F. A. Davis Development in adolescents & Young Adults

The nurse is teaching about suggested health screenings for a healthy female young adult. What should be included in the teaching? Select all that apply. A. A Papanicolaou (PAP) test should be performed every 3 years between the ages of 21 and 29. B. Regular inspection of breasts should be performed, with changes reported to your provider. C. Because you began your period at age 11, you won't need to get a mammogram until age 40. D. A bone density test for osteoporosis should be completed every 5 years beginning at age 25. E. A stool sample will be taken to evaluate for occult blood and colon cancer.

Correct! A. A Papanicolaou (PAP) test should be performed every 3 years between the ages of 21 and 29. Rationale: A Pap test (to screen for cervical cancer) should be performed every 3 years for women between the ages of 21 and 29. B. Regular inspection of breasts should be performed, with changes reported to your provider. Rationale: Tell the patient to be vigilant about breast cancer detection. If she notices any changes in her breasts, such as a new lump or skin changes, instruct her to consult her doctor. Wrong! C. Because you began your period at age 11, you won't need to get a mammogram until age 40. Rationale: Women younger than 40 who have risk factors should ask their healthcare provider whether they need mammograms. Risk factors include personal and family history of breast cancer, having the first child late in the childbearing cycle, having the first menstrual period before age 12, and certain breast changes. D. A bone density test for osteoporosis should be completed every 5 years beginning at age 25. Rationale: Osteoporosis screening is suggested for at-risk women who elect it. Most guidelines recommend assessing all adults age 50 years or older for risk facts (e.g., smoking, low body weight) with bone density measurement based on risk profile. E. A stool sample will be taken to evaluate for occult blood and colon cancer. Rationale: Occult blood testing and sigmoidoscopy or colonoscopy begins at age 50 (earlier and more frequently for high-risk patients) until age 75 years.

The nurse is performing an assessment on a young adult during the annual visit. Which finding would encourage the nurse to suggest a screening for diabetes? A. BMI of 34 B. Daily alcohol ingestion C. Family history of early heart disease D. Sedentary lifestyle

Correct! A. BMI of 34 Rationale: Being over weight contributes to the risk of metabolic syndrome, which includes diabetes and heart disease. Wrong! B. Daily alcohol ingestion Rationale: Alcohol abuse puts one at risk for liver disease and kidney problems. C. Family history of early heart disease Rationale: A family history of heart disease puts a client at high risk of developing heart disease, not diabetes. D. Sedentary lifestyle Rationale: Sedentary lifestyle can contribute to diabetes or heart disease, but many people with this lifestyle do not develop these health issues.

An adolescent girl comes to the clinic 4 months pregnant. She tells the nurse, "At least I'm young, that will make the pregnancy easier than if I was in my 20s or older." Which risks of adolescent pregnancy should the nurse teach about? Select all that apply. A. Bone density loss B. Iron-deficiency anemia C. Loss of educational opportunities D. Increased risk for gestational diabetes E. Interruption of development tasks

Correct! A. Bone density loss Rationale: Bone density loss is related to lack of calcium intake during pregnancy B. Iron-deficiency anemia Rationale: Poor diet and lack of prenatal care contribute to iron-deficiency anemia. C. Loss of educational opportunities Rationale: Many pregnant teens either leave school during pregnancy or after the baby is born. E. Interruption of development tasks Rationale: The mother must change her focus to the child instead of her own growth. Wrong! D. Increased risk for gestational diabetes Rationale: Adolescents are at higher risk for complications of pregnancy, but not specifically gestational diabetes.

The nurse is assessing a client who has been the victim of intimate partner violence (IPV) over the past 6 months. What should the nurse include in the assessment documentation? Select all that apply. A. Feelings of guilt B. Signs of sexual promiscuity C. Statements that the abuse was deserved D. Feelings of responsibility for being a victim E. Statement of hateful feelings

Correct! A. Feelings of guilt C. Statements that the abuse was deserved D. Feelings of responsibility for being a victim Rationale: Self-esteem disturbance related to feeling guilty, deserving of abuse, and responsible for being a victim are common in IPV. Wrong! B. Signs of sexual promiscuity Rationale: Promiscuity is not a reason for IPV and has nothing to do with abuse that occurred. E. Statement of hateful feelings Rationale: Hateful feelings are natural from someone who is being victimized. This is not necessary for documentation.

What type of advanced thinking develops during young adulthood? A. Post-formal operations B. Formal operations C. Rational thought D. Future thinking

Correct! A. Post-formal operations Rationale: In this phase, the young adult is able to accept contradictions and fine points in thinking. Wrong! B. Formal operations Rationale: This happens when adolescents develop rational thinking and the ability to predict outcomes C. Rational thought Rationale: Rational thought is developed during adolescence and continues through young adulthood. D. Future thinking Rationale: Future thinking develops during adolescence. Test-Taking Tip: Contemporary psychologists have identified and additional type of thinking: post-formal operations. This post-formal thinker recognizes that their opinion on a social controversy has aspects of two opposing viewpoints. They see merit in both parts of the argument and are comfortable with the discrepancy.

Adolescents are more likely to contract a sexually transmitted infection (STI). Which of the following is contributing to this growing trend? Select all that apply. A. Use of social media for "hooking up" B. Concurrent sexual partners and multiple sexual partners C. The belief that condoms protect from all STDs D. Sexually active teens use condoms E. Oral sex has increased in prevalence among adolescents

Correct! A. Use of social media for "hooking up" Rationale: Adolescents have the ability to seek out consensual partners by using dating apps on their phones. B. Concurrent sexual partners and multiple sexual partners Rationale: Having concurrent and multiple sexual partners has become more acceptable because of information shared via the internet. C. The belief that condoms protect from all STDs Rationale: Many teens have the mistaken belief that condoms protect them from every STD. Trichomonas and monilial infections and human papillomavirus (HPV) are common infections not prevented by condom use. E. Oral sex has increased in prevalence among adolescents Rationale: Between 2010 and 2013, 51% of males and 47% of females ages 15 to 19 years reported that they had engaged in oral sex with an opposite sex partner. Test-Taking Tip: Researchers now believe that increased social media use may be responsible for an increase in risky sexual behaviors and a decrease in overall social and sexual wellness in adolescents. Wrong! D. Sexually active teens use condoms Rationale: Two-thirds of sexually active teens report using a condom. Test-Taking Tip: Researchers now believe that increased social media use may be responsible for an increase in risky sexual behaviors and a decrease in overall social and sexual wellness in adolescents.

The nurse evaluates the social developmental stage of a young adult. Which statement shows normal development? A. "I care for my aging parents, fixing them dinner nightly." B. "Some of my best friends are my fraternity brothers from college 5 years ago." C. "I don't like to date, and I never plan to get married." D. "I finished my education, but I don't care if I work or not."

Correct! B. "Some of my best friends are my fraternity brothers from college 5 years ago." Rationale: Developing lasting relationships is an important aspect of young adulthood. Wrong! A. "I care for my aging parents, fixing them dinner nightly." Rationale: Taking care of aging parents could happen during this stage, but it may create social isolation and does not foster long-term relationships. C. "I don't like to date, and I never plan to get married." Rationale: Not all young adults choose to get married or have children, but an important aspect of this stage is finding lasting relationships. D. "I finished my education, but I don't care if I work or not." Rationale: The transition of young adulthood includes the development of self-sufficiency.

The nurse is interviewing a sexually active young adult who has multiple partners. Which sexually transmitted infections (STIs) should the client be screened for? Select all that apply. A. Pregnancy B. Chlamydia C. Genital Warts D. Candida E. Gonorrhea

Correct! B. Chlamydia Rationale: This is a very common STI that is contracted by 13 million teenagers and young adults (age 14-24 years) every year. C. Genital Warts Rationale: This is a commonly transmitted STI that appears as blisters on the sexual organs. E. Gonorrhea Rationale: This is an STI that is transmitted through anal, oral, and sexual intercourse. Wrong! A. Pregnancy Rationale: Pregnancy, although a result of sexual intercourse, is not an STI. D. Candida Rationale: Candida is a yeast infection, which can be caused by a variety of issues, including prescribed antibiotics.

The nurse is teaching a male teenage client about testicular self-examinations (TSEs). Which is important to include in the teaching? A. Perform a TSE weekly. B. Perform the exam after a warm bath or shower. C. Examine both testicles at the same time and compare how they feel. D. The testes should feel perfectly smooth, like an egg.

Correct! B. Perform the exam after a warm bath or shower. Rationale: When performing a TSE after a warm bath or shower, finding abnormalities is easier because heat relaxes the scrotum. Wrong! A. Perform a TSE weekly. Rationale: Doctors recommend that all men examine their testicles monthly after puberty. C. Examine both testicles at the same time and compare how they feel. Rationale: Each testicle should be examined individually for abnormal lumps, bumps, or tenderness. D. The testes should feel perfectly smooth, like an egg. Rationale: The testes are not like an egg, as the vans deferens and caput epididymis are palpable.

A client in the clinic tells the nurse that his partner yells and screams at him, telling him that he is ugly and stupid. He tells the nurse that he feels depressed and worthless because of it. What action should the nurse take? A. Tell him that no one should allow that to happen and that he needs help. B. Suggest that he reach out to a domestic violence organization and offer contact information. C. Confront the partner to confirm that this is true. D. Tell the healthcare provider to make a referral to a therapist.

Correct! B. Suggest that he reach out to a domestic violence organization and offer contact information. Rationale: If the patient discloses domestic violence, act immediately. Ask the patient whether they would like you to contact the agency's domestic violence advocate (if there is one). If not, provide contact information for community domestic violence programs. Wrong! A. Tell him that no one should allow that to happen and that he needs help. Rationale: This statement does not provide assistance or resolve the issue. C. Confront the partner to confirm that this is true. Rationale: This is inappropriate, as the victim should make the initial contact. D. Tell the healthcare provider to make a referral to a therapist. Rationale: The nurse is able to make these suggestions and provide information for domestic partner violence.

The nurse is teaching a group of adolescents about STIs. Which comment made by a participant is correct? A. "I cannot get an STI during oral or anal sex." B. "HIV/AIDS is only transmitted by anal intercourse." C. "About 25% of teens in the United State have an STI." D. "If I wear a condom every time, I won't get an STI."

Correct! C. "About 25% of teens in the United State have an STI." Rationale: Approximately one in four U.S. teens has an STI. STIs, including HIV/AIDS, are a major health consequence associated with sexual activity and especially with unprotected sexual activity. Wrong! A. "I cannot get an STI during oral or anal sex." Rationale: An STi can be passed with any mucous membrane-to-mucous membrane contact. Ant unprotected activity is a risk. B. "HIV/AIDS is only transmitted by anal intercourse." Rationale: HIV/AIDS is transmitted primarily through genital, oral, or anal sexual activities but can also be transmitted in other ways (e.g., by sharing needles with an infected person). D. "If I wear a condom every time, I won't get an STI."

The nurse is teaching a group of high schoolers in a health class about healthy dietary choices for their age group. What should the nurse include? A. Adolescents can eat whatever they want, as long as they exercise. B. Nutrition is only a concern if the adolescent is obese or anorexic. C. Adolescents should intake 1,300 mg of calcium and 400 IU of vitamin D daily. D. Sugar and fat intake do not need to be monitored because growth is so rapid.

Correct! C. Adolescents should intake 1,300 mg of calcium and 400 IU of vitamin D daily. Rationale: This is important for bone density, as the adolescent is in a period of rapid growth. Wrong! A. Adolescents can eat whatever they want, as long as they exercise. Rationale: Developing healthy eating habits is important for long-term health. Exercise is an important aspect of health, but diet should be emphasized. B. Nutrition is only a concern if the adolescent is obese or anorexic. Rationale: Healthy eating is important during all phases of life, not just for those with health challenges that focus on nutrition. D. Sugar and fat intake do not need to be monitored because growth is so rapid. Rationale: Developing healthy eating habits should be emphasized, as the adolescent is in a period of rapid growth. Test-Taking Tip: Adolescents should be encouraged to eat a diet high in calcium and vitamin D to support their rapid increase in growth and bone mass.

The nurse is screening an adolescent for depression. Which statement by the parent is most concerning? A. He recently broke up with his girlfriend and spends a lot of time in his room. B. All he does is play video games from dinner to bedtime. C. He used to be a straight-A student and now he's failing most of his classes. D. His friends ask him over and he always turns them down.

Correct! C. He used to be a straight-A student and now he's failing most of his classes. Rationale: A change in academic performance or lack of interest in school may indicate a problem such as depression. Wrong! A. He recently broke up with his girlfriend and spends a lot of time in his room. Rationale: Spending time alone is not a sign of depression, but allows him time to grieve the lost relationship. B. All he does is play video games from dinner to bedtime. Rationale: This is normal adolescent behavior. D. His friends ask him over and he always turns them down. Rationale: Refusal of social events is likely from anxiety and not depression.

Which strategy might help facilitate the relationship when a nurse is performing an examination of an adolescent? A. Speak only to the parent B. Remember that the client is a child, and be firm with instructions. C. Do not tell the client any assessment findings, as they will not understand the relevance. D. Establish rapport and reassure the teen that you will maintain confidentiality.

Correct! D. Establish rapport and reassure the teen that you will maintain confidentiality. Rationale: Adolescents can be challenging because they may feel the need to resist authority and be hesitant to share information. This builds confidence. Wrong! A. Speak only to the parent Rationale: Speaking only to the parent is not effective in gaining trust in an adolescent client. Adolescents have begun to develop independence and respond to being treated with respect. B. Remember that the client is a child, and be firm with instructions. Rationale: The client may still technically be a child, but their developmental tasks involve independence. C. Do not tell the client any assessment findings, as they will not understand the relevance. Rationale: An adolescent client can easily understand assessment findings and is curious about their own health.

The nurse is performing an adolescent health history. What should be included? Select all that apply. A. Psychosocial Profile B. Driving History C. Nutrition and Body Image D. Tattoos and Piercings E. Sleep Patterns

Correct! A. Psychosocial Profile Rationale: This is a time when peer relationships are very important. C. Nutrition and Body Image Rationale: Adolescents are at risk for anorexia, bulimia, and obesity, which are all related to nutritional intake and body image. D. Tattoos and Piercings Rationale: Adolescents may have hidden tattoos or piercings but should be made cognizant of the health risks involved in each. E. Sleep Patterns Rationale: Many adolescents are sleep deprived due to busy school schedules, use of social media, or other related issues. Wrong! B. Driving History Rationale: More important would be to determine whether the adolescent is practicing safety as a passenger or driver.