Chapter 29: Growth and Development of the Adolescent

The nurse is assessing a 14-year-old male client when the client's parent jokes about the changes in the client's voice and the hair under his armpits. Which response by the nurse to the client's parent is most appropriate? "I remember that time in my life, it was so awkward and uncomfortable." "It would be helpful to discuss with your child your trials with puberty and the changes you experienced." "Based on your child's age, changes in hair distribution and voice pitch are expected." "Your child can become modest and self-conscious and teasing may cause embarrassment."

"Your child can become modest and self-conscious and teasing may cause embarrassment." Explanation: It is never appropriate to discuss what is happening with a client in a way that is demeaning and hurtful. A 14-year-old adolescent is experiencing many bodily changes and is very self conscious. The nurse can share experiences with the client and the family, but it should not be in a way that the adolescent is embarrassed. Parents can share their experiences with the child, but they have to be open to this discussion or it can lead to an awkward experience for the adolescent. Reminding the parent of how the child is feeling and the possible feelings that can come from their interactions will bring the parent's attention to a delicate situation and is most appropriate. Simply stating these are expected findings does not address the joking manner of the parent.

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? whole grain bread organic carrots fat-free milk fresh orange juice

whole grain bread Explanation: Whole grain bread contains high amounts of iron and is a type of food the child would not have an aversion to. Milk is a good source of vitamin D. Carrots are high in vitamin A. Orange juice is a good source for vitamin C.

The nurse is caring for an adolescent female who is scheduled for an emergent laparoscopic surgical procedure. What question by the nurse would be appropriate? "What concerns do you have about scarring from the surgery?" "Do you want to read a story about the surgery?" "What immunizations have you received in the last 12 months?" "Do you want to talk with an adult who has had the surgery previously?"

"What concerns do you have about scarring from the surgery?" Explanation: Body image is important to the adolescent and scarring following the procedure would be a priority for the client. Offering to have the client read a story about the surgery would be appropriate for an older school-aged child. Immunizations are assessed with each admission, although those specifically within the last 12 months would not be a concern for this surgery. Talking with a peer, and not an adult, would be appropriate for an adolescent.

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

16 to 17 years old Explanation: Growth stops with closure of the epiphyseal lines of long bones which occurs at about 16 or 17 years of age in females and about 18 to 20 years of age in males.

A 15-year-old female adolescent tells the nurse she would like to get a tattoo. What response by the nurse is most appropriate? "You need to remember that a tattoo will be with you forever." "You are too young to have a tattoo." "If you are determined to get a tattoo you need to get a small one so you can hide it if you want." "Tattoos are invasive and there is the potential for disease with their application."

"Tattoos are invasive and there is the potential for disease with their application." Explanation: Piercings and tattoos are becoming increasingly common in adolescents. It is important to ensure that the girl and her family understand the potential risk for disease with the application of the tattoo. The adolescent is young, but that does not change the fact she wants to get a tattoo. Reminding the teen that it is a permanent alteration in the skin is important but not the most important response by the nurse.

A teacher refers a student to the school nurse because the student is frequently falling asleep during class. After talking with the student, the nurse is most concerned by which statement by the student? "I just can't seem to stay awake during that class because it's boring." "My mom keeps telling me to turn off my television when I go to bed." "I guess I need to be more careful about my curfew on school nights." "I get 7 hours of sleep every night so I don't know why I am so tired."

"I get 7 hours of sleep every night so I don't know why I am so tired." Explanation: The average number of hours of sleep that teens require per night is 8.5 to 9.5 due to rapid growth that occurs during these years. Following a curfew and limiting distractions at bedtime can help provide the student with adequate hours of sleep each night.

The nurse is caring for an adolescent athlete who is being seen for a fractured arm. The parent reports that this is the third sports injury in the past 2 years. The parent asks the nurse why the adolescent—who is healthy overall— continues to have injuries. How should the nurse respond? These are accidents and random in occurrence. The bones, joints, and tendons of adolescents are vulnerable to injury due to their rapid state of growth. There may be some underlying problems that your adolescent should be evaluated for. Some adolescents are accident-prone.

The bones, joints, and tendons of adolescents are vulnerable to injury due to their rapid state of growth. Explanation: Rapidly growing bones, muscles, joints, and tendons are more vulnerable to unusual strains and fractures. While some people may seem to be accident-prone, this adolescent's injuries are most likely the result of the stage of physical growth. There is no evidence the adolescent has any underlying medical conditions.

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? "I need to eat plenty of fruit each day." "Because of my age, my dairy intake is unlimited." "I avoid all fat intake." "To lose weight my protein intake should be limited to 2 to 4 servings per day."

"I need to eat plenty of fruit each day." Explanation: The sedentary teen needs to consume approximately 1,600 calories each day. A balanced diet includes plenty of fresh fruit and a small amount of fat. To avoid all fat could place the child's health at risk. Protein intake is important for the development of tissue. The teen will need about 5 ounces of protein daily.

A male adolescent comes to the clinic for a routine health care follow-up accompanied by the parents. During the visit, the parents tell the nurse, "Our son just doesn't seem to listen to us anymore. It's like he's tuning us out. Is there anything we can do to get him to hear what we're saying to him?" Which suggestions would be appropriate for the nurse to offer? Select all that apply. "When you talk to him, speak to him face to face and be careful of your body language." "Don't be afraid to ask him questions about why he feels a certain way." "Tell him firmly that you have the answers because you are his parents." "Talk to you son as an equal and don't talk down to him." "Choose words carefully to make sure that he understands you."

"When you talk to him, speak to him face to face and be careful of your body language." "Don't be afraid to ask him questions about why he feels a certain way." "Choose words carefully to make sure that he understands you." "Talk to you son as an equal and don't talk down to him." Explanation: To improve communication with an adolescent, it is important to talk face to face with the adolescent and be aware of body language that could influence what is being said. In addition, parents should not be afraid to ask the adolescent why he or she feels a certain way, Parents need to speak to their teenager as an equal and not talk down to the adolescent, making sure to choose words that the adolescent will understand. Parents also need to be open to not knowing all the answers and be able to admit that they do make mistakes.

A 15-year-old is hospitalized for acute appendicitis. Which activities would the nurse include in the client's plan of care? Select all that apply. Allow friends to visit during visiting hours. Have the nurse control the patient's care as much as possible. Arrange care to provide for extra rest and sleep. Keep the client in hospital gowns for sanitary reasons. Include the parents when educating the client.

Allow friends to visit during visiting hours. Include the parents when educating the client. Arrange care to provide for extra rest and sleep. Explanation: Because protein synthesis occurs most readily during sleep, and adolescents are building so many new cells, this age group may need proportionately more sleep than any other age group. When adolescents are admitted to the hospital they may sleep as if exhausted. Adolescents are capable of total self-care and because of their body awareness, may even be overly conscientious about personal hygiene and appearance. When caring for hospitalized provide time for self-care, such as shampooing the hair. Confidentiality is of utmost important as adolescents do not like to feel different than their peers and do not want their information shared unless they share it. At the beginning of care, the adolescent and the parents need to decide how much involvement the parents will have in care (e.g., will they stay in the room, will the adolescent be able to have a role in decision making).

A chronically ill adolescent is readmitted to the hospital with an infected wound requiring long-term dressing changes. What is the best way the nurse can encourage independence for this client? Have the school provide homework. Have the adolescent go to the teen room every day. Teach the parents to perform dressing changes at home. Allow the adolescent to choose the time for the dressing change.

Allow the adolescent to choose the time for the dressing change. Explanation: Achieving a sense of identity may be difficult for adolescents who have a chronic illness. Some of the nursing actions which encourage identity in the chronically ill adolescent include the following: respecting food preferences; allowing the adolescent to choose the time for the dressing changes; teaching the name, actions, and possible side effects of medication; and respecting modesty. The school can provide homework so the adolescent does not get further behind in school work, and the teen can go to the teen room each day. These provide a good emotional outlet, but they do not promote independence. Teaching the parents to do the dressing changes makes the adolescent dependent on the parents. If the dressings are at a location the adolescent can reach and dexterity is not limited, then the adolescent should be allowed self-care.

During the assessment of a 15-year-old female, the nurse notes a new body piercing in the navel. Which statements by the nurse would be appropriate in regard to this new piercing? Select all that apply. "I really like your belly ring. Where did you get it?" "I notice you have a new piercing. Be sure to clean it twice a day so you don't get an infection." "Did they tell you when you got your piercing how important cleaning it is? Infections can take up to a year to heal in a naval piercing." "A navel piercing is a lot better than a tattoo. At least the piercing doesn't have to be permanent if you don't want it to be." "You are very young to have a navel piercing. Do your parents know you have this?"

"I notice you have a new piercing. Be sure to clean it twice a day so you don't get an infection." "Did they tell you when you got your piercing how important cleaning it is? Infections can take up to a year to heal in a naval piercing." Explanation: Informing the client about infection risks and prevention are appropriate responses by the nurse when noticing a new body piercing. Judgmental responses and personal responses are not appropriate from the nurse.

A 17-year-old male adolescent on the high school swim team tells the nurse that during swim season he cuts the carbohydrates in his diet to 30% to help his swim times. What responses by the nurse are appropriate? Select all that apply. "Cutting carbohydrates is a good way to keep your weight down during swim season." "Twenty-five to 35 percent of your diet should be carbohydrates so you fall into the acceptable range." "Since you are so active, your carbohydrate intake should comprise 45% to 65% of your daily diet." "Can you tell me the reason you feel the need to cut your carbohydrates when your activity level is high?" "As long as you are taking in around 2,000 calories per day you should be just fine."

"Since you are so active, your carbohydrate intake should comprise 45% to 65% of your daily diet." "Can you tell me the reason you feel the need to cut your carbohydrates when your activity level is high?" Explanation: Teenage boys who are moderately active require between 2,200 and 2,800 calories per day and 45% to 65% should come from carbohydrates. Carbohydrates should not be cut, especially during an athletic season when energy use is increased. Asking the student why he or she is cutting carbohydrates is appropriate in order to help the nurse address the issue effectively.

An adolescent who is depressed states, "Nothing ever seems to be right in my life." Which would be the most appropriate response by the nurse? "You are feeling sad right now. It's a hard time." "Things will be better when you go off to college." "Being a teenager is hard work." "Try to look at the bright side of things."

"You are feeling sad right now. It's a hard time." Explanation: Some degree of depression is present in most adolescents because they are not only losing their parents while they grow apart from them but also their carefree childhood. When using therapeutic communication, it is important for the nurse to accept the client's verbalization as real. Support should be real. Telling the adolescent that things will be better in college provides false reassurance. Telling the adolescent to "look on the bright side of things" or that "being a teen is hard work" offer platitudes and interrupt the client's interactions.

To help prevent obesity, which intervention would the nurse include in an adolescent's plan of care? Plan a diet of 3,000 calories per day. Encourage sources of proteins with fat. Describe a normal serving size. Plan a diet of 1,500 calories per day.

Describe a normal serving size. Explanation: Some adolescents may be unaware that their food intake is excessive because they have been told they need excess nutrients for healthy adolescent growth and everyone in their family eats large portions. Health teaching with these adolescents may need to begin with a discussion of "normal" weight and standard food portions. If adolescents eat a diet too low in protein for any length of time, they can develop a negative nitrogen balance, which can lead to impaired growth. Therefore, a diet of fewer than 1,400 to 1,600 calories a day can rarely be tolerated by adolescents. Teenage girls who are moderately active require about 2,000 calories per day and teenage boys who are moderately active require between 2,200 and 2,800 calories per day. Eating in excess can lead to obesity and should be avoided.

A 17-year-old adolescent chats excitedly with the nurse about plans for college and a career. The adolescent states having checked out every college in the region and determined which one is the best fit and would give the adolescent the best career options. The nurse recognizes which developmental aspect in this client? Formal operational thought Identification of identity Sensorimotor Socialization

Formal operational thought Explanation: The final stage of cognitive development, the stage of formal operational thought, begins at age 12 or 13 years and grows in depth over the adolescent years, though it may not be complete until about age 25. This step involves the ability to think in abstract terms and use the scientific method (deductive reasoning) to arrive at conclusions. With the ability to use scientific reasoning, adolescents can plan their future. They can create a hypothesis (What if I go to college? What if I do not?) and think through the probable consequences (In the long run, I will earn more money; I could begin earning money immediately). This scenario does not pertain to socialization, role identification, or sensorimotor development.

The nurse is assessing the psychosocial development of an adolescent. The nurse determines that the client is in the middle post-conventional phase with which observation? The nurse hears the adolescent asking the parents, "How does God decide that some people get sick and some people don't?" The nurse hears the adolescent talking with a friend and states, "I don't understand how some of the rich in our society don't help the poor." The adolescent states, "I am glad my parents instilled such a good work ethic in me." The adolescent tells the nurse, "I'm starting to think that some of my friends care a lot more about what other people think of them than what I do."

The adolescent tells the nurse, "I'm starting to think that some of my friends care a lot more about what other people think of them than what I do." Explanation: According to Kohlberg, the middle post-conventional phase is characterized by the adolescent developing his or her own set of morals by evaluating individual morals in relation to peer, family, and societal morals. This is demonstrated when the adolescent stated. "I'm starting to think that some of my friends care a lot more about what other people think of them than what I do." The early post-conventional phase is characterized by asking broad, usually unanswerable questions about life such as the question about God. During the late post-conventional phase, the adolescent internalizes his or her own morals and values, and continues to compare morals and values to those of society. During this phase, the adolescent also evaluates the morals of others. The statements regarding the rich in society and work ethic demonstrate this late phase.

The parent of a 14-year-old adolescent states to the nurse that the adolescent is moody, shuts oneself in the bedroom, and fights with a younger sibling. Which comment is most helpful to support the parent? "Take away all of the adolescent's privileges until your adolescent starts acting better." "Calmly talk to your adolescent about your concerns." "Set some rules for family etiquette." "This is normal for the age."

"Calmly talk to your adolescent about your concerns." Explanation: Families and parents of adolescents experience changes that require adjustments and the understanding of adolescent development. The adolescent is striving for self-identity and increased independence. Thus, getting the parent and adolescent talking and sharing information is the most helpful advice. Telling the parent that this is normal does nothing for the family situation. Setting rules will likely alienate the adolescent, and taking away privileges will likely cause conflict between the parent and adolescent.

The nurse is discussing ways to promote discipline with parents who are becoming increasingly frustrated with their adolescent. What would the nurse suggest to the parents? Develop consistent expectations and use consistent responses each time. Avoid discussing situations of misbehavior and instead praise appropriate behavior. Make a chore chart and add stickers for completed chores and activities. Determine the consequences for misbehavior and explain them to the adolescent.

Develop consistent expectations and use consistent responses each time. Explanation: Consistency and predictability are the cornerstones of discipline. The use of a chore chart with stickers would be more appropriate for a preschool-aged or young middle-school-aged child. The parent should include the adolescent in establishing consequences rather than determine them without input. While appropriate behavior should be praised, when occurrences of misbehavior occur, they should be addressed and dealt with according to the agreed-upon consequences.

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 can be positive or negative influences. Parents should wait until the adolescent introduces them to their peers. Peers provide opportunity to learn and practice social roles. Adolescents need parental support and guidance as they move toward greater peer involvement.

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. Explanation: The parent should understand that at this stage of development, it is normal for peers to have a large role in the adolescent's life. The adolescent is finding his/her place outside the home and is filling a need for emotional security, an opportunity to learn and practice societal roles. It is true that peers can have a positive influence or a negative influence over the adolescent. Adolescents still need their parents' involvement in their life with support and guidance. The parents should take a proactive approach at getting to know their adolescent's peers.

The nurse is admitting a 15-year-old adolescent to the hospital pediatric unit. What does the nurse recognize as a priority for this adolescent? The adolescent should be encouraged to call friends often. The adolescent should be given freedom to participate in unit activities as desired. The adolescent's need for privacy should be respected. The adolescent's need for parental support should be discussed.

The adolescent's need for privacy should be respected. Explanation: When an adolescent is ill or injured, it affects the body and body image. A hospitalized adolescent's primary concerns are pain and the loss of privacy. The adolescent is also anxious about being separated from friends and losing control of one's life. When an adolescent is hospitalized, it is very important the adolescent be given privacy. The adolescent needs individualized attention, confidentiality, and the right to participate in decisions about one's own health care. The adolescent should have contact with friends and be allowed in unit activities. Because the adolescent is under the age of 18, the parents should be involved and informed of the care. The nurse can talk with the adolescent and parents about care decisions and the adolescent's need for support from family.

A male nurse is meeting with a group of 12-year-old boys to discuss expected bodily changes. After one of the boy's says, "My older brother told me my bed might be wet and that means I had a wet dream. Is that true?" What is the best response from the nurse? "It will be several years before you will start having wet dreams." "When you are thinking about people you find sexually attractive or dating those people you might have a wet dream." "Having wet dreams indicates that your body is going through a process of maturing." "It is not common to wet the bed or urinate when you have a wet dream."

"Having wet dreams indicates that your body is going through a process of maturing." Explanation: In boys, the appearance of nocturnal emissions ("wet dreams") is often used as the indication that the preadolescent period has ended and that the adolescent is maturing into an adult. Nocturnal emissions usually occur at about the age of 11 in boys. Wet dreams are not associated with urination. Boys at this age start thinking of relationships with people they find sexually attractive, but this is not the best response.

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. Children from ages 2 to 7 years investigate and explore the environment and look at things from their own point of view. Up to age 2, children learn by touching, tasting, and feeling. They learn to control body movement. From ages 7 to 11 years, children internalize actions and can perform them in the mind.

After age 12 children can think in the abstract, including complex problem solving. Explanation: 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 takes place in children 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. At the formal operations, after age 12, children can think in the abstract. Complex problem solving is included in this category.

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? Brush the girl's hair for her. Allow the girl to wear her own clothes, despite hospital policy. Assist the girl with using the bed pan to urinate. Offer to assist the girl in washing her hair and let her pick the shampoo.

Offer to assist the girl in washing her hair and let her pick the shampoo. Explanation: When caring for hospitalized adolescents, providing time for self-care, such as shampooing hair, is important to include in an adolescent's nursing care plan. Offering to assist the client in washing her hair and letting her pick the shampoo both encourages a sense of autonomy to the client and offers her dignity related to her body image. Brushing the girl's hair for her and assisting her with using the bed pan for urination do not encourage a sense of autonomy. If it is the hospital's policy to require clients to be dressed in a hospital gown while admitted, the nurse should not allow the girl to wear her own clothes.

The mother of a 9-year-old female voices concern to the nurse about her daughter developing breasts "at such a young age." How should the nurse respond? "I understand your concern, but girls typically enter puberty around the age of 9 or 10." "I am sure you are concerned but children develop at different rates." "This is rather young to be developing breasts. I will be sure to let the doctor know." "Do the females in your family typically develop at an early age?"

"I understand your concern, but girls typically enter puberty around the age of 9 or 10." Explanation: Voicing empathy regarding the mother's concern conveys support, and letting her know that this is normal growth and development helps ease her concerns. The other responses don't address her concerns or show genuine empathy.

The nurse is promoting nutrition to a 13-year-old child who is overweight. Which instruction should the nurse include? "Keep a food diary." "Go out for a sport at school." "Eliminate sugar from your diet." "You need to go on a low-fat diet."

"Keep a food diary." Explanation: Having the child keep a detailed food diary for 1 week will determine current patterns of eating. This can then be used to show the child how to make small changes with results, especially if eating is done before periods of inactivity such as before going to bed or when bored. Speaking and thinking in terms of diet or eliminating sugar are negative and can lead to poor body image. The child could too easily choose the wrong sport or do poorly. It is best to offer solutions with more variety.

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 is not doing anything to cause the nocturnal emissions; they occur spontaneously." "My son must be sexually active or having overly sexual thoughts to have a nocturnal emission." "My son is developing normally and the traits of puberty vary from child to child." "My son's spontaneous erections and nocturnal emissions are very normal."

"My son must be sexually active or having overly sexual thoughts to have a nocturnal emission." Explanation: Spontaneous erections and nocturnal seminal emissions do not mean that the child is sexually active or having overactive sexual thoughts. Parents need to be instructed that these occurrences are spontaneous and that the child is not doing anything to cause them.

The parent of a Black adolescent voices concern to the nurse because the daughter, "has gotten her period before all of her friends." How should the nurse respond? "I will be sure to let the health care provider know this. We do not want to miss something that may be wrong." "Some girls just get their period earlier than others." "On average Black girls start their period earlier than other ethnicities." "How old are most of her friends? Maybe that is the issue instead of it being a sign of something abnormal."

"On average Black girls start their period earlier than other ethnicities." Explanation: Menarche, the first menstrual period, usually begins between the ages of 9 and 15 years (average 12.8 years), but on average Black adolescents reach menarche earlier than adolescents of other ethnicitic backgrounds. This response addresses the parent's concern. The other responses do not address the parent's concern or may lead the parent to think this is an abnormal occurrence.

An adolescent's parent states not knowing what to do with the adolescent. The parent reports the teenager is taking two or three showers a day when not that long ago the parent could barely get the teen to take a shower at all. What should the nurse's reply be to the parent? "Remind the adolescent about needing to be on a schedule so as to not disrupt the family." "Reinforce the family rules but also allow the adolescent to develop one's own routine." "Reevaluate the adolescent's ability to perform hygiene care since showering is so frequent." "Do not encourage multiple baths; it can be very drying to the skin."

"Reinforce the family rules but also allow the adolescent to develop one's own routine." Explanation: Adolescents find that frequent baths and deodorants are important due to the apocrine sweat gland secretion activity. The increases in sex hormones and steroids cause the skin to be oily. This leads to more showers or baths daily. This is a time when the adolescent is defining what type of personal hygiene products are preferred. Hygiene and personal care can become a source of family arguments as the young person develops a style of personal care. Parents need to be mindful of the adolescent yet maintain family rules and boundaries regarding aspects of personal care. It is important for teenagers to feel that they have some ability to develop their own personal care standards and daily patterns.

During an examination, an adolescent client tells the nurse about being anxious and frustrated because of the facial acne. Which nursing response is appropriate? "This is one of the most common physical changes during adolescence." "I will tell your primary health care provider about your acne." "Consuming fried foods and chocolate can cause acne to develop." "Most people get acne during adolescence. It will go away as you get older."

"This is one of the most common physical changes during adolescence." Explanation: It is important for the nurse to inform the client that acne is a normal physical changes that characterizes adolescence as a result of increased glandular activity. The nurse should address the client's concern and not refer the client to the primary health care provider. The client's worries should not be trivialized or ignored as this is a situation that is worrisome for the adolescent. The type of foods consumed do not cause acne.

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

Banding together with other girls and dressing like them Explanation: In early adolescence, girls tend to band together with girls. They dress identically with other members of their group: jeans and sweatshirts, special jackets, or whatever the fashion may be. On the surface, this makes adolescents appear to be losing their identities rather than finding them.

The nurse is preparing a presentation for a local health fair depicting the differences in maturity between preadolescents. Which differing factor should the nurse prioritize in the presentation? Boys grow at a slower, steadier rate than do girls. Boys grow at a rapid, sporadic rate. Boys and girls grow at the same rate. Girls grow at a slower, steadier rate than do boys.

Boys grow at a slower, steadier rate than do girls. Explanation: Preadolescent boys grow generally at a slower, steadier rate than do girls. Girls grow more rapidly during preadolescence and then their growth rate slows dramatically after menarche.

A nurse is admitting a 16-year-old male to the floor for an appendectomy. How can the nurse prepare this client for hospitalization? Select all that apply. Interview the adolescent separately from the parent to allow expression of information that he may not be comfortable sharing in front of the parent. Remind him that there are strict rules regarding meal times and when lights are turned out on the floor. Provide privacy when client is changing into the hospital gown or going to the bathroom. Encourage parents to do as much as possible for the client, including ADLs and meal selection. Encourage him to keep his cell phone nearby to communicate with his friends.

Encourage him to keep his cell phone nearby to communicate with his friends. Interview the adolescent separately from the parent to allow expression of information that he may not be comfortable sharing in front of the parent. Provide privacy when client is changing into the hospital gown or going to the bathroom. Explanation: In order for an adolescent to adapt well to hospitalization, the nurse needs to provide him privacy and allow him control over his surroundings and care when possible. Keeping in contact with peers is very important to an adolescent, as is being discreet in regard to sharing personal information that typically is elicited in an admission interview.

The nurse is assessing a teenage client and notes his lower front teeth are slightly crossed over. The nurse points out to his caregiver that he should see an orthodontist about this to prevent which potential situation? Uncorrected malocclusions lead to infection and ultimately tooth loss. This could have a lasting effect on his future to include everything from dating to hiring. Leaving even slightly crooked teeth will lead to more cavities later in life. Even slight malocclusions make chewing and jaw function less efficient.

Even slight malocclusions make chewing and jaw function less efficient. Explanation: Dental malocclusion (improper alignment of the teeth) is a common condition that affects the way the teeth and jaws function. Correction of the malocclusion with dental braces improves chewing ability and appearance. Crooked teeth do not lead to more cavities, nor do they lead to infection and tooth loss. While appearance and acceptance in society is important to the adolescent, that is not the most important reason for orthodontic care for the adolescent.

The school nurse is developing a school wellness program to promote healthy eating habits and regular physical activity. What is the most important element to emphasize to maximize compliance, healthy habits, and long-term change? Eliminate sweetened, carbonated beverages in the cafeteria. Incorporate activity in parts of the daily schedule. Serve fruits and vegetables in the cafeteria. Include both parents and children in the wellness program.

Include both parents and children in the wellness program. Explanation: Every campaign to support good nutrition and daily physical activity must include parents and their children as active members of the learning community. Although the other actions can accomplish in-school enhancements to health, long-term change tends to be more likely when the programs implemented involve the family. Programs implemented without a family-centered approach often fail when the child's home life and school life are disconnected.

The nurse is meeting with a group of caregivers of adolescents. Which example should the nurse point out is most effective for the caregiver to support the adolescent? Leave pamphlets about topics such as drugs and alcohol in their room so they can read them. Our house rules are stricter than their friends but everyone follows the same rules in our home. Discourage spending too much time with school friends since we know they can be a negative influence. Let them choose their hairstyle, even though it may not look the best for them.

Let them choose their hairstyle, even though it may not look the best for them. Explanation: The adolescent whose family caregivers make it difficult to conform are adding another stress to an already emotion-laden period. By allowing the adolescent to follow trends and fads in clothing choices, hairstyles, and music, the caregiver decreases the stress for the child. Information about drugs and alcohol is important to share, but these topics would be better discussed with the child. It is important the adolescent spend time with peers.

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

Menarche should follow in about 2 years. Explanation: Menarche usually follows within 2 years of the first signs of breast development. Peak height velocity (PVH) in girls occurs 6 to 12 months following menarche. It does not follow immediately. Breast development progresses through several stages and will not be complete until late puberty. Adult height is not reached at the time of menarche but about 6 to 12 months following menarche.

A 16-year-old client has been hospitalized 100 miles from home for 1 week to repair a fractured patella suffered in a skateboarding accident. 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 nursing intervention should the nurse prioritize for this client? Take her to the teen lounge so she can meet and interact with other teens. Ask her caregivers to bring her siblings and friends to visit. Suggest that she read books and magazines from the hospital bookmobile. Call the hospital's mental health unit to see if she can get some counseling.

Take her to the teen lounge so she can meet and interact with other teens. Explanation: Adolescents need access to their peers so they can keep up social contacts. Meeting other teens in the facility is one way to accomplish that. The client most likely also has an electronic device which will enable her to stay in contact with family and friends back home but meeting others can also help meet social needs. Recreation areas are important. In settings specifically designed for adolescents, recreation rooms can provide an area where teens can gather to do schoolwork, play games and cards, and socialize. Because she is 100 miles from home, a visit from friends might be difficult.

The father of a 15-year-old daughter is concerned she is not getting adequate nutrition to play high school basketball. Her games are on Friday nights. Which suggestion should the nurse point out will best suit the needs of this adolescent? Three daily meals that include choices from each of the food groups; Friday's lunch eaten around 2 p.m. with a small amount of fat and a somewhat larger than usual portion of complex carbohydrates. 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. 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. 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 eaten around 2 p.m. with a small amount of fat and a somewhat larger than usual portion of complex carbohydrates. Explanation: A meal that is low in fat and high in complex carbohydrates, eaten 3 to 4 hours before an event, is appropriate for the teen athlete. Carbohydrate-loading, which some practice during the week before an athletic event, increases the muscle glycogen level to 2 to 3 times normal and may hinder heart function. The other suggested menus would not provide the additional muscle glycogen needed for optimal functioning.

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? developing stability sharing problems following role models negotiating differences

following role models Explanation: Peers serve as role models for social behaviors, so their impact on an adolescent can be negative if the group is using drugs, or the group leader is in trouble. Sharing problems with peers helps the adolescent work through conflicts with parents. The desire to be part of the group teaches the child to negotiate differences and develop loyalties and stability.

A teen is suspected of having anovulatory menstrual cycles. This would be the result of which hormone? progesterone estrogen prolactin luteinizing hormone

luteinizing hormone Explanation: Luteinizing hormone is responsible for ovulation. Estrogen and progesterone impact the menstrual cycle but do not control ovulation. Prolactin is responsible for preparing the breasts for nursing.

The parents of a 16-year-old are fearful that their child may be using illegal drugs. They report to the nurse that they have noticed recently that their child seems much more focused when doing homework or chores, is losing weight, displays a high level of energy, and becomes agitated easily. The nurse is aware that the teen is displaying symptoms of which type of drug use? CNS depressant methamphetamine opiate inhalant

methamphetamine Explanation: Euphoria, increased energy and alertness, agitation, weight loss, insomnia, tachycardia, and hypertension are symptoms of methamphetamine use. Stimulants have similar effects as alcohol but the high only lasts a few minutes and includes slurred speech, lack of coordination, euphoria, and dizziness. Opiates produce feelings of relaxation and euphoria. CNS depressants cause euphoria followed by depression or hostility, impaired judgment, decreased inhibitions, slurred speech, and incoordination.

Nurses should provide anticipatory guidance to males to prepare them for what particular pubertal change in middle-to-late adolescence? pubic hair growth reddening of the scrotum lengthening of the penis nocturnal emissions

nocturnal emissions Explanation: Involuntary ejaculation during the night can be disturbing to the adolescent male who has little or no understanding of what is happening in the body. Lengthening of the penis begins to occur in early adolescence as does reddening of the scrotum and emergence of pubic hair.