Adolescents EAQ
What is a primary factor influencing the onset of puberty in adolescents? 1 Genetics 2 Intelligence 3 Type of birth 4 Weight at birth
1 Genetics Genetics is one of the primary influences on the age at which puberty occurs. Intelligence, type of birth, and weight at birth do not affect the onset of puberty in adolescents.
A 16-year-old single mother of a 1-month-old infant and the infant's grandmother bring the baby to the emergency department and report that the infant accidentally fell down the stairs. The nurse knows that a consent form for treatment should be signed. Who has the responsibility for signing the consent? 1 The mother, despite her age 2 No one, because this is an emergency 3 The grandmother, because she is a relative 4 Family court, because the mother is a minor
1 The mother, despite her age The client is an emancipated minor, meaning that she has adult status. In most states the age of majority is 18 years; however, parents younger than 18 years are considered emancipated minors and may sign consents for themselves and their children. Consent always is needed when a parent is present and capable of providing it. The grandmother does not have the legal right to give consent. Family court is unnecessary.
The nurse is helping an adolescent with iron-deficiency anemia make breakfast meal choices. Which foods should the nurse suggest? 1 Apple fruit cup 2 Bowl of raisin bran 3 Cup of blueberry yogurt 4 Slice of wheat bread toast with butter
2 Bowl of raisin bran The iron content in the options is as follows: ¾ cup raisin bran, 13.5 mg; one slice of wheat bread, 0.9 mg; 1 cup of blueberry fruit yogurt, 0.2 mg; and apple fruit cup, 0.2 mg. The best choice is the bowl of raisin bran cereal, which has the highest iron content of all the choices.
A nurse is caring for a 15-year-old adolescent who was admitted to the hospital after taking an acetaminophen (Tylenol) overdose. The result of which diagnostic study is most important for the nurse to monitor at this time? 1 Blood gas level 2 Liver function tests 3 Complete blood count 4 Glycosylated hemoglobin
2 Liver function tests Acetaminophen (Tylenol) is metabolized by the liver, and an excess may result in increased aspartate aminotransferase and bilirubin levels and prothrombin time. Hepatic involvement may last as long as 7 days, and liver damage may be permanent. Blood gas results are not the priority at this time. They will become important if hepatic failure or respiratory distress develops. The hematological components measured in a complete blood count are not profoundly affected by an acetaminophen overdose. Glycosylated hemoglobin is a measure of diabetic control, not a measure of response to an acetaminophen overdose.
A 16-year-old male asks the nurse about the use of condoms. He states, "I've used condoms in the past, but I'm not sure I'm using them correctly." What should be included as part of the teaching about condoms? 1 Petroleum jelly should be used as a lubricant. 2 The condom must be positioned after an erection has occurred. 3 Withdrawal after ejaculation should be delayed until the penis has become flaccid. 4 The condom should be fitted against the tip of the penis with no space left at the end.
2 The condom must be positioned after an erection has occurred. The condom should be positioned after the penis is erect to achieve the desired fit. Vaseline can break down the material used for the condom; a water-based lubricant should be used if lubrication is desired. A space should be left at the tip of the penis to provide room for the ejaculate and prevent breakage of the condom. The penis should be withdrawn immediately after ejaculation, while the penis is still erect; if the penis is allowed to become flaccid, semen may leak from the loose-fitting condom.
Which condition is more common in adolescent girls than boys? 1 Obesity 2 Dental caries 3 Anorexia nervosa 4 Acquired immunodeficiency syndrome (AIDS)
3 Anorexia nervosa Adolescents (predominantly girls) who are obsessed with their body image may develop eating disorders, including anorexia nervosa, characterized by limited food intake to control body weight. Obesity rates are increasing nationally for preschoolers and children ages 6 to 11 years. Dental caries are most commonly observed in young children due to teeth eruption and unhealthy eating habits. Acquired immunodeficiency syndrome (AIDS) is not more common in adolescent girls.
After 3 months of supplemental oral iron therapy, there is no significant increase in a female adolescent's hemoglobin level. Iron dextran (Imferon) is ordered. What is the best way for the nurse to administer this medication? 1 With a transdermal needle 2 By massaging the injection site 3 With the use of the Z-track method 4 By administering a local anesthetic first
3 With the use of the Z-track method The Z-track injection method prevents seepage of Imferon through the needle track, thereby limiting irritation of subcutaneous tissue and staining of the skin. The length of a transdermal needle is too short to reach a muscle; a 1½-inch needle is required. Massage will force Imferon into the subcutaneous tissue, causing irritation and staining. Although an injection may be uncomfortable, a local anesthetic is unnecessary.
A nurse is caring for a 15-year-old client who is undergoing chemotherapy for leukemia. The nurse expects that adolescents with health problems are most concerned about: 1 Missing time at school 2 Limiting social activities 3 Being dependent while enjoying the sick role 4 Feeling different regarding changes in body image
4 Feeling different regarding changes in body image The 15-year-old is preoccupied with appearance. The side effects of the antineoplastics and prednisone may result in the adolescent feeling different, which affects body image. Although missing school may be a concern, it is not the primary concern. Although limitation of social activities is a concern, it is not the primary concern. Socialization can be facilitated. A 15-year-old enjoys and strives for independence and does not enjoy the sick role.
The nurse is caring for an adolescent with hemophilia. Which statement by the client indicates a need for further teaching? 1 "I'll use a straight razor when I start shaving." 2 "I plan on trying out for the swim team next year." 3 "If I injure a joint, I'll keep it still, elevate it, and apply ice." 4 "If I get a little scratch, I can apply gentle pressure for 10 to 15 minutes."
1 "I'll use a straight razor when I start shaving." A straight razor should not be used by the adolescent with hemophilia, so further teaching is required. The adolescent with hemophilia should be taught to use an electric razor for shaving. Contact sports should be avoided, but swimming is a recommended activity, so trying out for the swim team indicates that the adolescent understands the teaching. If a superficial injury occurs, gentle, prolonged pressure should be applied until the bleeding has stopped. If a muscle or joint injury occurs, the area should be immobilized, elevated, and iced. Both statements indicate that the adolescent has understood the teaching.
A 17-year-old child was recently found to have type 2 diabetes mellitus. What information will the nurse include when providing education to the family? 1 "Your child will need insulin injections for the rest of her life." 2 "The most important interventions are good nutrition and portion control." 3 "This is a condition where the body produces antibodies against its own cells." 4 "This condition causes weight loss and increased appetite, thirst, and urination."
2 "The most important interventions are good nutrition and portion control." Most children with type 2 diabetes are overweight or at risk for becoming overweight. With nutritional intervention to promote proper weight, the condition may often be managed with diet and exercise alone. A lifelong insulin regimen, the production of antibodies against the child's own cells, and weight loss with increased appetite, thirst, and urination are all typical of type 1 diabetes.
A nurse is conducting a health class for adolescents. What modifiable risk factor, most closely associated with the development of coronary heart disease (CHD) in both men and women, should the nurse discuss? 1 Opioid use 2 Cigarette smoking 3 Judicious alcohol intake 4 Moderate exercise program
2 Cigarette smoking Nicotine in cigarette smoke constricts blood vessels, including coronary arteries, which contributes to the occurrence of angina and CHD. Opioid use is not a risk factor for CHD. Judicious alcohol intake may promote relaxation, decreasing stress and limiting the development of CHD. Inactivity, not moderate exercise, is a risk factor for coronary heart disease. Exercise decreases hypertension, blood clotting, and heart rate. Exercise also increases metabolism, the plasma level of high-density lipoprotein cholesterol, and cardiac capillary blood flow.
An adolescent who has had a leg amputated because of bone cancer begins to experience phantom limb sensations. How should the nurse respond when the client complains of pain and requests medication? 1 By withholding the medication to help prevent addiction 2 By stating that the limb has been removed and that the pain is psychological 3 By acknowledging that the pain is real and administering medication to relieve it 4 By explaining that the phantom limb sensation will subside within a few more days
3 By acknowledging that the pain is real and administering medication to relieve it Pain medication is required, along with intensive supportive nursing care. To the client the pain is real, requiring pain medication; addiction is not a concern at this time. Explaining that the pain is psychological in origin does not help relieve the pain; medication and emotional support are required. The pain may not recede within a few days; pain medication should be administered.
