Chapter 29: Growth and Development of the Adolescent - ML3

Correct response: Have the adolescent keep a food diary for 1 week. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, THE NURSE'S ROLE IN ADOLESCENT GROWTH AND DEVELOPMENT, p. 1043. Explanation: Having Jordan keep a food diary over a week allows you as well as him to examine what he is eating and when he is eating it. Keeping a food journal allows Jordan and the nurse to discuss the choices that he has made and the substitutes that he could possibly make. The times that Jordan eats may also lead to his weight gain. When the patterns are set in writing it gives the adolescent the chance for review and change

A 15-year-old adolescent shows a pattern of gaining weight, not a large amount but a little more each visit. The adolescent is not active in any sports and eats out frequently with parents. What is the best way for the nurse to assess the adolescent's eating pattern? Ask the adolescent to show the nurse what a healthy portion looks like. Have the adolescent keep a food diary for 1 week. Have the adolescent guess the calorie intake in a 24-hour period. Ask the adolescent to recall what was eaten in the last 3 days.

Correct response: "Wet dreams are not the result of anything you are doing but are simply the body's way of ridding itself of excess semen." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PHYSIOLOGIC CHANGES ASSOCIATED WITH PUBERTY, p. 1035. Explanation: Boys who are unprepared for nocturnal emissions may feel guilty, believing that they have caused these "wet dreams" by sexual fantasies or masturbation. They need to understand that this is a normal occurrence and is simply the body's method of getting rid of surplus semen. The other suggestions do not address the situation in a professional manner.

A 15-year-old client tells the nurse he has been having wet dreams and is ashamed and afraid he will get into trouble because he believes his parents think he is too young to understand or know about sex. To which statement would be the most appropriate for the nurse to respond? "You don't need to feel ashamed. I will speak to your parents about the importance of allowing you to experiment with and feel good about your sexuality." "Wet dreams are not the result of anything you are doing but are simply the body's way of ridding itself of excess semen." "Since your parents feel you are not ready to talk about sex, you need to honor their wishes and not bother them with this." "Don't worry, it is perfectly normal for 15-year-olds to have the kinds of fantasies that lead to wet dreams. You should tell your parents about this."

Correct response: "This is common for this age group and it will get better with time." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1051.

A 15-year-old client's parent comments on the fact that the adolescent seems to always choose the opposite of what everyone else wants and that mood swings are a common occurrence. What statement shows the nurse that the client's parent understands these changes? "My adolescent will never find anyone to live with if the adolescent acts like this." "This is common for this age group and it will get better with time." "This is my adolescent's temperament, and we will have to learn how to deal with it." "I know that my adolescent is doing this because of all the hormones."

Correct response: "Tattoos are invasive and there is the potential for disease with their application." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1052.

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

Correct response: Offer to assist the girl in washing her hair and let her pick the shampoo. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1052. Remember 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 patients to be dressed in a hospital gown while admitted, the nurse should not allow the girl to wear her own clothes.

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? 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. Brush the girl's hair for her. Allow the girl to wear her own clothes, despite hospital policy.

Correct response: Allow friends to visit during visiting hours. Include the parents when educating the client. Arrange care to provide for extra rest and sleep. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, THE NURSE'S ROLE IN ADOLESCENT GROWTH AND DEVELOPMENT, p. 1042. 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 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. Keep the client in hospital gowns for sanitary reasons. Include the parents when educating the client. Allow friends to visit during visiting hours. Arrange care to provide for extra rest and sleep. Have the nurse control the patient's care as much as possible.

Correct response: "I only tan before going on spring break to get a base tan so I won't burn." "My favorite time of day to be outside is the middle of the day, around noon." "The more exposure and burns I get now will toughen my skin so I won't get skin cancer when I'm older." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1053.

A 16-year-old adolescent is talking with the nurse at a local health clinic about skin care. Which comments by the teen does the nurse determine require additional conversation? Select all that apply. "My favorite time of day to be outside is the middle of the day, around noon." "Our coach makes us wear sun-protective clothes when we practice outside on the weekends." "I only tan before going on spring break to get a base tan so I won't burn." "My mom had melanoma so she always makes me wear a sunscreen with an SPF of 30." "The more exposure and burns I get now will toughen my skin so I won't get skin cancer when I'm older."

Correct response: Take her to the teen lounge so she can meet and interact with other teens. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT - TEACHING GUIDELINES 29.1, pp. 1046-1048.

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? Suggest that she read books and magazines from the hospital bookmobile. Ask her caregivers to bring her siblings and friends to visit. 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.

Correct response: "Be sure to clean the navel several times a day." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1052.

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? "This is a risk for hepatitis, tetanus, and AIDS." "Be sure to clean the navel several times a day." "I hope for your sake the needle was clean." "This is a wound and can become infected."

Correct response: "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: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1049.

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." "As long as you are taking in around 2,000 calories per day you should be just fine." "Can you tell me the reason you feel the need to cut your carbohydrates when your activity level is high?" "Since you are so active, your carbohydrate intake should comprise 45% to 65% of your daily diet." "Twenty-five to 35 percent of your diet should be carbohydrates so you fall into the acceptable range."

Correct response: "Drinking sodas is not related to my blood pressure." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1050.

A black adolescent male has been diagnosed with hypertension. Which statement made by the adolescent indicates to the nurse that additional teaching is needed? "My dad has hypertension, so I have to be careful." "Playing baseball is good exercise for me." "My blood pressure should remain less than 130/90 mm Hg." "Drinking sodas is not related to my blood pressure."

Correct response: Allow the adolescent to choose the time for the dressing change. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, THE NURSE'S ROLE IN ADOLESCENT GROWTH AND DEVELOPMENT, pp. 1042-1043.

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. Teach the parents to perform dressing changes at home. Have the adolescent go to the teen room every day. Allow the adolescent to choose the time for the dressing change.

Correct response: Provide reassurance that these are normal changes. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PHYSICAL GROWTH, p. 1035.

A female client tells the nurse about noticing an increase in weight and fat deposits during the past 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? Share what foods can be eaten on a low-fat diet to prevent fat deposits. Review dietary measures to assist in controlling weight gain. Provide reassurance that these are normal changes. Encourage increased exercise to control weight gain.

Correct response: "Do you take anabolic steroids?" Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, HEALTHY PEOPLE 2030, p. 1059. Anabolic steroids are used by adolescents who play sports. They are used to enhance the adolescent's athletic ability. They produce euphoria and lessened fatigue. Unfortunately, steroid use can also lead to early closure of the epiphyseal plate, acne, elevated triglyceride levels, hypertension, aggressiveness, and possibly psychosis. Human growth hormone is also used to enhance athletic performance. The side effects of it are joint pain and swelling and the development of diabetes. Amphetamines provide a sense of well-being, alertness, and self-esteem. They can produce paranoia and extreme restlessness. Cocaine produces increased pulse and respirations, increased temperature, and blood pressure and decreased appetite.

A high school athlete comes to the emergency department with hypertension, aggressiveness, and psychosis. What question would be important for the nurse to ask the client? "Do you take human growth hormone?" "Do you take cocaine?" "Do you take anabolic steroids?" "Do you take amphetamines?"

Correct response: "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: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, BOX 29.1 Ways to Improve Communication with Teens, p. 1039.

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. "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." "Tell him firmly that you have the answers because you are his parents." "When you talk to him, speak to him face to face and be careful of your body language."

Correct response: "Having wet dreams indicates that your body is going through a process of maturing." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PHYSIOLOGIC CHANGES ASSOCIATED WITH PUBERTY, pp. 1034-1035.

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? "When you are thinking about people you find sexually attractive or dating those people you might have a wet dream." "It will be several years before you will start having wet dreams." "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."

Correct response: After age 12 children can think in the abstract, including complex problem solving. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, COGNITIVE DEVELOPMENT, pp. 1037-1038.

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. 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. Children from ages 2 to 7 years investigate and explore the environment and look at things from their own point of view.

Explanation: Because many adolescents who run away are not good problem solvers, setting goals with them may be difficult. As the adolescent has no money for food, telling her to eat a nutritious diet is not attainable. If the adolescent does not have a means of transportation, she may be unable to return to the health care facility for frequent follow-up visits. The nurse should ask the adolescent if she wants to return home and if possible, ascertain if the parents will allow the adolescent back home. While food and antenatal visits are necessary, safety is the priority for the mother and the baby.

A runaway female adolescent has come to the community clinic because she is pregnant. When developing a plan of care, the nurse should identify which priority goal for this client? returning home to parents safe housing monthly prenatal visits adequate nutrition

Correct response: "I get 7 hours of sleep every night so I don't know why I am so tired." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1051.

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 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 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."

Correct response: autonomy Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PSYCHOSOCIAL DEVELOPMENT, p. 1036.

A teenage boy tells the nurse that his parents embarrass him in front of his friends when they kiss him goodbye. The nurse is aware that this teenager is revisiting which stage of development identified by Erikson? industry autonomy generativity initiative

Correct response: identity vs. role confusion. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, TABLE 29.2 Developmental Theories, p. 1037.

According to Erikson, the adolescent develops their own sense of being an independent person with individual thoughts and goals. This stage is referred to as: industry vs. inferiority. autonomy vs. doubt and shame. identity vs. role confusion. intimacy vs. isolation.

Explanation: Adolescence is a period of rapid growth with dramatic changes in body size and proportions. It is the time between puberty and the end of physical growth. During this time, sexual characteristics develop and reproductive maturity occurs. Puberty is the point at which an individual becomes capable of sexual reproduction. Puberty starts at different ages for males and females. Puberty is defined as sexual maturity only. It does not describe emotional maturity.

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

Correct response: "You are feeling sad right now. It's a hard time." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, THE NURSE'S ROLE IN ADOLESCENT GROWTH AND DEVELOPMENT, p. 1043.

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? "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."

Correct response: "Reinforce the family rules but also allow the adolescent to develop one's own routine." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1054.

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? "Do not encourage multiple baths; it can be very drying to the skin." "Reevaluate the adolescent's ability to perform hygiene care since showering is so frequent." "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."

Correct response: "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: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1052.

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. "You are very young to have a navel piercing. Do your parents know you have this?" "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." "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." "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."

Correct response: the amount of carbohydrates the student is eating Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1049. Explanation: Glycogen loading is a procedure used to ensure there is adequate glycogen to sustain energy through an athletic event. Several days before a sports event, athletes lower their carbohydrate intake and exercise heavily to deplete muscle glycogen stores. They then switch to a diet high in carbohydrate. With the renewed carbohydrate intake, muscle glycogen is stored at 2 to 3 times the usual level, which supplies them with up to 2 times the glucose needed for sustained energy. Athletes need more energy from carbohydrates than protein. Participating in this practice would cause a negative nitrogen balance, not a positive.

Glycogen loading is practiced regularly by the local high school football team. What is most important for the nurse to monitor in these students? the amount of carbohydrates the student is eating how many hours the student exercises each day how often the students engage in this practice the amount of protein the student is eating

Correct response: nocturnal emissions Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PHYSIOLOGIC CHANGES ASSOCIATED WITH PUBERTY, p. 1035.

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

Correct response: lack of coordination excessive itching confusion Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, TABLE 29.3 Drugs Commonly Abused, p. 1057. Explanation: Adolescents who misuse cough medications with codeine can have a drunken appearance, a lack of coordination, confusion, and excessive itching. They may also be found with empty bottles of cough medications. Enlarged pupils would be seen with marijuana use. Excessive giggling and silliness can be seen with stimulant ingestion.

Teachers are in a class on drug use taught by the school nurse. The nurse instructs the teachers to observe for which physical symptoms from misuse of cough medications with codeine? Select all that apply. confusion giggling enlarged pupils lack of coordination excessive itching

Correct response: development of a trusting relationship compliance with existing laws an environment where adolescents can be truthful Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, EMOTIONAL AND SOCIAL DEVELOPMENT, pp. 1040-1041.

The adolescent comes to the clinic seeking information about sexuality concerns. The clinic nurse assures the adolescent that confidentiality and privacy will be maintained unless a life-threatening situation occurs. Maintaining confidentiality demonstrates which nursing goal? Select all that apply. an environment where adolescents can be truthful development of a trusting relationship compliance with existing laws inappropriate response because adolescents are minors concern from parents who pay the office visit bill

Correct response: "You are experiencing rapid and uneven growth now which can interfere with coordination." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, MOTOR SKILL DEVELOPMENT, p. 1038.

The clinic nurse is assessing a 14-year-old client. The client states "I am worried I have a brain tumor. I am so clumsy when I play sports now that it is totally embarrassing." Which response by the nurse is appropriate? "I will request the primary health care provider prescribe a magnetic resonance image (MRI)." "I understand why you are worried. Has anyone else in your family had a brain tumor." "Have you noticed any changes in your vision or hearing lately?" "You are experiencing rapid and uneven growth now which can interfere with coordination."

Correct response: 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: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1049. 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 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? 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. 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. 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.

Correct response: Require the son to wear a helmet. Require the son to wear long pants. Require the son to wear full body covering. Require the son to learn all relevant safety rules. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, TEACHING GUIDELINES 29.1, p. 1047. Explanation: Equally dangerous as cars for adolescents are motorcycles, motorbikes, and motor scooters, which are appealing because of their low cost and convenience in parking. Both drivers and riders should wear safety helmets to prevent head injury; long pants to prevent leg burns from exhaust pipes; and full body covering to prevent abrasions in case of an accident. Advise adolescents who choose these forms of transportation to be as familiar with safety rules as automobile drivers and to wait until they are emotionally mature enough to use sound driving judgment. In the interest of an adolescent's safety and that of others, parents need to have the courage to insist on emotional maturity rather than age as the qualification for obtaining a driver's license. Motorcycles do not have seat belts.

The mother of a 15-year-old boy confides in the nurse that she is concerned because her son is about to turn 16 and is pressuring her and her husband to buy him a motorcycle. Her husband is okay with the idea, but she is concerned about his safety. What information should the nurse mention to the mother regarding motorcycle safety? Select all that apply. 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 full body covering. Require the son to learn all relevant safety rules. Require the son to wear a seat belt. Require the son to wear a helmet.

Correct response: "I understand your concern, but girls typically enter puberty around the age of 9 or 10." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PHYSIOLOGIC CHANGES, p. 1036.

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 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."

Correct response: The adolescent's need for privacy should be respected. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, THE NURSE'S ROLE IN ADOLESCENT GROWTH AND DEVELOPMENT, p. 1042.

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.

Correct response: pubic hair spreading to the sides enlargement of the testes longer extremities relative to trunk Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, TABLE 29.1 Physiologic Changes of Adolescence, p. 1034.

The nurse is assessing a 12=year-old boy. Which assessment finding(s) are consistent with the child's age? Select all that apply. changes in voice coarse pubic hair longer extremities relative to trunk pubic hair spreading to the sides enlargement of the testes

Correct response: "Your child can become modest and self-conscious and teasing may cause embarrassment." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, TABLE 29.1 Physiologic Changes of Adolescence, p. 1034.

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? "Based on your child's age, changes in hair distribution and voice pitch are expected." "It would be helpful to discuss with your child your trials with puberty and the changes you experienced." "I remember that time in my life, it was so awkward and uncomfortable." "Your child can become modest and self-conscious and teasing may cause embarrassment."

Correct response: Even slight malocclusions make chewing and jaw function less efficient. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1052. 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 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? Leaving even slightly crooked teeth will lead to more cavities later in life. Even slight malocclusions make chewing and jaw function less efficient. 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.

Correct response: 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: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, MORAL AND SPIRITUAL DEVELOPMENT, p. 1038. Explanation: According to Kohlberg, the middle post-conventional phase is characterized by the adolescent developing their 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 their own morals and values, and continue to compare own morals and values to those of society. During this phase the adolescent also evaluates morals of others. The statements regarding the rich in society and work ethic demonstrate this late phase.

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 talking with a friend and states, "I don't understand how some of the rich in our society don't help the poor." The nurse hears the adolescent asking the parents, "How does God decide that some people get sick and some people don't?" 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 states, "I am glad my parents instilled such a good work ethic in me."

Correct response: Discuss adverse side effects with the client. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 1056.

The nurse is caring for a 16-year-old client. The client confides in the nurse that they use of marijuana daily. Which action by the nurse is appropriate? Discuss adverse side effects with the client. Notify local law enforcement. Determine how long the client has used marijuana. Ask the client where the marijuana is obtained.

Correct response: The bones, joints, and tendons of adolescents are vulnerable to injury due to their rapid state of growth. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1045. 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 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.

Correct response: "Boys your age will often continue growing for a few more years." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PHYSICAL GROWTH, p. 1035.

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? "Boys your age will often continue growing for a few more years." "I am sure you are not the shortest guy in your class." "Being short is nothing to be ashamed of." "Are the other men in your family short?"

Correct response: "Our adolescent is working toward achieving a sense of personal identity." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PSYCHOSOCIAL DEVELOPMENT, pp. 1036-1037.

The nurse is discussing an adolescent's development with the client's parents. Which statement by the parents indicate an understanding of the nurse's teaching? "It is most important for our adolescent to achieve independence from our dominance." "We will work toward ensuring our adolescent is developing trusting relationships." "It is vital our adolescent learns to help others achieve their goals." "Our adolescent is working toward achieving a sense of personal identity."

Correct response: The adolescent will likely have the greatest influence on one's own decisions. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, COGNITIVE DEVELOPMENT, p. 1037.

The nurse is educating a 17-year-old adolescent after a new diagnosis of diabetes. What does the nurse understand about teaching an adolescent? The adolescent will likely have the greatest influence on one's own decisions. The siblings of the adolescent will need to be taught healthy cooking classes related to diabetes. The parents will need to be instructed separately from the adolescent. The adolescent will respond best to teaching about how to avoid future complications.

Correct response: chicken, whole-wheat bread, watermelon Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, Promoting Nutrition, p. 1049. Chicken, whole-wheat bread, and watermelon are all foods high in iron. The calorie content will not promote weight gain. All the other options do not include good sources of iron but are nutritious foods. Calorie content is also acceptable.

The nurse is educating an adolescent female who needs to increase dietary iron but has expressed concern about weight gain. What dietary choices would the nurse recommend? raspberry yogurt, granola, apple chicken, whole-wheat bread, watermelon pasta, broccoli, pear cottage cheese, crackers, oranges

Correct response: Being honest and straightforward with teenagers will encourage them to ask about subjects like sexuality. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, EMOTIONAL AND SOCIAL DEVELOPMENT, p. 1040.

The nurse is meeting with a group of caregivers of adolescents and discussing sex and sexuality, including how to discuss these issues with their children. Which comment should the nurse prioritize with this group of caregivers? Being honest and straightforward with teenagers will encourage them to ask about subjects like sexuality. Most schools have excellent programs to teach adolescents about sex and sexuality. Teenagers spend so much time with their peers, and that is usually how they find out about sex. Internet resources, movies, and television have the most accurate and current information for your adolescent to learn about sexuality issues.

Explanation: If the boy has just entered adolescence, he is likely to exhibit frequent mood changes. A growing interest in attracting girls' attention and understanding that actions have consequences are typical of the middle stage of adolescence. Feeling secure with his body image does not occur until late adolescence.

The nurse is performing a health surveillance visit with a 12-year-old boy. Which characteristic suggests the boy has entered adolescence? experiences frequent mood changes feels secure with his body image understands that actions have consequences shows growing interest in attracting girls' attention

Correct response: Ask the parents to wait in the family lounge while finishing the assessment, then ask the teen during the assessment. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, THE NURSE'S ROLE IN ADOLESCENT GROWTH AND DEVELOPMENT, pp. 1042-1043.

The nurse is performing an admission assessment of an adolescent with the teen and the parents. During the assessment the nurse suspects that the teen may be pregnant. What is the best way for the nurse to address this situation? Ask the parents to wait in the family lounge while finishing the assessment, then ask the teen during the assessment. Ask the teen's physician to talk to the parents and the teen about the possibility of pregnancy. Ask the parents to step out of the room and tell them the nurse's suspicion. Ask the teen, with the parents present, if she might be pregnant.

Correct response: Participate in 60 minutes of moderate to vigorous physical activity each day. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, Promoting Growth and Development Through Sports and Physical Fitness, p. 1045. The U.S. Department of Health and Human Services (HHS) recommends that adolescents participate in 60 minutes of moderate to vigorous physical activity each day (CDC, 2018a). Nurses should encourage all adolescents to be physically active daily.

The nurse is planning a presentation to an adolescent group. What recommendations would the nurse include in the presentation? Engage in aerobic exercise for 30 minutes, three days per week. Participate in weekly physical activities that cause sweating and rapid breathing. Participate in 60 minutes of moderate to vigorous physical activity each day. Engage in at least one competitive sport during the school year.

Correct response: Boys grow at a slower, steadier rate than do girls. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PHYSIOLOGIC CHANGES ASSOCIATED WITH PUBERTY, pp. 1034-1035. 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.

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? Girls grow at a slower, steadier rate than do boys. Boys and girls grow at the same rate. Boys grow at a slower, steadier rate than do girls. Boys grow at a rapid, sporadic rate.

Correct response: whole grain bread Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, BOX 29.3 Foods High in Iron, p. 1049. 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 promoting nutrition to a teen who is going through a growth spurt. Which food should the nurse recommended for its high iron content? organic carrots fresh orange juice whole grain bread fat-free milk

Correct response: Checking for signs of depression or lack of friends. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1054.

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? Checking for signs of depression or lack of friends. Becoming acquainted with the teen's friends. Monitoring video games, TV shows, and music. Watching for aggressive behavior or racist remarks.

Correct response: "That must be hard for you to manage. Perhaps we can explore some strategies with her to establish more predictable sleep patterns." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT It takes multiple groups who address, p. 1051.

The nurse is providing anticipatory guidance to the parents of a 15-year-old who voice concerns with their teenager's sleep habits. They state, "Left to her own devices, I'm sure she'd stay up until 3:00 in the morning on the weekends and sleep until after lunchtime." Which should the nurse explain to the parents? "It's very important that you communicate to your daughter that this is unacceptable because it can have a negative effect on her health." "That must be hard for you to manage. Perhaps we can explore some strategies with her to establish more predictable sleep patterns." "I can hear that this is exasperating for you, but know that children do grow out of this in time, with no ill effects." "This is expected at this stage of development. Are there any ways that you could adjust your family routines to accommodate this?"

Correct response: "Taking a course on driving safety is sufficient to teach safe driving skills." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, TEACHING GUIDELINES 29.1 Promoting Safety, p. 1047.

The nurse is providing education on adolescent safety to a group of caregivers. Which statement by a caregiver indicates additional teaching is needed? "Teenagers should not cook on the stove when home alone." "Setting limits is beneficial when rearing teenagers." "Firearms should be kept in locked boxes, closets, or cabinets." "Taking a course on driving safety is sufficient to teach safe driving skills."

Correct response: following role models Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, EMOTIONAL AND SOCIAL DEVELOPMENT, p. 1040.

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? negotiating differences developing stability following role models sharing problems

Correct response: Is there a gun in your home? Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT- TEACHING GUIDELINES 29.1, pp. 1047-1048. He may be at risk for suicide. Firearm-related suicides have been responsible for a large number of the suicide deaths in 15- to 19-year-olds nationwide. All the other questions assess for depression and do not protect against suicide.

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

Correct response: "On average Black girls start their period earlier than other ethnicities." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PHYSIOLOGIC CHANGES ASSOCIATED WITH PUBERTY, pp. 1034-1035.

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." "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." "Some girls just get their period earlier than others."

Correct response: "The calories help his body increase muscle mass." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PHYSICAL GROWTH, pp. 1035-1036.

The parents are concerned their 14-year-old child is always eating. The child weighs 54 kg and is 65 inches (165 cm) tall. What is the best explanation the nurse can give the parents? "He is substituting food for unfilled needs." "He needs the calories because he participates in sports." "His calorie intake predisposes him to future obesity." "The calories help his body increase muscle mass."

Correct response: He 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. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, EMOTIONAL AND SOCIAL DEVELOPMENT, pp. 1040-1042.

The parents of a 16-year-old male are worried about recent changes in his behavior, ignoring his schoolwork and sports, and spending almost all of his free time interacting with his girlfriend. Which suggestion should the nurse point out would best address this situation? He 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. He 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. He 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. He 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.

Correct response: The teen is uncertain and frequently unable to make decisions. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PSYCHOSOCIAL DEVELOPMENT, p. 1036.

The physician has made a notation in the medical record of a 17-year-old that the teen is not demonstrating successful completion of Erikson's stages of development. What behavior would be consistent with this assessment? The teen is distrustful of others. The teen is uncertain and frequently unable to make decisions. The teen is sexually promiscuous. The teen is anxious to move away from his parent's home.

Correct response: Include both parents and children in the wellness program. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, pp. 1059-1060.

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. Include both parents and children in the wellness program. Serve fruits and vegetables in the cafeteria.

Correct response: motor vehicle safety Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1046.

The school nurse is preparing health promotion presentations regarding unintentional injuries for a high school health fair. On which topic should the nurse place as the priority when preparing the presentation? water sports injuries drug and alcohol use prevention poison prevention motor vehicle safety

Correct response: Describe a normal serving size. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, pp. 1049-1050.

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

Correct response: Menarche should follow in about 2 years. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PHYSIOLOGIC CHANGES ASSOCIATED WITH PUBERTY, pp. 1034-1035.

What anticipatory guidance can the nurse provide the girl who has noted the development of breast buds?

Correct response: Allow the client's friends to visit while the client is hospitalized Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, PSYCHOSOCIAL DEVELOPMENT, p. 1036.

Which nursing action will best assist a 15-year-old client accomplish the developmental task according to Erikson? Allow the client's friends to visit while the client is hospitalized Provide the client with crafts and puzzles to complete independently Permit the client to make decision regarding one's care Praise the client for correctly performing self-care

Correct response: Urine drug screen Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, TABLE 29.3 Drugs Commonly Abused, pp. 1057-1058.

While assessing a 17-year-old client, the nurse notes the following: blood pressure 152/96 mm Hg, pulse 124 beats/minute, respirations 20 breaths/minute, temperature 98.8°F (37.1°C), dilated pupils, euphoric state, and pressured speech. Which intervention would the nurse anticipate the health care provider to prescribe first? Urine drug screen Hydrochlorothiazide daily Low-sodium diet Magnetic resonance imaging (MRI)

Correct response: Wear sunglasses. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 29: Growth and Development of the Adolescent, TEACHING GUIDELINES 29.1, p. 1048. Sunglasses can be a fashion statement and are likely to be accepted. The other pieces of advice are less appealing to adolescents who link a tan body to beauty. Unfortunately sun exposure is cumulative over a lifetime, and much of it occurs in youth making protecting young skin important.

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