Evolve Adolescent Mastery II
What nursing intervention should the nurse provide to a hospitalized individual during the identity versus role confusion stage? 1 Choosing creative ways to promote social participation 2 Providing information to the client about his or her treatment plan 3 Involving the client's partners or family members in the caring process 4 Encouraging the client to participate actively in treatment procedures
2 During the identity versus role confusion or puberty stage, the nurse should help hospitalized adolescents deal with their illness by giving them enough information to allow them to make decisions about their treatment plan. During the generativity versus self-absorption and stagnation stage, the nurse should help clients choose ways to promote social participation. This action helps clients find a sense of fulfillment. If an individual in the intimacy versus isolation stage is admitted to the hospital, the nurse should try involving the client's partners or family members in the caring process so that the client can have a strong support structure. During the industry versus inferiority stage, a nurse should ensure the active participation of a hospitalized client.
Which drug causes euphoria and hallucinations in an addicted adolescent but does not show any ill effects when withdrawn abruptly? 1 Heroine 2 Cocaine 3 Cannabis 4 Morphine
3 Cannabis is a mind-altering drug that does not cause physical dependence and can be abruptly withdrawn without ill effect. Heroine and morphine are narcotic drugs that cause withdrawal symptoms such as nausea, vomiting, and agitation. Agitation and restlessness are the common withdrawal symptoms seen with cocaine abuse.
A client with recurrent episodes of nausea, vomiting, and abdominal pain arrives at the hospital. Assessments by the primary healthcare provider reveal that the cremasteric reflex is absent, and emergency surgery is performed. What is the likely diagnosis? 1 Varicocele 2 Epididymitis 3 Penile neoplasia 4 Testicular torsion
4 Nausea, vomiting, and abdominal pain are symptoms of testicular torsion. The cremasteric reflex is absent in cases of torsion. Emergency surgery may be performed in cases of torsion as a means of preserving the testicle. Varicocele is characterized by elongation, dilation, and tortuosity of the veins of the spermatic cord superior to the testicle. Urethral discharge, dysuria, fever, and pyuria are signs of epididymitis. Penile neoplasia is associated with human papillomavirus type 16 infection.
5. A pregnant adolescent already diagnosed as HIV-positive with a viral load of more than 1,000 copies/mL is currently in her 38th week of gestation. Which is the best method of delivery in this situation? 1 Cesarean section 2 Vaginal delivery with forceps extraction 3 Vaginal delivery with vacuum extraction 4 Fetal scalp electrode
1 According to the Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission, antiretroviral therapy and a scheduled cesarean birth are recommended to prevent vertical transmission of HIV for adolescents with viral loads of more than 1,000 copies/mL. Normal vaginal delivery with forceps or vacuum extraction should be avoided. Use of a fetal scalp electrode is not a delivery method, and it is a procedure that should also be avoided to prevent transmission of the virus to the baby.
The nurse is teaching cleansing procedures to a client with acne. Which statement made by the client indicates a need for further teaching? 1 "I will avoid frequent shampooing." 2 "I will use a mild cleanser twice a day." 3 "I will brush my hair away from the forehead." 4 "I will avoid washing my face with antibacterial soap."
1 Frequent shampooing will help to improve a client's acne. Gentle cleansing with a mild cleanser twice a day helps improve acne. Brushing the hair away from the forehead will help to improve acne. Antibacterial soaps are ineffective and may cause drying; these soaps should be avoided.
Upon assessment, the nurse observes unilateral breast enlargement in a 14-year-old male client. The client states he has had this condition for 18 months. Which treatment would the primary healthcare provider administer? 1 Plastic surgery 2 Testosterones 3 Calcium channel blockers 4 Testing for Klinefelter syndrome
1 Gynecomastia is a condition in which the adolescent has some degree of unilateral or bilateral breast enlargement. If gynecomastia persists or is extensive enough to cause embarrassment, plastic surgery is indicated for cosmetic and psychological reasons. Administering testosterones and calcium channel blockers may aggravate the condition. When gynecomastia has a prepubertal onset, the adolescent should be evaluated for Klinefelter syndrome.
While providing nursing care for an adolescent undergoing chemotherapy for leukemia, a nurse notes blood on the child's pillowcase, as well as several bloody tissues. Which of the child's laboratory test results should the nurse review? 1 Platelet count 2 Hematocrit level 3 Prothrombin time 4 Red blood cell count
1 The platelet count is reduced as a result of bone marrow depression associated with leukemia and the side effects of chemotherapeutic agents. A low hematocrit level might indicate anemia, but it does not establish its cause. Prothrombin time is influenced by vitamin K factors, not by lack of platelets. The red blood cell count does not affect this type of bleeding.
Which of these thoughts in an individual correspond to the society-maintaining orientation stage? Select all that apply. 1 "I should avoid parties where alcohol is served." 2 "I should avoid risky driving and follow traffic rules." 3 "I should follow the rules or the teacher will punish me." 4 "I have to follow all state and federal laws." 5 "I should complete my homework so that the teacher will reward me."
12 During the society-maintaining orientation stage, an individual's thoughts are influenced by moral values and societal concerns. These individuals would avoid going to parties where alcohol is served, avoid risky driving, and follow traffic rules in order to be a good member of society. When an individual thinks that breaking the rule will lead to a physical punishment, this thought corresponds to the punishment and obedience orientation stage. Under this stage, an individual's moral dilemma is in terms of absolute obedience to authority and rules. When an individual thinks that he or she should follow all the laws formulated by the government, this thought corresponds to the universal ethical principle orientation. When an individual thinks that completing his or her homework will help win a reward, this thought corresponds to the good boy-nice girl orientation stage.
A pregnant adolescent reports genital warts. What suggestions should the nurse provide to reduce the discomfort? Select all that apply. 1 Take bath with oatmeal solution 2 Wear loose-fitted cotton clothes 3 Try out cryotherapy if needed 4 Use less water for cleaning the genitals 5 Anticipate a prescription of imiquimod
123 To reduce the irritation and discomfort of genital warts, bathing with oatmeal solution can be helpful. Wearing loose-fitted cotton clothes helps in reducing the irritation and friction. Depending upon the severity of the warts, cryotherapy can be an option to treat the warts. Proper cleaning and hygiene of the genital area is necessary to reduce the growth of the warts. Drugs like imiquimod should not be used during pregnancy.
What instructions should a nurse provide to adolescent boys regarding the usual procedure to be followed and normal findings observed during testicular self-examination. Select all that apply. 1 A firm, smooth, egg-shaped organ can be palpated. 2 Each testicle is examined individually after relaxing the scrotal skin. 3 A hard mass that can be palpated on anterior or lateral aspect of testicle. 4 The thumb and fingers of both hands can be used to apply firm and gentle pressure. 5 A raised swelling that can be palpated on the superior aspect of the testicle is the epididymis.
1245 Testicular self-examination is usually performed after a warm bath when the scrotal skin is relaxed. A firm organ with smooth and egg shaped contours that can be palpated is the testicle. Each testicle is examined individually using thumb and fingers of both hands applying firm and gentle pressure. A raised swelling that can be palpated on the superior aspect of testicle is the epididymis. Testicular cancer can be suspected if a hard mass can be palpated on the anterior or lateral aspect of testicle.
What are the differences between the pubertal growth of girls and boys? Select all that apply. 1 Girls tend to begin their physical changes two years prior to boys. 2 Girls grow till the age of 17 years whereas boys grow till 20 years of age. 3 Girls gain weight at an increased rate whereas boys gain height at an increased rate. 4 Girls show alteration in the width of hips whereas boys show alteration in shoulder width. 5 Girls who mature early are less happy with their body appearance whereas boys who mature early are satisfied.
1245 The physical changes in girls start two years prior to that in the boys. The growth spurt in girls occurs around 12 years of age whereas in boys, the growth spurt occurs at about 14 years. Girls grow till the onset of menarche (16 or 17 years old) whereas boys continue to grow until 18 to 20 years of age. Girls who mature early are shorter and heavy compared to girls who mature late. Because of this, girls are less satisfied with their body appearance. Boys who mature early are more athletic as compared to boys who mature late; boys who mature earlier are more satisfied with their appearance. The proportion of weight and height gain is almost the same in boys and girls. Sex-specific changes such as changes in shoulder and hip width are seen in both girls and boys.
What teaching methods should be adopted for an adolescent? Select all that apply. 1 Using teaching as a collaborative activity 2 Encouraging questions and offering explanations 3 Teaching psychomotor skills needed to maintain health 4 Using role play, imitation, and play to make learning fun 5 Allowing adolescents to make decisions about health and health promotion
15 Teaching should be framed as a collaborative activity in adolescents. An adolescent should be allowed to make decisions about health and health promotion. Preschoolers should be encouraged to ask questions, and answers should be provided through simple explanations and demonstrations. School-age children should be taught about the psychomotor skills needed to maintain health. The nurse should instruct mothers to include role play, imitation, and play to make learning fun for preschoolers. Independent learning should be encouraged in young and middle-aged adults.
A registered nurse is teaching a nursing student about sexual assault in teenagers. Which statement made by the nursing student indicates a need for further education? Select all that apply. 1 "Sexual intercourse that occurs by physical force is referred to as rape." 2 "A sexual assault committed on a person above the age of consent is called statutory rape." 3 "A medical examination of rape victims provides evidence of penetration and ejaculation." 4 "A rape that occurs when the assailant is 18 years of age or older is referred to as acquaintance rape." 5 "Inappropriate sexual activity such as inappropriate touching and psychological coercion in sexual acts is referred to as sexual assault."
23 A rape that occurs when the assailant is above 18 years of age and the victim is under 18 years of age is referred to as statutory rape. A rape that occurs when the assailant and victim know each other is referred to as acquaintance rape. Forced sexual intercourse that occurs by physical force or psychological coercion is referred to as rape. Penetration, ejaculation, and the use of force are clinical manifestations of rape. Inappropriate touching and inappropriate sexual activity is referred to as sexual assault.
A nurse is teaching parents about the nutritional needs of their 15-year-old child. What information should the nurse provide? Select all that apply. 1 Increase the child's fat intake 2 Provide iron-rich foods to the child 3 Increase the child's daily protein intake 4 Curb the child's diet to help prevent obesity 5 Provide adequate vitamin supplementation to your child
23 The nurse should instruct the parents to provide an iron-rich diet to the child. This will help prevent anemia. The nurse should instruct the parents to increase the child's protein intake. Fat needs do not increase in adolescents, so the nurse should not ask the parents to increase the child's fat intake. Increasing physical activity is often more important than curbing fat intake in countering obesity. Vitamin and mineral supplements are not required, so the nurse should instruct the parents to avoid them.
What psychosocial clues should be explored to confirm substance abuse in an adolescent? Select all that apply. 1 Overly polite behavior 2 Increased school absenteeism 3 Presence of drug-oriented magazines 4 Changes in interpersonal relationships 5 Wearing light clothes despite cold weather
24 Psychosocial clues to substance abuse include increased school absenteeism and changes in interpersonal relationships. Other psychosocial clues include falling grades, changes in dress, isolation, and increased aggressiveness. Adolescents with substance abuse problems become increasingly aggressive rather than overly polite. The presence of drug-oriented magazines may indicate substance abuse, but this is an environmental clue, not a psychosocial one. Adolescents with substance abuse issues tend to wear long-sleeved shirts in hot weather.
An adolescent with a BMI of 30 reports fatigue, frequent urination, and a tingling sensation on the feet. The adolescent is then diagnosed with type 2 diabetes mellitus. Which nursing interventions would be appropriate? Select all that apply. 1 Bariatric surgery 2 Physical activities 3 Dietary restrictions 4 Dietary counseling 5 Behavior modification
245 An adolescent with type 2 diabetes mellitus should engage in regular physical activity to reduce his or her weight and glucose levels. Dietary counseling helps to improve nutritional intake and decrease saturated fats and sugars. Behavior modification weight programs help adolescents identify and eliminate inappropriate eating behavior habits. Bariatric surgery is recommended for clients with morbid obesity (characterized by a BMI greater than 40). Dietary restriction should not be recommended because this action may cause a lot of nutrients.
While counseling the parents of an adolescent with anemia related to an inadequate diet, a nurse explains that several different nutrients, including protein, iron, and vitamin B12, are involved. What other nutrient should the nurse include in the teaching? 1 Calcium 2 Thiamine 3 Folic acid 4 Riboflavin
3 Folic acid acts as a necessary coenzyme in the formation of heme, the iron-containing protein in hemoglobin. Calcium is not involved in the production of red blood cells. Thiamine is a coenzyme in carbohydrate metabolism. Riboflavin is a control agent for energy production and tissue formation.
An adolescent comes to the school nurse complaining of a 2-day history of low-grade fever, exhaustion, and lack of energy and appetite. He has been tardy to school twice in the past week. Which assessment should the nurse use to identify the possible origin of the problem? 1 Eliciting the Kernig sign 2 Eliciting the Brudzinski sign 3 Checking for lymphadenopathy 4 Checking the pupillary response to light and accommodation
3 Infectious mononucleosis is caused by the Epstein-Barr virus. Mononucleosis is common in people between the age of 15 and 30 years. Signs and symptoms of mononucleosis include fever, fatigue, swollen lymph glands, and enlargement of the liver and spleen. Pupillary response to light and accommodation is checked as part of a neurologic assessment. The Kernig sign (asking the child to straighten a leg that is bent at a 90-degree angle at the knee) and Brudzinski sign (asking a child who is lying flat to bend his head and try to put his chin on his chest) are elicited as part of the assessment when meningitis is suspected.
A nurse is planning to discuss the importance of following the prescribed course of treatment with a group of adolescent clients. What is the nurse's priority consideration regarding these clients? 1 They are in touch with their feelings and concerns. 2 Their thinking is both concrete and reality oriented. 3 They are involved more with the present than with the future. 4 Their developmental goal is striving for industry versus inferiority.
3 The future seems far away; immediate gratification takes priority. Adolescents are often confused about their feelings. School-age children (7 to 11 years) use concrete operational reasoning ; adolescents are learning to think in abstract terms and use formal operational reasoning. Striving for industry versus inferiority is the developmental stage of children 6 to 12 years of age; identity versus role confusion is the developmental stage of the adolescent.
In order to implement primary prevention of STIs (sexually transmitted infections) a nurse is counseling an adolescent. What would be the priority nursing action? 1 Help the adolescent recognize the risk. 2 Educate the adolescent about proper preventive measures. 3 Provide complete information about STIs. 4 Assess the adolescent's sexual risk behaviors.
4 The priority step for primary STI prevention is to assess the sexual risk behavior of the adolescent to identify the risk factors and provide appropriate counseling accordingly. With that information in mind, the nurse can then help the adolescent recognize the risk, encourage usage of preventive measures, and provide proper information about STIs.
Which statement is true regarding varicocele? 1 It is commonly seen in prepubertal children. 2 It results in partial or complete venous occlusion. 3 It results in the red, warm, and edematous scrotum. 4 It causes elongation of the veins of the spermatic cord.
4 Varicocele is characterized by dilation and elongation of the veins of spermatic cord that is presently superior to a testicle. It is rarely seen in prepubertal children. Testicular torsion results in partial or complete venous occlusion. In cases of severe torsion, scrotum becomes red, warm, and edematous and appears to be immobile.