Ch. 19 Care of Adolescent

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: A. identity vs. role confusion. B. autonomy vs. doubt and shame. C. industry vs. inferiority. D. intimacy vs. isolation.

A. identity vs. role confusion.

The nurse is assigned to care for a 14-year-old child who is hospitalized in traction for serious leg fractures after an automobile accident. The parents ask the nurse to avoid administering analgesics to their child to help prevent him from becoming addicted. Which response by the nurse is indicated? A. "We can talk with the health care provider to see about reducing the amount of medications given to reduce the potential for addiction." B. "If there is no history of substance use disorder in the family there should be no increased risk for the development of addiction." C. "Administering medications to manage reports of pain is not going to cause addiction." D. "Your child is too young to experience drug addiction."

C. "Administering medications to manage reports of pain is not going to cause addiction."

Which of the following ages best link to stage 5 of Erikson's theory of psychosocial development? A. Young Adult (20-30 Years) B. Infancy (Birth to 18 Months) C. Toddler (1-3 Years) D. Adolescent (12-18 Years)

D. Adolescent (12-18 Years)

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: A. usually grows before pubic hair. B. is rarely present before 20 years of age. C. is delayed in boys with acne. D. usually follows pubic hair growth.

D. usually follows pubic hair growth. Rationale: In the average adolescent, pubic hair develops at 13 to 15 years, facial hair at 15 to 16.

Which of the following is a virtue most likely associated with stage 5 of Erikson's theory of psychosocial development? A. Competence B. Hope C. Purpose D. Love E. Will F. Fidelity

F. Fidelity

True or False: Adolescents who experience role confusion have a stable peer group and are less likely to participate in risky behaviors.

False

True or False: Adolescents with chronic illnesses often have delayed onset of puberty.

True

True or False: Egocentrism and invincibility are developmental characteristics that can lead to an increase in risk-taking behavior during the adolescent period.

True

____________ is painful uterine cramps before the onset of menses that are severe enough to interfere with school and other activities.

dysmenorrhea

The parent of a 16-year-old female states, "I know she's pregnant because she missed her period for the second time." What is the best response by the nurse? A. "I hear your concerns about pregnancy. There may be some other causes we need to explore." B. "Have you done a pregnancy test?" C. "It is normal for teenagers to have unpredictable menstrual cycles." D. "Who do you think is the father?"

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

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. A. "I only tan before going on spring break to get a base tan so I won't burn." B. "My mom had melanoma so she always makes me wear a sunscreen with an SPF of 30." C. "My favorite time of day to be outside is the middle of the day, around noon." D. "Our coach makes us wear sun-protective clothes when we practice outside on the weekends." E. "The more exposure and burns I get now will toughen my skin so I won't get skin cancer when I'm older."

A. "I only tan before going on spring break to get a base tan so I won't burn." C. "My favorite time of day to be outside is the middle of the day, around noon." E. "The more exposure and burns I get now will toughen my skin so I won't get skin cancer when I'm older."

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? A. "You seem concerned. Let's talk about your feelings." B. "I think you are beautiful just as you are." C. "Looking like everyone else is not what makes someone pretty." D. "Do you not think you are pretty now?"

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

The nurse is interviewing an adolescent. What should the nurse recognize as an important aspect of interviewing the adolescent? A. Adolescents will share more about themselves in a private conversation. B. Adolescents will talk more openly if their caregiver is in the same room. C. Adolescents should be asked if they would like a peer in the room during the interview. D. Adolescents will not likely share information related to sexual relationships or to use of substances.

A. Adolescents will share more about themselves in a private conversation.

An adolescent with a new piercing comes to the health center at the school. The client reports feeling hot. Which action will the nurse complete first? A. Assess the client for signs of infection. B. Inquire about the piercing technique used. C. Determine when the client started feeling hot. D. Ask the client if any other piercings are present.

A. Assess the client for signs of infection.

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? A. Offer to assist the girl in washing her hair and let her pick the shampoo. B. Allow the girl to wear her own clothes, despite hospital policy. C. Brush the girl's hair for her. D. Assist the girl with using the bed pan to urinate.

A. Offer to assist the girl in washing her hair and let her pick the shampoo.

A 15-year-old girl has been experiencing dysmenorrhea for the past year. Over the past 6 months, she has been taking ibuprofen and oral contraceptives, with no improvement. What underlying condition should be assessed for in this client at this point? A. endometriosis B. mittelschmerz C. amenorrhea D. toxic shock syndrome

A. endometriosis

An adolescent is diagnosed as having gonorrhea. The nurse can anticipate that her management will include: A. identification of sexual contacts. B. catheterization for a urine specimen. C. administration of a corticosteroid. D. prescription of a diaphragm.

A. identification of sexual contacts.

A 14-year-old boy has come to his primary care physician's office for a routine well-child visit with his parent. Which statement by the parent should the nurse prioritize for further investigation after noting the father has a history of alcohol use disorder? A. "I wish there was a blood test for alcohol use disorder. I know my son is at risk." B. "Our next door neighbor is older than my son, and he drinks when they hang out together." C. "I think I know how my son feels about drinking. He has had substance use disorder education in school." D. "Sometimes my son asks me questions about his father's low tolerance for alcohol."

B. "Our next door neighbor is older than my son, and he drinks when they hang out together."

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? A. "I know that my adolescent is doing this because of all the hormones." B. "This is common for this age group and it will get better with time." C. "This is my adolescent's temperament, and we will have to learn how to deal with it." D. "My adolescent will never find anyone to live with if the adolescent acts like this."

B. "This is common for this age group and it will get better with time."

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? A. cultural B. socioeconomic C. marital status D. racial

B. socioeconomic

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? A. "Heterosexual adolescents have a higher risk for suicide than adolescents who are gay." B. "A maternal history of suicide has little bearing on the offspring's risk for suicide." C. "Adolescents who have attempted suicide once are at increased risk to try to commit suicide again." D. "The mental health disorder that increases the risk for suicide is depression."

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

Which comment suggests that an adolescent has grasped the concept of how syphilis is spread? A. "I'm lucky I got this early in life. Now I don't have to worry about getting it again." B. "Can't I be prescribed birth control pills so I'll have some protection from getting this again?" C. "Next time I'll be smart enough to look at my partner to see if he has any sores." D. "In the future I'll void immediately after sex to prevent this."

C. "Next time I'll be smart enough to look at my partner to see if he has any sores."

During a health maintenance visit, a 15-year-old girl mentions that she is not happy with being overweight. Which approach is best for the nurse to take? A. "Good observation. Let's talk about diet and exercise." B. "Don't worry; you are within the weight and height guidelines." C. "What specifically have you been noticing?" D. "Tell me about your parents. Are they overweight?"

C. "What specifically have you been noticing?"

The nurse teaches a 14-year-old client's mother about the adolescent developmental task of identity versus role confusion. What is the best way for the mother to help her adolescent complete this task? A. Set limits and offer concrete choices. B. Set limits according to what other adolescents are allowed to do. C. Allow the adolescent to participate in decisions. D. Allow the adolescent to set his/her own limits.

C. Allow the adolescent to participate in decisions.

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

C. Allow the client's friends to visit while the client is hospitalized Rationale: The developmental task of adolescence is to develop a sense of identity, or deciding who and what kind of person one is. Friends and peers are important to facilitating the adolescent in determining one's identity.

Which of the following of Freud's psychosexual stages most likely parallels stage 5 of Erikson's theory of psychosocial development? A. Oral B. Anal C. Genital D. Latency E. Birth F. Phallic

C. Genital Rationale: Fundamentally, the genital stage would be compared to puberty. Hormonal and physical changes in the adolescent's body cause a surge in sexual thoughts, feelings and behavior. This is the time of adolescent sexual experimentation, as dramatic physiological changes associated with sexual maturation mark this stage.The successful resolution after this stage would be settling down in a loving relationship with another person.

Which of the following is most likely associated with stage 5 of Erikson's theory of psychosocial development? A. Oral Stage B. Initiative vs. Guilt C. Identity vs. Role Confusion D. Trust vs. Mistrust E. Phallic Stage F. Latency Stage

C. Identity vs. Role Confusion

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? A. Some adolescents are accident-prone. B. There may be some underlying problems that your adolescent should be evaluated for. C. The bones, joints, and tendons of adolescents are vulnerable to injury due to their rapid state of growth. D. These are accidents and random in occurrence.

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

Which of the following is best linked to stage 5 of Erikson's theory of psychosocial development? A. Exploration B. School C. Career and Parenthood D. Toilet Training E. Social Relationships F. Romantic Relationships

E. Social Relationships

True or False: Early or late development of secondary sexual characteristics can have a positive effect on body image and self-esteem.

False

True or False: Adolescents should be screened for depression at every visit with questions asked of both the parent and adolescent.

True

An adolescent on fluoxetine should be monitored for restlessness, _______, and agitation.

hyperactivity

The major tasks of adolescence are to develop a(n) _________, a moral compass, and abstract thinking, which help the adolescent transition to adulthood.

identity

Adolescents with mononucleosis should avoid participation in contact sports for 2 to 3 weeks due to the risk of ___________ rupture.

splenic

Validated screening tools such as the CRAFT (Car, Relax, Alone, Forget, Friends, and Trouble) and SBIRT (Screening, Brief Intervention, and Referral to Treatment) tools help determine the extent of an adolescent's __________ use.

substance