NUR410 PrepU PEDS

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?

"Our adolescent is working toward achieving a sense of personal identity."

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

Menarche should follow in about 2 years.

An adolescent is diagnosed with a trichomonal infection. Which medication would the nurse include when teaching the adolescent about treatment for this infection?

Metronidazole

A nurse in the teen clinic is using anticipatory guidance to educate parents about preventing violence in teens. Which of the following responses by a parent would show the nurse that the teaching on suicide was effective?

"I will check for signs of depression and a lack of peers."

The nurse has prepared an IM injection to give a 13-year-old client. After some searching, the nurse locates the adolescent in the playroom in front of a video game. Which action by the nurse would be most appropriate?

Have the child socialize with peers with and without disabilities.

When caring for an adolescent with a disability, it is best for the nurse to promote which of the following?

Have the child socialize with peers with and without disabilities.

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?

Let them choose their hairstyle, even though it may not look the best for them.

The nurse is preparing to explain to an adolescent and family how to reduce serum potassium levels and keep them lower. What point will the nurse identify as erroneous when reviewing the teaching plan?

Limit water and other fluid intake.

The school nurse is planning to teach a segment on smoking during the freshman health classes. The nurse is aware that this needs to be a forum rather than a lecture. Which of the following techniques will also help deliver a "don't smoke" message?

Listening to all comments nonjudgmentally

The nurse is caring for 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 adolsecent who is healthy overall continues to have injuries. How should the nurse respond?

The bones, joints and tendons of adolescents are vulnerable to injury due to their rapid state of growth.

The nurse is caring for an adolescent in the acute care setting. The adolescent has undergone abdominal surgery. The primary health care provider has prescribed acetaminophen and hydrocodone with acetaminophen as needed every 6 hours for pain. The nurse would assess the adolescent closely for which of the following when administering these drugs?

Total daily dosage of acetaminophen because of liver toxicity

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 prescription will the nurse anticipate first from the primary health care provider?

Urine drug screen

A nurse is assessing a teenager with a chronic condition in preparation for transition to adult services. Which of the following would the nurse identify as a factor to promote successful transitioning?

The teen talks about functioning as an adult.

A 15-year-old girl who is sexually active comes to a health care facility because she is concerned that she has contracted gonorrhea from a partner who has the disease. Upon history of present illness, which symptom is anticipated?

No noticeable symptoms

Nurses should provide anticipatory guidance to males to prepare them for what particular pubertal change in late adolescence?

Nocturnal emissions

A 15-year-old client presents to the emergency room reporting an abrupt onset of severe, sudden pain on the right side of the scrotum while playing football. The nurse notes a blue-black swelling of the affected scrotum. Which action will the nurse complete next?

Notify the primary health care provider

Which question would be most important for a nurse to ask when taking a history from a client who is suspected of having amenorrhea?

"Are you sexually active?"

The nurse is educating the parents of a 10-year-old girl in ways to help their child avoid tobacco. Which suggestion should be part of the nurse's advice?

"As parents, you need to be good role models."

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?

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

A nurse is educating a middle school class of male adolescents about sex education. The topic of multiple partners is discussed. Which of the following statements from the nurse would be the most effective?

"Contraception is a responsibility of both parties involved."

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 anabolic steroids?"

When questioning a 15-year-old about his health history, what would be an appropriate way for the nurse to ask about the child's drug history?

"Have you heard that some teens like to smoke? Have you tried this?"

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 get 7 hours of sleep every night so I don't know why I am so tired."

The nurse is reviewing the causative organisms noted on laboratory reports. Which organism is transmitted solely by sexual contact?

Trichomonas

In working with middle to older adolescents with special needs, the nurse teaches the teens when to seek help from a health professional and about the medical insurance process. This nurse is:

beginning to prepare the teen for transition to adult care.

A young adult female is suspected of having gonorrhea. The nurse would anticipate additional testing for which sexually transmitted infection?

chlamydia

A 17-year-old girl comes to the clinic for her first check-up and informs the physician that she has yet to have a period. After ruling out any pathology problems, which treatment would the nurse suspect the physician to order?

estrogen

An adolescent girl comes to the clinic and reports occasional pain on one side of the abdomen which goes away with acetaminophen. What do these symptoms indicate?

mittelschmerz

While obtaining a history from a 15-year-old girl, the girl tells the nurse that she often experiences cramping abdominal pain about in the middle of her menstrual cycle. The nurse documents this as:

mittelschmerz.

A 14-year-old female has been brought to the pediatric ambulatory care clinic for a "sports physical" by her mother. The teen tells the nurse she does not want to have her mother present during the examination. What action by the nurse is most appropriate?

Ask the teen's mother to wait in a separate area nearby until the physical examination has been completed.

A 16-year-old female adolescent reports to the nurse that she is trying to improve her diet to lose weight. When assessing her dietary intake for adequacy, which finding(s) indicates the need for further education? Select all that apply.

1. Calcium intake is 1,000 mg per day. 2. Average caloric intake is 2,500 per day. 3. Fat comprises about 40% of the daily intake. 4. Iron intakes is between 8 and 10 mg per day.

The nurse is working with an adolescent with a chronic condition who will be transitioning adult health care. The nurse advocates for the adolescent based on the understanding that with advances in health care, which percentage of children with chronic conditions reach adulthood?

95%

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?

"Your child can become modest and self-conscious and teasing may cause embarrassment."

The nurse is preparing to conduct a physical examination on an adolescent. Which actions would be important for the nurse to do? Select all that apply.

1. Allow the adolescent to undress in private. 2. Question the adolescent about any sexual changes.

A teenager arrives at the emergency department with a fever of 103 degrees F along with vomiting and diarrhea. She states that she has her period. What should the nurse suspect?

"I hear your concerns about pregnancy. There may be some other causes we need to explore."

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 have 4 servings of fruit each day."

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.

"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."

The nurse is planning to assess the amount of pain that a 15-year-old child is experiencing after a motor vehicle crash. Which pain scale should the nurse use to measure this patient's pain?

Adolescent Pediatric Pain Tool

The nurse is interviewing an adolescent. What should the nurse recognize as an important aspect of interviewing the adolescent?

Adolescents will share more about themselves in a private conversation.

A 17-year-old female is meeting with the nurse for an annual well-visit and is asking the nurse questions about how to know when one is in love. The nurse should point out which factor to help decide if both individuals have reached a mutual agreement and are ready for an intimate relationship?

A sense of trust and identity

The nurse is discussing recommended immunizations with the mother of an adolescent female. Which immunization would be important for the nurse to include during this discussion?

Gardasil

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.

What is one of the most commonly reported communicable diseases in the United States?

Gonorrhea

An adolescent client is concerned about the presence of facial acne. What should the nurse teach the client about the cause of this skin disorder?

Caused by the activation of androgen hormones

The nurse caring for an adolescent diagnosed with gonorrhea will provide medication education for which drug of choice to treat the gonorrhea?

Ceftriaxone

The school nurse is providing nutritional guidance to a 9th-grade health class. Which foods should the nurse recommend as good sources for calcium?

Cheese, yogurt, and white beans

A nurse is attending to a group of boys at a school. The nurse is required to document the sexual development in boys on a regular basis. The nurse would anticipate which clients having the highest incidence of nocturnal emissions?

Clients who are showing pubertal changes

The school nurse is presenting information to a group of high school students who are asking about vegetarian diets? Which foods will the nurse point out are not eaten when following the vegan diet?

Dairy products, meat, poultry, fish, and eggs

Which scenario does the nurse anticipate for the life of an adolescent with a chronic condition who has deteriorating function?

Decline in involvement with peer activities

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

Computer use at home and at school has increased adolescents' comfort in gaining access to and using the Internet. This has expanded their exposure to risks. What potential risks are there for an adolescent to be exposed to?

Teens can be exposed to inappropriate materials, harassment, threats, and potential for molestation.

The nurse is caring for a client experiencing amenorrhea. When reviewing the client's past history and physical examination, which is a potential cause of the condition? (Select all that apply.)

Pregnancy Tension Anxiety Fatigue

The nurse is leading a discussion in a health class at the high school on adolescent relationships. The nurse determines the session is successful when the students correctly choose which type of relationship as involving a member of the opposite sex?

A heterosexual relationship

The nurse is caring for a family with a chronically ill adolescent. The parents are frustrated that the adolescent will not complete the treatment plan during the school day. Which approach by the nurse will be most appropriate?

Explaining to the parents that the adolescent may be struggling to fit in with his peers

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 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.

An adolescent is being evaluated for appendicitis. When assessed for pain, the patient points to the lower left abdominal region. What type of pain should the nurse document that this patient is experiencing?

Referred pain

Caleb and his mother are visiting the clinic for Caleb to get his sports physical. After the exam without Caleb in the room, his mother mentions that she worries that he is participating in risk behaviors and that his dependence on his peers is growing stronger. "What can I do to keep Caleb safe?" Which response by the nurse would be most appropriate?

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

The nurse knows that barriers to the adolescent's health and successful achievement of the tasks of adolescence exist. What is the major barrier to health for this population?

Socioeconomic

A 16-year-old adolescent tells the nurse about having severe dysmenorrhea. Which action would be the best health teaching measure?

Take over-the-counter ibuprofen for its prostaglandin action.

The nurse is discussing growth and development issues with the parents of an adolescent with special health needs. Which comments indicate further education is necessary?

"It is common for teens to be very compliant with the planned medication therapies with little parental oversight."

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?

"Reinforce the family rules but also allow the adolescent to develop one's own routine."

The nurse has provided an education conference for a group of teachers about suicide risks for adolescents. Which statement by a teacher indicates a correct understanding of the nurse's teaching?

"Teens who have attempted suicide once are at increased risk to try to commit suicide again."

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?

"That must be difficult, but on average black girls start their period earlier than other ethnicities."

A single male caregiver of a 14-year-old girl accompanies his daughter to her pre-high school physical. In the course of discussion about how his daughter is developing, he remarks, "She's terrific most of the time. Of course when she gets her period, she's miserable and mean, but I tell her that's just what it's like to be a woman." What would be the most appropriate response by the nurse?

"There are nutritional and medical things she can do to lessen the symptoms; I'll give both of you information about some strategies and we'll track her for a few months."

A 15-year-old male patient diagnosed with gonorrhea states, "I can't tell my partner about this." What is the best response by the nurse?

"What concerns you about telling your partner?"

A nurse is working with an older child who has a chronic condition. When assessing the impact of the condition on the child, which question would the nurse most likely ask first?

"What does your condition mean to you?"

The school nurse is assessing a 15-year-old female client. The client states, "I just want to be pretty and to look like everyone else." Which response by the nurse is appropriate?

"You seem concerned. Let's talk about your feelings."

A nurse is examining a 17-year-old adolescent in the emergency room who is being disruptive in the waiting area. On assessment, the nurse finds dilated pupils, and the teen is talking very fast. Which of the following drugs does the nurse suspect the teen may be abusing?

Amphetamines

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?

Motor vehicle safety

The nurse is promoting learning and school attendance to a 13-year-old girl. Which factor will affect the child's attitude most?

Peer group behaviors and attitudes

While caring for a 16-year-old client expected to be hospitalized for several months, the nurse will perform which action to assist the client in meeting the current stage of psychosocial development?

Permit peers to visit during open visitation hours

The nurse is caring for a 16-year-old child with a diagnosis of acquired immunodeficiency syndrome (AIDS). What treatment goal has the highest priority for this child?

Preventing spread of infection

The parents of an 11-year-old ask the nurse for suggestions about activities that they can encourage to help their child to be physically fit. Which of the following would be an appropriate suggestion? Select all that apply.

Strength training Team sport Biking Brisk walking

The nurse is caring for an adolescent who is physically challenged. Which activity should the nurse suggest that will foster the developmental task of adolescence?

Talking to another adolescent who has a similar disorder

The nursing instructor is leading a class discussion on the various aspects of adolescents. The instructors determines the class is successful after the students correctly choose which milestone as the beginning of adolescence?

The beginning of puberty

The school nurse is preparing for a career fair at the local high school. Which factor should the nurse point out when presenting various medical career options to the students?

The individual's sex no longer decides which career options are available.

An adolescent girl and her caregiver present at the pediatrician's office. The adolescent reports severe abdominal pain. A diagnosis of pelvic inflammatory disease (PID) is made. The nurse notes in the child's chart that this is the third time she has been treated for PID. The mostappropriate action by the nurse would be to:

take the child to a private room and interview her regarding her sexual history and partners.

A client has been admitted to the emergency department with nausea, vomiting, and severe scrotal pain. These findings indicate what condition?

testicular torsion

An adolescent is concerned that although he has pubic hair, he has no facial hair yet. He wishes facial hair would grow to cover acne lesions. The nurse would advise him that facial hair:

usually follows pubic hair growth.

The nurse is discussing nutrition with a group of caregivers of adolescents. One of the caregivers tells the group she is concerned because her daughter has decided to become a vegetarian. With further discussion the caregiver says her child won't eat any food of animal origin, including dairy products, eggs, fish, meat, and poultry. The vegetarian diet the caregiver is describing is:

vagan