" means. What is your best response? a) "It denotes the beginning of secondary sex characteristics." b) "It is the time span between 12 and 18 years." c) "It is the time span that denotes the onset of maturity." d) "It is the age at which one first becomes capable of sexual reproduction."

"It is the age at which one first becomes capable of sexual reproduction."

For reasons of anticipatory guidance, nurses should be aware that menarche appears earlier in some ethnic groups than others. In which ethnic group is menarche likely to appear first? a) Mexican-American b) Caucasian c) African-American d) Indian-American

African-American

Based on the most frequent cause of death in adolescents, what preventive measure would you most want to teach an adolescent? a) Motor-vehicle safety b) Firearm safety c) Water safety d) Home safety

Motor-vehicle safety

Nurses should provide anticipatory guidance to males to prepare them for what particular pubertal change in late adolescence? a) Breast enlargement b) Reddening of the scrotum c) Nocturnal emissions d) Lengthening of the penis

Nocturnal emissions

The time period known as adolescence usually begins with which of the following occurrences. a) The fine motor skills fully developed. b) The child becoming self-supported c) The beginning of puberty. d) The deciduous teeth falling out.

The beginning of puberty.

The nurse is caring for an 11-year-old girl. The girl's mother complains that the girl does not want to play team sports like soccer or volleyball anymore. Her daughter insists she does not enjoy them. The mother is concerned that her daughter will not get enough physical activity and asks the nurse for guidance. How should the nurse respond? a) "Why don't you sign her up for an aerobics or dance class?" b) "Give her some options; it's important to find something she enjoys." c) "Organized sports are just a complementary activity to other physical activities." d) "Remind her of the importance of regular physical activity for good health."

"Give her some options; it's important to find something she enjoys."

The nurse is caring for a 13-year-old girl. The child has been identified as overweight with no underlying psychological or secondary causes. The nurse is reviewing the child's weight-loss progress and nutrition at a follow-up visit. Which of the following indicates a need for further discussion and teaching? a) "Her goal is to be a size smaller by our vacation in two weeks." b) "My daughter is helping us plan our family's weekly menu." c) "We are using family outings and activities as a reward for weight loss." d) "Our whole family has changed our eating habits."

"Her goal is to be a size smaller by our vacation in two weeks."

The nurse is discussing psychosocial development of the adolescent with a group of family caregivers. Which of the following statements made by the caregiver is an example of the most effective way the caregiver can support the adolescent? a) "I leave pamphlets about topics such as drugs and alcohol in his room so he can read them any time." b) "Our house rules are strict and we know many of his friends are not, but they all follow the same rules at our house." c) "The hairstyles she chooses are not what I think looks good on her, but I just let her do what she wants to with her hair." d) "We discourage him from spending too much time with his school friends since we know they can be a negative influence."

"The hairstyles she chooses are not what I think looks good on her, but I just let her do what she wants to with her hair."

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) "You must be eating fried foods or sweets in large quantities." b) "It could be serious; seek consultation when your primary care physician examines you." c) "Most of us get acne during adolescence. Even some adults do. Don't worry." d) "This is one of the most common physical changes during adolescence."

"This is one of the most common physical changes during adolescence."

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? a) "That is not something we will discuss today." b) "Tell me what you know about sex." c) "Are you actively having sex at this time?" d) "We can discuss that as well as other aspects of sexuality."

"We can discuss that as well as other aspects of sexuality."

The school nurse is talking with a group of 11-year-old girls. One of the girls states, "I just feel like my whole body is changing and I don't know why." The best response by the nurse would be which of the following? a) " You may feel like you are changing, but you still look the same." b) "Your other friends are feeling like this too." c) "You have lots of hormone changes going on right now." d) "You will feel better about yourself as you get older."

"You have lots of hormone changes going on right now."

When adolescents form relationships with members of the opposite sex, the relationship is categorized as what type of relationship? a) A heterosexual relationship b) A bisexual relationship c) A homosexual relationship d) An unhealthy relationship

A heterosexual relationship

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) Helping others achieving their goals b) Developing trust c) Achieving their own identity d) Achieving independence from parental dominance

Achieving their own identity

The school nurse is assessing a 16-year-old girl who was removed from class because of disruptive behavior. She arrives in the nurse's office with dilated pupils and is talking rapidly. Which drug might she be using? a) Marijuana b) Opiates c) Barbiturates d) Amphetamines

Amphetamines

A 16-year-old girl with acne has been prescribed tretinoin (Retin-A cream). Which of the following instructions should the nurse give this girl related to prevention of a common side effect of this medication? a) If taking an oral contraceptive, switch to a different type of contraception while taking this medication b) Be certain of the expiration date on the drug c) Avoid prolonged sun exposure d) Take the medication on an empty stomach

Avoid prolonged sun exposure

The nurse is providing anticipatory guidance for violence prevention to a group of parents with adolescents. Which parental action should the nurse include as the most effective in preventing suicide? a) Checking for signs of depression or lack of friends b) Watching for aggressive behavior or racist remarks c) Becoming acquainted with the teen's friends d) Monitoring video games, TV shows, and music

Checking for signs of depression or lack of friends

What has the most influence in deterring an adolescent from beginning to drink alcohol? 1. Drinking habits of parents 2. Drinking habits of peers 3. Drinking philosophy of adolescent's culture 4. Drinking philosophy of adolescent's religion

Drinking habits of peers

A 17-year-old boy chats excitedly with the nurse about his plans for college and a career. He says he has checked out every college in the region and determined which one is the best fit for him and which one offers the best career options for him. The nurse recognizes which developmental aspect in this young man? a) Puberty b) Formal operational thought c) Socialization d) Role confusion

Formal operational thought

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. Which of the following should the nurse do to encourage a sense of autonomy and dignity related to the girl's body image? a) Assist the girl with using the bed pan to urinate b) Brush the girl's hair for her c) Offer to assist the girl in washing her hair and let her pick the shampoo d) Allow the girl to wear her own clothes, despite hospital policy

Offer to assist the girl in washing her hair and let her pick the shampoo

What exercise recommendation should nurses give to adolescents? a) Participate in physical activities that cause sweating and hard breathing weekly. b) Participate in 60 minutes of moderate to vigorous physical activity each day. c) Engage in aerobic exercise for 30 minutes three days per week. d) Engage in at least one competitive sport during the school year.

Participate in 60 minutes of moderate to vigorous physical activity each day.

Linda and her mother are in the office. As Linda uses the restroom, her mother asks you about the changes that Linda is going through. She would like to talk to her about sexuality and its changes but she is unsure of how to do this. As the nurse, what reminders should you give her when she discusses sex? a) Promote open lines of communication; listen instead of lecture; and share family values. b) Discuss with the teen the experiences that you had so that she can connect on a personal level. c) Encourage her to talk to her peers and teachers in health class. d) Do not initiate any conversation; let the teen come and seek the advice of the parent.

Promote open lines of communication; listen instead of lecture; and share family values.

Sixteen-year-old Bettina has been hospitalized 100 miles from home for a week. She is recovering from surgery to repair a broken kneecap, an injury incurred while skateboarding. She was cheerful and chatty when she first arrived, but the nurse notes in recent days she has become increasingly quiet and seems lonely. Which of the following nursing interventions would be most appropriate for Bettina? The nurse should a) Suggest that she read books and magazines from the hospital bookmobile. b) Ask Bettina's caregivers to bring her siblings and friends to visit. c) Call the hospital's mental health unit to see if Bettina can get some counseling. d) Show Bettina where the teen lounge in the hospital is so she can meet other teens, use a phone, and check her e-mail.

Show Bettina where the teen lounge in the hospital is so she can meet other teens, use a phone, and check her e-mail.

Which is associated with early adolescence? (Choose all that apply.) 1. Uses scientific reasoning to solve problems 2. Still at times wants to be dependent upon parents 3. Incorporates own set of morals and values 4. Is influenced by peers and values memberships in cliques

Still at times wants to be dependent upon parents Is influenced by peers and values memberships in cliques

Which action would provide an indication that an adolescent's parents understand their daughter's need for increased independence? a) Saying, "We will always be here for her whenever she needs us." b) Telling you that they now understand that their daughter's chief need is for increased privacy c) Verbalizing, "We try to do everything we can to make things easier for her." d) Telling you that they are encouraging their daughter in her search for an after-school job

Telling you that they are encouraging their daughter in her search for an after-school job

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. Which of the following should the nurse mention to the mother regarding motorcycle safety? (Select all that apply.) a) Require the son to wear long pants b) Require the son to wear a helmet c) Require that the son to wear a seat belt d) Require the son to wear full body covering e) Require the son to learn all relevant safety rules f) Insist on age and not emotional maturity as the qualification for obtaining a driver's license

• Require the son to wear long pants • Require the son to wear a helmet • Require the son to wear full body covering • Require the son to learn all relevant safety rules

The nurse is promoting safe sex to a 14-year old boy who is frequently dating. Which of the following points is most likely to be made during the talk? a) "Adolescents account for 25% of sexually transmitted infection (STI) cases." b) "Girls are more susceptible to STIs than boys." c) "Be careful or you'll wind up being a teenage dad." d) "Contraception is a shared responsibility."

"Contraception is a shared responsibility."

When giving parents guidance for the adolescent years, the nurse would advise the parents to: (Choose all that apply.) 1. Accept the adolescent as a unique individual 2. Provide strict, inflexible rules 3. Listen and try to be open to the adolescent's views 4. Screen all of his or her friends 5. Respect the adolescent's privacy 6. Provide unconditional love

Accept the adolescent as a unique individual Listen and try to be open to the adolescent's views Respect the adolescent's privacy Provide unconditional love

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) Provide information about sex and sexuality b) Educate the client about the changes that occur during adolescence c) Convince him that involuntary discharge of semen during sleeping needs immediate attention of the primary care provider d) Review about sexually transmitted diseases

Educate the client about the changes that occur during adolescence

A client tells the nurse that she has noticed an increase in 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? a) Provide reassurance that these are normal changes. b) Share what foods can be eaten on a low fat diet to prevent fat deposits. c) Review dietary measures to assist in controlling the weight gain. d) Encourage increased exercise to control weight gain.

Provide reassurance that these are normal changes.

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. a) Adolescents need parental support and guidance as they move toward greater peer involvement. b) Peers provide opportunity to learn and practice social roles. c) Peers can be positive or negative influences. d) Peers are needed for emotional security while stepping away from family.

• Adolescents need parental support and guidance as they move toward greater peer involvement. • Peers provide opportunity to learn and practice social roles. • Peers can be positive or negative influences. • Peers are needed for emotional security while stepping away from family.

Billy's mother is with him at a visit for a sore throat. In the interview she states that she does not know what to do with him: He is taking two or three showers a day, when not that long ago she could barely get him to take a bath at all. What should the nurse's reply be to the mother? a) "Reinforce the family rules but also allow him to develop his own routine." b) "Do not encourage multiple baths, it can be very drying to the skin." c) "Remind him that he needs to be on a schedule so that he does not disrupt the family." d) "Reevaluate his ability to do hygiene care since he is showering so frequently."

"Reinforce the family rules but also allow him to develop his own routine."

In discussing the psychosocial development of the adolescent, it is important to understand that in order for adolescents to be in intimate relationships in which feelings are mutually shared, both persons must have which of the following? a) An ability to be autonomous b) A willingness to take initiative c) An understanding of socialization and of isolation d) A sense of trust and of identity

A sense of trust and of identity

A 17-year-old girl needs to increase her iron intake but is concerned about weight gain. The nurse will suggest which foods? a) Egg white omelet, broccoli, pear b) Chicken, whole-wheat bread, watermelon c) Cottage cheese, crackers, oranges d) Raspberry yogurt, granola, apple

Chicken, whole-wheat bread, watermelon

A boy and his mother are visiting the clinic so he can get his sports physical. After the exam, when the boy is not in the room his mother mentions that she worries that he is participating in risk behaviors and that his dependence on his peers is growing stronger. She asks what she as the parent can do to make sure that Caleb is safe. a) Suggest that he invite his friends over to the house and include them in family activities. b) Remind her that family connectedness is a strong factor in helping kids to remain resilient. c) Encourage the family to spend more time together playing games or watching movies. d) Remind her that this is normal behavior that Caleb will eventually outgrow.

Remind her that family connectedness is a strong factor in helping kids to remain resilient.

The nurse is performing a physical assessment on an 11-year-old girl during a health surveillance visit. Which of the following findings would suggest the child has reached adolescence? a) The child has higher blood pressure b) Eruption of last four molars c) Increased shoulder, chest and hip widths d) A significant muscle mass increase

The child has higher blood pressure

The nurse is admitting a 15-year-old to the pediatric unit. Which of the following does the nurse recognize as a priority for this child? a) The child's need for parental support should be discussed. b) The child should be encouraged to call friends often. c) The child's need for privacy should be respected. d) The child should be given freedom to participate in unit activities as desired.

The child's need for privacy should be respected.

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. a) "There are a lot of size differences in your age group now because everyone enters puberty and grows at slightly different times than others." b) "If you know how tall you were at age 3, you can double that and predict fairly well how tall you will get." c) "You are at the age now when most boys begin their growth spurt and grow very rapidly." d) "Girls begin to grow rapidly at a younger age than boys do. Boys start later and grow longer." e) "You can't control when and how much you will grow. Basketball can use some really fast guards." f) "You could add as much as 12 inches to your height before you stop growing."

• "There are a lot of size differences in your age group now because everyone enters puberty and grows at slightly different times than others." • "Girls begin to grow rapidly at a younger age than boys do. Boys start later and grow longer." • "You could add as much as 12 inches to your height before you stop growing."

For what reasons do nurses work to prevent tobacco use by teens? Select all that apply. a) Teens who smoke are more likely to use alcohol and drugs. b) Smoking damages the respiratory system. c) Smokeless tobacco damages gums and teeth. d) Smoking is associated with fighting and unprotected sex. e) Tobacco use is addicting (nicotine).

• Smoking damages the respiratory system. • Smokeless tobacco damages gums and teeth. • Teens who smoke are more likely to use alcohol and drugs. • Smoking is associated with fighting and unprotected sex. • Tobacco use is addicting (nicotine).

During an office visit for a sports injury, 16-year-old Derek's caregivers tell the nurse they are worried about changes in Derek's behavior. He has always been industrious in his schoolwork and very focused on sports. Now he has a girlfriend and seems to spend almost all of his time with her or on the phone with her and little or no time on his schoolwork. What information might the nurse offer these caregivers about Derek's behavior? a) Derek has chosen a girl who is overly dependent on him. They should talk to him about making sure he meets his own needs, including doing the schoolwork he enjoys, in any relationship. b) Derek has developed his own identity by now; being able to establish close relationships with girls is important preparation for all of his adult relationships. They should honor his need to be with or talk to his girlfriend as long as he has completed his schoolwork for the day. c) Derek is not developmentally mature enough to make healthy choices about the ways in which he spends his time, so it would be helpful if they would make a schedule for him that includes about a half-hour per day to talk with his girlfriend. d) Derek is not developmentally mature enough to have an intimate relationship with one girl; they should encourage him to spend time with groups of friends rather than time alone with his girlfriend.

Derek has developed his own identity by now; being able to establish close relationships with girls is important preparation for all of his adult relationships. They should honor his need to be with or talk to his girlfriend as long as he has completed his schoolwork for the day.

The nurse is performing a health surveillance visit with a 12-year-old boy. Which characteristic suggests the boy has entered adolescence? a) Feels secure with his body image b) Understands that actions have consequences c) Experiences frequent mood changes d) Shows growing interest in attracting girls' attention

Experiences frequent mood changes

The nurse is counseling an overweight, sedentary 15-year-old girl. The nurse is assisting her to make appropriate menu choices. Which statement indicates the adolescent understands how to make appropriate dietary selections? a) "Because of my age, my dairy intake is unlimited." b) "To lose weight my protein intake should be limited to 2 to 4 servings per day." c) "I avoid all fat intake." d) "I need to have 4 servings of fruit each day."

"I need to have 4 servings of fruit each day."

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? a) "That's okay; you can try out for basketball in a few months." b) "Don't let it get you down; sports are a waste of time, anyway." c) "I'm really sorry; I know that must be a big disappointment." d) "It's not that big of a deal; a lot of kids don't make the football team."

"I'm really sorry; I know that must be a big disappointment."

Jenny is a 15-year-old who is being seen today in the clinic, and her mom comments on the fact that Jenny seems to always choose the opposite of what everyone else wants and that her mood swings are a common occurrence. What statement below shows the nurse that Jenny's mom understands these changes? a) "This is her temperament and we will have to learn how to deal with her." b) "She will never find anyone to live with her if she acts like this." c) "This is common for this age group and it will get better with time." d) "I know that she is doing this because of all the hormones."

"This is common for this age group and it will get better with time."

A 13-year-old girl has grown rapidly in height over the past 2 years and is still taller than most of the boys in her class. She wonders when she will stop growing. Which of the following should the nurse tell her as a general guideline for the ages at which most girls stop growing? a) 20 to 21 years old b) 18 to 19 years old c) 14 to 15 years old d) 16 to 17 years old

16 to 17 years old

The nurse is meeting with a 16-year-old girl who reports being physically active on the track and basketball teams at school. The child reports a weight loss of 7 lb (3.2 kg) since she began training for the track season. When reviewing her caloric needs the nurse recognizes the diet should include how many calories? a) 1,800 calories per day b) 2,200 calories per day c) 2,000 calories per day d) 2,400 calories per day

2,200 calories per day

A client has confided in a nurse that her 13-year-old daughter has recently changed dramatically in her social interactions with others. Which of the following is a social behavior most likely to be exhibited by a girl at this age? a) Hanging out with girls but maintaining her own unique style b) Banding together with boys and girls but maintaining her own unique style c) Hanging out primarily with boys her own age d) Banding together with other girls and dressing like them

Banding together with other girls and dressing like them

The nurse is working with a teenage patient. He has relatively straight teeth, but his lower front teeth are slightly crossed over. The nurse suggests to the child's caregiver that an orthodontist see him. What is the reason the nurse might make this suggestion? a) Even slight malocclusions make chewing and jaw function less efficient. b) The more common braces become, the more unacceptable crooked teeth are in society at large, affecting everything from dating possibilities to hiring. c) Uncorrected malocclusions lead to infection and ultimately tooth loss. d) Leaving even slightly crooked teeth will lead to more cavities later in life.

Even slight malocclusions make chewing and jaw function less efficient.

Jordan is coming back to the office for a follow-up visit. He is 15 years old and he shows a pattern of gaining weight, not a large amount but a little more each visit. Jordan says that he is not active in any sports but that he and his father eat out a lot. What is the best way for the nurse to assess Jordan's eating pattern? a) Ask Jordan to show you what a healthy portion looks like. b) Have Jordan guess what his calorie intake is in a 24-hour period. c) Have Jordan keep a food diary for one week. d) Ask Jordan to recall what he has had to eat in the last three days.

Have Jordan keep a food diary for one week.

What anticipatory guidance can the nurse provide the girl who has noted the development of breast buds? a) Breast development will be complete with 12 months. b) Adult height will be reached at the time of menarche. c) The growth spurt will begin immediately with menarche. d) Menarche should follow in about 2 years.

Menarche should follow in about 2 years.

Puberty is said to begin when what occurs? a) The production of sperm in the male. b) The voice deepens in the male. c) The growth spurt in the female ends. d) The areola separate from the contour of the breasts in the female.

The production of sperm in the male. Adolescence begins with the onset of menstruation in the female and the production of sperm in the male.

While taking care of a teenager in the late adolescence stage, what behavior of the client will the nurse most likely observe during data collection for annual physical examination? a) Introspection and fluctuations in self assurance b) Seclusion and moodiness c) True attitude of maturity d) Childish ways of appearing, thinking and behaving

True attitude of maturity

The nurse is promoting nutrition to a teen who is going through a growth spurt. Which food should the nurse recommended for its high iron content? a) Fresh orange juice b) Fat-free milk c) Whole grain bread d) Organic carrots

Whole grain bread

The developmental task of the adolescent period, according to Erikson, is to form a sense of: a) identity versus role confusion. b) decisiveness versus indecisiveness. c) initiative versus guilt. d) autonomy versus shame or doubt.

identity versus role confusion.

The nurse is collecting data from a 15-year-old boy who is being seen at the ambulatory care clinic for immunizations. During the initial assessment, he voices concerns about being shorter than his peers. What response by the nurse is indicated? a) "Being short is nothing to be ashamed of." b) "Are the other men in your family short?" c) "I am sure you are not the shortest guy in your class." d) "Boys your age will often continue growing a few more years."

"Boys your age will often continue growing a few more years."

A 16-year-old uses marijuana daily. To help her do better in school, what advice would you offer that would be most important? a) Marijuana increases blood pressure; she should not run after smoking it. b) The effect of marijuana fades fastest if she eats after use. c) Marijuana causes memory gaps that interfere with learning. d) Marijuana leads to muscle laxness, so it should not be used close to gym class.

Marijuana causes memory gaps that interfere with learning.

What anticipatory guidance can the nurse provide the girl who has noted the development of breast buds? a) The growth spurt will begin immediately with menarche. b) Adult height will be reached at the time of menarche. c) Menarche should follow in about 2 years. d) Breast development will be complete with 12 months.

Menarche should follow in about 2 years.

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 which of the following? a) Self-esteem b) Shyness c) Modesty d) Independence

Self-esteem

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 of the following topics would the nurse identify as the area that the child needs immediate information regarding? a) Signs of substance addiction b) Signs of infection c) Prevention of sexually transmitted infection d) Prevention of pregnancy

Signs of infection

Which behavior by an 18-year-old is consistent with successful progression through the stages of Piaget's theory of development? a) Uses critical thought processes to handle a problem b) Is able to be part of a large group of peers while maintaining a sense of self c) Reflects a strong moral code d) Has a strong sense of understanding of internal identity

Uses critical thought processes to handle a problem

With summer approaching, the nurse discusses sun safety with a group of teen girls. Which suggestion is most likely to be followed? a) Limit sun exposure between 10:00 AM and 2:00 PM. b) Do not attempt to get a tan. c) Wear a hat when in the sun. d) Wear sunglasses.

Wear sunglasses.

A 16-year-old girl has arrived for her sports physical with a new piercing in her navel. Which response by the nurse is best? a) "I hope for your sake the needle was clean." b) "This is a risk for hepatitis, tetanus, and AIDS." c) "Be sure to clean the navel several times a day." d) "This is a wound and can become infected."

"Be sure to clean the navel several times a day."

Evan, a 14-year-old, and his mother are in the office for an annual visit and his mother jokes openly in front of you about the changes in Evan's voice and the hair under his armpits. What is an appropriate response from the nurse when she is talking with the mother? a) "I remember that time in my life, it was so awkward and uncomfortable." b) "Discuss with Evan your trials with puberty and the changes you experienced." c) "Has he gone through the big change, smelly armpits and hair all over his body?" d) "Remember that he can become modest and self-conscious and teasing may cause embarrassment."

"Remember that he can become modest and self-conscious and teasing may cause embarrassment."

Jerry and his mother have come to the office for a routine visit. In the hall away from Jerry, his mother confides that she is concerned because Jerry is playing games that the girls play and she has noticed that when he plays any role-playing games his character is very feminine. She tells you that she is worried about his sexual orientation. What is the best response to her concerns? a) "Close parental monitoring of his activities has been shown to decrease these behaviors." b) "Do not allow him to play any of these games, get him some manly games." c) "This is a concern; you should examine what you are exposing him to that could affect his behavior." d) "This behavior may be exploratory or reflect peer pressure, so do not make assumptions regarding sexual orientation."

"This behavior may be exploratory or reflect peer pressure, so do not make assumptions regarding sexual orientation."

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) Children from ages 2 to 7 years investigate and explore the environment and look at things from their own point of view. b) Up to age 2, children learn by touching, tasting, and feeling. They learn to control body movement. 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.

After age 12 children can think in the abstract including complex problem solving.

A 16-year-old girl with acne has been prescribed tretinoin (Retin-A cream). Which of the following instructions should the nurse give this girl related to prevention of a common side effect of this medication? a) Take the medication on an empty stomach b) Be certain of the expiration date on the drug c) If taking an oral contraceptive, switch to a different type of contraception while taking this medication d) Avoid prolonged sun exposure

Avoid prolonged sun exposure

In comparing the rate of growth in preadolescent girls and preadolescent boys, which of the following is the most accurate about growth rate? a) Boys and girls grow at the same rate. b) Boys grow at a slower, steadier rate than do girls. c) Boys grow at a rapid, sporadic rate. d) Girls grow at a slower, steadier rate than do boys.

Boys grow at a slower, steadier rate than do girls.

The school nurse is providing nutritional guidance during a 9th grade health class. Which foods should the nurse recommend as good sources for calcium? a) Beans, poultry, and fish b) Strawberries, watermelon, and raisins c) Peanut butter, tomato juice, and whole grain bread d) Cheese, yogurt, and white beans

Cheese, yogurt, and white beans

The nurse is performing an assessment on a 12-year-old boy. Which finding is consistent with the child's age? a) No pubic hair b) Curling pubic hair c) Coarse pubic hair d) Sparse pubic hair

Curling pubic hair

In developing a weight-loss plan for an adolescent, which would the nurse include? (Choose all that apply.) 1. Have parents make all of the meal plans. 2. Eat slowly and place the fork down between each bite. 3. Have the family exercise together. 4. Refer to an adolescent weight-loss program. 5. Keep a food and exercise diary.

Eat slowly and place the fork down between each bite. Have the family exercise together. Refer to an adolescent weight-loss program. Keep a food and exercise diary.

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 which of the following? a) Identity vs. role confusion b) Industry vs. inferiority c) Autonomy vs. doubt and shame d) Intimacy vs. isolation

Identity vs. role confusion

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? a) Vitamin D b) Iron c) Calcium d) Zinc

Iron

The nurse is talking with parents of a depressed 16-year-old boy. Which question is of the most importance? a) Does he exercise? b) Have his sleeping and eating habits changed? c) Is there a gun in your home? d) How is his personal hygiene?

Is there a gun in your home?

A 14-year-old girl arrives at the nurse's office carrying a tooth knocked out in gym. The nurse knows, prior to dental care, the action that will best preserve the tooth is: a) Place the tooth in a dry, sterile container. b) Reinsert the tooth into the socket. c) Rinse the tooth and place in a container of warm water. d) Place the tooth on ice in a clean container.

Reinsert the tooth into the socket.

Jamie, an 18-year-old, comes to the clinic. In the health history she reveals that she has a nipple ring and is looking to get a tattoo in the next few months. What is the most important thing that the nurse can teach her at this time? a) Complications are more likely when they are done on your own. b) Review the safety rules for those who do the tattooing. c) It is not recommended to get the tattoo from your friend in his garage. d) Tattooing carries risks such as infection, disease, and nerve damage.

Tattooing carries risks such as infection, disease, and nerve damage.

What is the best explanation of Erikson's theory of psychosocial development during the adolescence period? a) The adolescent develops many skills during the teen ages, which help adolescents make educational and career choices. b) The adolescent faces many different decisions during the teen years concerning the future and the adult world. c) Cognitive development is cumulative; that is, what is learned is based on what has been known before. d) The adolescent thinks in the abstract and develops skills to participate in complex problem solving.

The adolescent faces many different decisions during the teen years concerning the future and the adult world.

The father of a 15-year-old basketball player is following a very low carbohydrate diet. He realizes his daughter should not follow the same eating plan. Which of the following would be most advisable for this father to serve his daughter so that she can perform at her optimum level in a Friday basketball game that starts at 6 p.m.? a) Boiled eggs with bacon or ham and a glass of orange juice for breakfast on Thursday and Friday mornings along with some sliced turkey and a salad at noon on Friday. b) Three daily meals that include choices from each of the food groups; Friday's lunch should be eaten around 2 p.m. and include a small amount of fat and a somewhat larger than usual portion of complex carbohydrates c) Three daily meals that include choices from each of the food groups with an additional serving of fruit and several extra glasses of water on Friday. d) Pasta with a small amount of meat sauce and two slices of bread for dinner on Wednesday and Thursday evenings and again at 2 p.m. on Friday.

Three daily meals that include choices from each of the food groups; Friday's lunch should be eaten around 2 p.m. and include a small amount of fat and a somewhat larger than usual portion of complex carbohydrates

Suicide is so common in adolescents it ranks third as a cause of death in the 10- to 24-year-old age group. a) False b) True

True

The high school soccer coach asks the nurse how soft tissue ankle injuries to the players might be prevented. The nurse's main recommendation is: a) Use semi-rigid ankle orthoses. b) Wear high-top athletic shoes. c) Exercises to improve coordination and proprioception. d) Ankle conditioning and strength training.

Use semi-rigid ankle orthoses

The nurse knows that the 13-year-old girl in the exam room is in the process of developing her own set of values. Which activity will this child be experiencing according to Kohlberg's theory? a) Wondering what is the meaning of life b) Assuming everyone is interested in her favorite pop star c) Wishing her parents were more understanding d) Comparing morals with those of peers

Wondering what is the meaning of life

A 15-year-old is seen at a health care facility for facial acne. When counseling him, you would teach him that the basic cause of his acne is a) vitamin deficiency from an inadequate diet. b) thyroid-gland secretions increasing with adolescence. c) lack of showering adequately after gym class. d) activation of androgen hormones.

activation of androgen hormones

The activity that would best foster the developmental task of an adolescent who is physically challenged would be a) talking to another adolescent who has a similar disorder. b) deciding whether she wants her bath before or after lunch. c) watching television on the set in her room. d) having a teacher bring her school homework in for her.

talking to another adolescent who has a similar disorder.

The nurse is discussing nutrition with a group of adolescents. The nurse would encourage the adolescents to eat which foods to increase their intake of iron? Select all that apply. a) Peanuts b) Hard-boiled eggs c) Cheese sticks d) Grapes e) Dried fruits f) Milk shakes

• Dried fruits • Peanuts • Hard-boiled eggs

The nurse is discussing the topics of sex and sexuality and how to discuss these issues with a group of caregivers of adolescents. Which of the following statements made by the nurse is most appropriate to tell this group of caregivers? a) "Most schools have excellent programs to teach adolescents about sex and sexuality." b) "Being honest and straightforward with teenagers will encourage them to ask their parents about subjects like sexuality." c) "Internet resources, movies, and television have the most accurate and current information for your adolescent to learn about sexuality issues." d) "Teenagers spend so much time with their peers, and that is usually how they find out about sex."

"Being honest and straightforward with teenagers will encourage them to ask their parents about subjects like sexuality."