Pediatric Nursing - Adolescent
After conducting a class for female adolescents about human reproduction, which student statement indicates that the school nurse's teaching has been effective? "Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes, resulting in pregnancy." "I won't become pregnant if I abstain from intercourse during the last 14 days of my menstrual cycle." "Sperm from a healthy male usually remain viable in the female reproductive tract for 96 hours." "After an ovum is fertilized by a sperm, the ovum then contains 21 pairs of chromosomes."
"Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes, resulting in pregnancy."
An 11-year-old child is diagnosed with scoliosis and scheduled for brace application. The parent asks the nurse how long her child will have to wear the brace. How should the nurse respond? "about 6 to 8 weeks" "about 6 months" "about 1 to 2 years" "about 3 to 5 years"
"about 3 to 5 years"
An adolescent sustains a head injury and develops diabetes insipidus. The healthcare provider orders desmopressin, 10 mcg subcutaneously. When does the nurse assess the client to determine the need for an additional dose? 15 to 30 minutes 30 minutes to 2 hours 2 to 4 hours 4 to 7 hours
4 to 7 hours
A nurse is preparing to administer the first dose of tobramycin to an adolescent with cystic fibrosis. The order is for 3 mg/kg I.V. daily in three divided doses. The client weighs 95 lb (43.2 kg). How many milligrams should the nurse administer per dose? Record your answer using one decimal place.
43.2 To perform this dosage calculation, the nurse should calculate the client's daily dose using this formula:43.2 kg × 3 mg/kg = 129.6 mgLastly, the nurse should calculate the divided dose:129.6 mg ÷3 doses = 43.2 mg/dose
A student with type 1 diabetes tells the nurse she is feeling light-headed. The student's blood sugar is 60 mg/dL (3.3 mmol/L). Using the 15-15 rule, what should the nurse do to treat the blood glucose? Administer 15 mL of juice and give another 15 mL in 15 minutes. Administer 15 g of carbohydrate and retest the blood sugar in 15 minutes. Administer 15 g of carbohydrate and 15 g of protein. Administer 15 oz of juice and retest in 15 minutes
Administer 15 g of carbohydrate and retest the blood sugar in 15 minutes.
A nurse reviews the care plan for an adolescent receiving chemotherapy for leukemia. The adolescent's platelet count is 50,000 μl. The client also has pneumonia. Which item in the care plan should the nurse revise? Keep a sign over the bed that reads: "No needle sticks. Nothing per rectum." Keep two peripheral IV devices: one for blood draws and one for infusions. Administer oxygen at a rate of 4 L/minute using a non-humidified nasal cannula. Use a tympanic membrane sensor to measure temperature at the bedside.
Administer oxygen at a rate of 4 L/minute using a non-humidified nasal cannula.
The nurse is providing nutrition counseling for an obese adolescent. What is the most effective way for the nurse to obtain a nutrition history from this client? Ask her what she knows about good nutrition. Tell her to list what she plans to eat for the next 24 hours. Ask her what she ate yesterday if it was a typical day. Telephone her mother and ask her what she ate yesterday.
Ask her what she ate yesterday if it was a typical day.
Which information would the nurse include in a teaching plan about treatments for sexually transmitted infections? Acyclovir can be used to cure herpes genitalis. Chlamydia trachomatis infections are usually treated with penicillin. Ceftriaxone sodium may be used to treat Neisseria gonorrhoeae infections. Metronidazole is used to treat condylomata acuminata.
Ceftriaxone sodium may be used to treat Neisseria gonorrhoeae infections.
The nurse prepares to teach an adolescent scheduled for an appendectomy about what to expect. The adolescent says, "I would rather look this up on the Internet." What should the nurse do? Explain that completing a teaching checklist is required by the hospital. Help the client find information on the Internet. Provide the client with written information instead. Explain that information found on the Internet cannot be trusted.
Help the client find information on the Internet.
An adolescent with chest pain goes to the school nurse. The nurse determines that the teenager has a history of asthma but has had no problems for years. What should the nurse do next? Call the adolescent's parent. Have the adolescent lie down for 30 minutes. Obtain a peak flow reading. Have the teen take two puffs of a short-acting bronchodilator.
Obtain a peak flow reading.
The nurse is preparing a presentation on nutrition to a group of pregnant adolescents. Which information would be important for the nurse to include in the teaching plan? Spinach is an excellent source of calcium in the diet. Two to four servings of whole-grain products is recommended. Three or more servings of dairy products meet the calcium requirement. Vitamin A supplements may be necessary for clients who are vegetarian.
Three or more servings of dairy products meet the calcium requirement.
The nurse is interviewing an adolescent with a new onset of fatigue. What communication strategies will help the nurse establish a therapeutic relationship with the adolescent? asking personal questions unrelated to the situation writing down everything the client says asking open-ended questions discussing the nurse's own thoughts and feelings about the situation listening to the client
asking open-ended questions listening to the client
A school-age client with leukemia is receiving cyclophosphamide. The nurse should assess the client for which adverse effect of cyclophosphamide? photosensitivity. ataxia. cystitis. cardiac arrhythmias.
cystitis
A 14-year-old client with acne vulgaris asks what causes it. Which factors should the nurse identify for this client? Select all that apply. chocolates and sweets increased hormone levels growth of anaerobic bacteria caffeine fatty foods
increased hormone levels growth of anaerobic bacteria
An adolescent client with polycystic ovarian syndrome (PCOS) has been placed on metformin. The nurse determines the client needs more teaching about metformin if she states the medication helps achieve which outcome? reduced androgen levels normalization of the menstrual cycle increased insulin levels reduced blood glucose levels
increased insulin levels
Which interview strategy contributes to a poor nurse-adolescent relationship? maintaining objectivity by avoiding assumptions, judgments, and lectures beginning with less-sensitive issues and proceeding to more-sensitive ones interviewing adolescents with their parents present asking open-ended questions and moving to more directive questions when possible
interviewing adolescents with their parents present
An adolescent, age 14, is hospitalized for nutritional management and drug therapy after experiencing an acute episode of ulcerative colitis. Which nursing intervention is appropriate? administering digestive enzymes before meals as ordered providing small, frequent meals administering antibiotics with meals as ordered providing high-fiber snacks
providing small, frequent meals
When assessing a 13-year-old adolescent, what is an expected finding? Tanner stage I of development decision about a career primarily one friend subjective judgments of right and wrong
subjective judgments of right and wrong
What should be the priority assessment for an adolescent on return to the nursing unit after an appendectomy? the dressing on the surgical site intravenous fluid infusion site nasogastric (NG) tube function amount of pain
the dressing on the surgical site
An adolescent client is brought to the emergency department with suspected appendicitis. Which assessment findings does the nurse expect to find with this diagnosis? Select all that apply. white blood cell count of 12,000 rebound pain at McBurney's point statement of epigastric discomfort vomited 100 mL of stomach contents hematuria
white blood cell count of 12,000 rebound pain at McBurney's point vomited 100 mL of stomach contents
An adolescent with ulcerative colitis who is taking corticosteroids is at risk for which complication? jaundice decreased bowel sounds perianal lesions delayed sexual maturation
delayed sexual maturation
A 16-year-old adolescent is brought to the clinic for evaluation for a suspected eating disorder. To best assess the effects of role and relationship patterns on the client's nutritional intake, the nurse should ask: "What activities do you engage in during the day?" "Do you have any allergies to foods?" "Do you like yourself physically?" "What kinds of foods do you like to eat?"
"Do you like yourself physically?"
The nurse is assessing a 17-year-old client with a seizure disorder. Driving privileges were suspended for failure to comply with anti-epileptic medications. The parents express concern because the client is withdrawn, not completing schoolwork, and spends increased time sleeping. Which is the nurse's best response? "Have you seen any evidence of illegal drug use?" "Further evaluation is needed for a mood disorder." "Establish firm behavioral guidelines for the adolescent." "Do you think there is a risk for self-harm?"
"Further evaluation is needed for a mood disorder."
An adolescent has been diagnosed with polycystic ovarian syndrome (PCOS). Which statement by the adolescent indicates the need for more teaching? "High levels of male hormones contribute to my PCOS." "I am at risk for type 2 diabetes." "Maintaining a healthy weight is an important part of my treatment plan." "Untreated PCOS will make getting pregnant impossible."
"Untreated PCOS will make getting pregnant impossible."
Which symptom reported by an adolescent's parents suggests that the adolescent may be abusing amphetamines? Select all that apply. restlessness fatigue excessive perspiration talkativeness watery eyes Excessive nasal drainage
restlessness excessive perspiration talkativeness
The nurse on the burn unit is caring for an adolescent with burns to the face and anterior neck, anterior chest, bilateral arms circumferentially, and the right anterior leg. Based on the Rule of Nines, calculate the body surface area that is burned. Record your answer using one decimal place. Rule of Nines Surface area Anterior head 4.5% Posterior head 4.5% Anterior torso 18% Posterior torso 18%Anterior leg, each 9% Posterior leg, each 9%Anterior arm, each 4.5%Posterior arm, each 4.5%Genitalia/perineum 1%
49.5 The Rule of Nines is the standard for estimating total body surface area burned. To calculate: anterior head = 4.5% anterior chest (torso) = 18% both arms anterior and posterior - 9% each = 18% anterior right leg = 9% Total = 49.5%
The nurse is witnessing a surgical consent for an adolescent client who is deemed an emancipated minor. What are the nursing considerations for the client's rights as an emancipated minor? Select all that apply. Each state has laws defining an emancipated minor. The adolescent can be legally married and be considered an emancipated minor. The adolescent must be self-supporting as an emancipated minor. The hospital defines the emancipated minor abilities. The emancipated minor is often incapable to make healthcare decisions.
Each state has laws defining an emancipated minor. The adolescent can be legally married and be considered an emancipated minor. The adolescent must be self-supporting as an emancipated minor.
After an appendectomy, an adolescent is alert and oriented. Parenteral fluids are infusing, and a nasogastric tube is attached to low intermittent suction. Which nursing measure would be most appropriate for the adolescent during this early postoperative period? Irrigate the nasogastric tube every hour. Test the urine for protein. Remove the nasogastric tube when the adolescent is fully alert. Encourage the adolescent to urinate frequently.
Encourage the adolescent to urinate frequently.
The nurse assesses an adolescent client with lethargy, retractions of the intercostal spaces, a persistent expiratory wheeze, diminished breath sounds, tachycardia, and tachypnea. Arterial blood gas results are pH 7.10; PCO2 80 mm Hg (10.64 kPa); PO2 35 mm Hg (4.66 kPa), HCO3 29 mEq/l (29 mmol/l). What is the priority condition the nurse must address? change in mental status increased heart rate breathing pattern respiratory acidosis
respiratory acidosis
The nurse reviews the plan of care of an adolescent client with diabetes using an insulin pump. This is the second visit that the client has come without his parent. The client's hemoglobin A1C and blood glucose levels are normal. The client reports that he is playing a sport and has not had any hypoglycemic episodes. Which factor does the nurse determine is the best indicator that the client is transitioning to independent self-management? managing an insulin pump attending health care appointments alone having normal hemoglobin A1C and blood glucose levels playing sports without hypoglycemic episodes
attending health care appointments alone
The nurse developed a plan of care for an adolescent who is receiving chemotherapy for lymphoma and has developed stomatitis. What statement made by the adolescent demonstrates understanding of the education provided from the plan of care? "I will use a hard bristle toothbrush to clean my teeth." "I will remove the white patches from my tongue and cheek with a toothbrush." "I will rinse my mouth every 2-4 hours with baking soda and water." "I will use an alcohol based mouthwash after brushing my teeth."
"I will rinse my mouth every 2-4 hours with baking soda and water."
A nurse has been teaching an adolescent how to self-administer insulin. Despite repeated instruction, the adolescent will use only the left thigh for insulin administration. What is the best question for the nurse to ask the adolescent before conducting further teaching? "What makes you feel in control of your situation?" "Do you need me to spend more time teaching you?" "Is it less painful for you when you use the same site?" "Are you afraid of scarring and bruising in other areas?"
"Is it less painful for you when you use the same site?"
The nurse is caring for an adolescent client after an overdose on barbiturate drugs and alcohol. The client is hypotensive with a mean arterial pressure below 30 mm Hg and a urine output of 5 mL/hr. Serum creatinine and potassium are elevated. The parents of the client ask why there is so little urine in the indwelling catheter drainage bag. What is the best response by the nurse? "Oliguria is common after a barbiturate overdose." "The body is conserving fluids to dilute the barbiturates." "There is not enough blood circulating to the kidneys." "Dialysis is needed to clear the toxins from the blood."
"There is not enough blood circulating to the kidneys."
An adolescent presents with a large round ring with a swollen border on the left arm. The adolescent often plays ball games in a field behind the school. What condition does the nurse suspect? Lyme disease actinic keratosis impetigo cellulitis
Lyme disease
The nurse talks to an adolescent about how she can tell her friends about her new diagnosis of diabetes. Which behavior by the adolescent indicates that the adolescent has responded positively to the discussion? She asks the nurse for material on diabetes for a school paper. She introduces the nurse to her friends as "the one who taught me all about my diabetes." She says, "I will try to tell my friends, but they will probably quit hanging out with me." She asks her friends what they think about someone who has a lifelong illness.
She introduces the nurse to her friends as "the one who taught me all about my diabetes."
A 16-year-old client is admitted to the emergency department following an accident. The client sustained a head injury, is unconscious, and has compound fractures of the right tibia and fibula. No family members accompanied the client and none can be reached by phone. The surgeon instructs the nurse to take the client to the operating room immediately. Which of the following actions should the nurse take regarding informed consent? Call the nursing supervisor and ask that the hospital lawyer be contacted. Keep the client in the emergency department until the family is contacted. Take the client to the operating room for surgery without informed consent. Contact the hospital chaplain to sign the consent on the client's behalf.
Take the client to the operating room for surgery without informed consent.
An adolescent is being prepared for an emergency appendectomy. The nurse should tell the client? Select all that apply. Friends can visit whenever they want. The scar will be small. The teen will be back in school in 1 week. Antibiotics will be given to prevent an infection. A dressing will stay in place for 1 week.
The scar will be small. The teen will be back in school in 1 week.
Which clients should the nurse assign to unlicensed assistive personnel? Select all that apply. a 3-month-old infant with dehydration who will be discharged tomorrow a 10-month-old infant with bronchiolitis admitted last night a 5-year-old child with a fractured humerus going to surgery this morning an 11-year-old child in sickle cell crisis admitted 3 hours ago a 16-year-old adolescent with mononucleosis and a temperature of 103.8º F (39.9º C) a 17-year-old adolescent who underwent an appendectomy last night and now has stable vital signs
a 3-month-old infant with dehydration who will be discharged tomorrow a 17-year-old adolescent who underwent an appendectomy last night and now has stable vital signs
The nurse is teaching a group of adolescents about proper nutrition. The nurse should explain that during this phase of development, it is necessary to increase intake of which nutrients? Select all that apply. calcium vitamin D iron protein grain
calcium vitamin D iron protein
An 18-year-old tells the nurse, "Everyone does it, so it is all right," to justify rule-breaking behavior. The nurse realizes this is an example of which level or stage of moral reasoning development as described by Kohlberg? preconventional postconventional autonomous conventional
conventional
A nurse is caring for an adolescent who has been diagnosed with a spleen laceration resulting from a skateboard accident. Which nursing diagnosis is the highest priority? risk for injury pain deficient fluid volume risk for infection
deficient fluid volume the dressing on the surgical site intravenous fluid infusion site nasogastric (NG) tube function amount of pain
An adolescent client is admitted to the hospital with the diagnosis of acute lymphocytic leukemia. Which signs and symptoms require the most urgent nursing intervention? fatigue and anorexia fever and petechiae swollen neck lymph glands and lethargy enlarged liver and spleen
fever and petechiae
A school-age child with leukemia will be taking vincristine. The nurse should encourage the child to eat what kind of diet? high-residue low-residue low-fat high-calorie
high-residue Vincristine may cause constipation, so the client should be encouraged to eat a high-residue (fiber) diet. The other diets do not help with constipation that can occur while receiving vincristine.
Which finding should lead the nurse to decide that spinal shock was resolving in the adolescent with a spinal cord injury? atonic urinary bladder flaccid paralysis hyperactive reflexes widened pulse pressure
hyperactive reflexes
A 14-year-old client in skeletal traction for treatment of a fractured femur is expected to be hospitalized for several weeks. When planning care, the nurse should take into account the client's need to achieve what developmental milestone? autonomy initiative industry identity
identity
Family members and friends stage an intervention for an alcoholic adolescent. The intervention is successful when the adolescent: breaks down and cries. says, "I'm sorry. I'll never drink again." is motivated to enter an alcohol rehabilitation program. is willing to talk with the friends.
is motivated to enter an alcohol rehabilitation program.
Physical examination of an adolescent reveals an abnormally convex angulation in the curvature of the thoracic spine. How should the nurse should document this finding? dowager's hump kyphosis lordosis scoliosis
kyphosis
When counseling an obese adolescent, the nurse should advise the client that which complication is the most common? lifelong obesity gastrointestinal problems orthopedic problems psychosocial problems
lifelong obesity
An adolescent client who is being seen by the crisis nurse after making several superficial cuts on her wrist states that all her friends are siding with her ex-boyfriend and will not talk to her anymore. She says she knows that the relationship is over, but "If I can't have him, no one else will." Which client problem takes the highest priority? situational low self-esteem risk for other-directed violence risk for suicide risk-prone health behavior
risk for other-directed violence
A nurse is caring for a 17-year-old female client with cystic fibrosis who has been admitted to the hospital for administration of intravenous antibiotics and respiratory treatment for exacerbation of a lung infection. The client states, "I have a number of questions about my future and the consequences of this disease." Which statements about the course of cystic fibrosis are true? Select all that apply. Breast development is delayed. The client is at risk for developing diabetes. Pregnancy and child-bearing are not affected. Normal sexual relationships can be expected. Only males carry the gene for the disease. By age 20, the client should be able to decrease the frequency of respiratory treatment.
Breast development is delayed. The client is at risk for developing diabetes. Normal sexual relationships can be expected.
A nurse is caring for a 14-year-old client who was admitted with cellulitis and has been ordered warm compresses. The nurse delegates the treatment to the unlicensed assistive personnel (UAP). The compress causes a first-degree burn to the area. Which actions should the nurse initiate? Select all that apply. Initiate a disciplinary action toward the UAP. Complete an incident report regarding the event. Notify the healthcare provider of the injury. Place ice compresses on the injured area. Document the injury describing the UAP's actions.
Complete an incident report regarding the event. Notify the healthcare provider of the injury.
An adolescent with type 1 diabetes checks his blood glucose level at 9:00 p.m. (2100). The current blood glucose level is 60 mg/dl (3.3 mmol/L). The client reports shakiness. What should the nurse suggest? Eat graham crackers with peanut butter and 8 oz (240 mL) of milk. Drink 6 oz (200 mL) of orange juice with a cheese sandwich. Take a dose of oral glucagon and recheck the glucose level in 15 minutes. Consume a candy bar and regular soda and sit down for at least 30 minutes.
Eat graham crackers with peanut butter and 8 oz (240 mL) of milk.
The nurse is developing a care plan for a female child who is 12 years of age and receiving surgery to correct idiopathic scoliosis. Which postoperative problem is a priority? pain control hypotension prevention of pressure wounds infection control
pain control
A nurse interviews the parent of a middle school student who is exhibiting behavioral problems, including substance abuse, following a sibling's suicide. The parent says, "I'm a single parent who has to work hard to support my family, and now I've lost my only son, and my daughter is acting out and making me crazy! I just can't take all this stress!" Which issue is the priority? the parent's ability to emotionally support the adolescent in this crisis potential suicidal thoughts/plans of both family members the adolescent's anger the parent's frustration
potential suicidal thoughts/plans of both family members
Which of the following nursing interventions is most likely to be beneficial initially in helping the parents of an adolescent hospitalized with appendicitis deal with the hospitalization? Reassure the parents that their adolescent will be fine. Assess the parents' current knowledge level before providing information. Encourage the parents to participate in the client's physical care. Interact with the parents when they ask for information.
Assess the parents' current knowledge level before providing information.
The parents of an adolescent client newly diagnosed with anorexia nervosa are meeting with the nurse during the admission process. Which remarks should the nurse interpret as typical for parents of a client with anorexia nervosa? "We've given her everything, and look how she repays us!" "She's had behavior problems for the past year both at home and at school." "She's been a model child. We've never had any problems with her." "We have five children, all normal kids with some problems at times."
"She's been a model child. We've never had any problems with her." Parents commonly describe their child as a model child who is a high achiever and compliant. These adolescents are typically well liked by teachers and peers. It is not typical for behavior problems to be reported. The description about having given the child everything and being repaid is more likely to describe an adolescent who is exhibiting behavior problems.
A nurse is providing health teaching to a group of adolescent girls. The focus is on urinary tract infections. One of the girls tells the nurse that she wants to know more about cystitis. Which statement by the nurse is the most appropriate response? "This condition can result from irritation and inflammation from sexual activity." "This is a serious condition that occurs after intercourse or vaginal cleanses." "This condition happens frequently in young women and is not harmful." "This is a minor bacterial infection of the bladder that can occur at anytime."
"This condition can result from irritation and inflammation from sexual activity."
A 17-year-old adolescent with a history of muscular dystrophy is admitted with aspiration pneumonia. The client's medical history reveals that this is the third time in the past 6 months that the client has been diagnosed with pneumonia. Which topics should the nurse plan to address for teaching? need to avoid crowds and large gatherings need for good hand hygiene need for a feeding tube need for an advance directive
need for a feeding tube
