Exam 4 B230
A nurse is teaching parents of school-aged children about atomoxetine. Which of the following should the nurse include in her teaching?
"give dose in the morning to prevent insomnia"
A nurse is providing teaching to a client about the reduced risks of Cardiovascular disease. Which comment indicates the need for further teaching?
"increasing my intake of foods containing trans-fatty acids can lower my risk"
Health promoting behaviors taught at school must meet the child's _________ level to be effective. A. Psychomotor B. Cultural C. Cognitive D. Affective
C. Cognitive
In preparing for a college heath fair, which of the following topics would reflect Health People 2020 goals>?
- Healthy nutrition - Substance use - Positive mental health practices
Which of the following would be caterforized as a moderate physical activity for young adulthood?
- Water aerobics - Dancing
Question: What physical activities are appropriate for the school-aged child?
- approximately four permanent teeth erupt each year - participate in competitive team games - creating new rules or changing the rules of the game
Question: What developmental tasks should be achieved for the school-aged child?
- verbal and nonverbal intelligence - mastering difficult tasks - accepting and following rules and internalizing them - developing responsibility - learning many new skills, including social skills (especially same-sex peer relationships) - selecting adult role models of the same sex - continuing to learn how the world works - increasing their independence - enhancing their ability to reason - becoming more cooperative -Ask a lot of questions as they gather information about the world and how it works. They are also eager to learn new skills, including social skills. -They are very interested in rules and why they exist. They want people to obey rules even though they do not necessarily abide by them. They may test rules, disagree with them, break them, or try to set them as they learn to make the rules their own. -They use their more mature reasoning abilities to understand the reasons why the rules exist and to differentiate between wants and needs. Along with exploration of rules and the beginnings of a cooperative spirit, games become prominent in their play.
Setting limits in school-aged children:
-Allowing children to see the results of their behavior by imposing appropriate consequences and following through with the consequences you set. -setting negotiable and non-negotiable rules. -letting them make decisions about things that effect them, to the degree that their judgment allows. -pointing out what is real versus fantasy and encouraging children to report events accurately. -Young children may lie or steal. Without thinking they are doomed to a life of crime and without blaming or humiliating them, you can confront children with the facts and help them to tell the truth and make amends. -assigning chores to encourage cooperation, responsibility, and feeling that they are part of and are needed in the family.
Question: What physical changes in the structure and function of various parts of the body are expected during adolescence?
-Girls continue to add fat and boys lose fat. Boys also add much more muscle than girls. -boys develop more strength, speed, endurance . -During puberty, growth proceeds in the reverse direction, and sex differences in body proportions appear. - Increased body size and muscle strength lead to continued motor gains in adolescence. As they develop, children integrate previously acquired motor skills into more complex, dynamic systems of action. Girls: Begins with budding of breasts, growth spurt, pubic hair. Menarche. Occurs later in sequence of pubertal events. Boys - Begins with enlargement of testes & changes in scrotum.Pubic hair and penis enlarges.Height growth occurs later in sequence but peaks at 14.Then facial & body hair emerge, voice deepens.Spermarche.Occurs around 13 ½
Puberty
-Girls tend to grow more rapidly in height and weight -Girls tend to mature, enter puberty and stop growing earlier than boys - Attaining adult-sized body and becoming capable of producing offspring.
Setting limits in adolecence
-gradually turning over decision-making to your teens: allowing them to make decisions about things that effect their lives to the extent that their judgment permits. -matching their increased judgment and responsibility with increased privileges. -continuing to set firm rules and limits about safety matter and important values - you are still the parent and have the ultimate authority in your home. -setting and following through with consequences. choosing your battles - you might let issues about clothing or appearance go. -continuing to monitor friendships, academic performance, internet/technology use; step in if you feel your children need guidance or limits. -supporting involvement in activities that interest your teen. -encouraging healthy peer involvement; make your home teen-friendly without compromising your values. -remembering that even if your teens are pushing you away, they really do still want your input; find new ways to stay connected. -continuing to let your teens know what your values are.
Encouraging emotional and cognitive Development
-helping them to understand their feelings and identify the feelings of others. -teaching them to solve problems so they can deal with conflict and life's challenges. -encouraging activities that reflect their interests, build skills, and increase their confidence and sense of accomplishment. -allowing, encouraging, and helping them to finish tasks. -praising them for trying to do things. -being a reliable source of information -Time with friends -Establishing a role model for them
Menarch
-most experience same age as their mothers -12.5 white girls; 12.0 in black girls
vision screening
1/3 schools require eye exams before school. Visual capacity is reached by 6 -7 yrs
Young adult ages
18 - 35 years
Young Adult G&D
18-35 per our text (20 and 40) years of age Legal age of adulthood in the United States is18 years of age Achieve the tasks of becoming self-supportive, acquiring independence, developing intimate relationships, and establishing a stable family and lifestyle Developmental process from adolescence to adulthood is most often a gradual one Physical health, motor coordination, and physiological performance typically peak between the ages of 20 and 30 Epiphyses of the long bones fuse by the early twenties Muscular strength is at its peak Heart and lungs are also at their peak capacity Should perform at least 2.5 hours of moderately intense aerobic exercise every week HR 220- age x 65%-85%Muscle-strengthening activitiesExercises involving balance and coordinationMajor causes of death in young adulthood are most often related to accidents or violence, both of which often are preventable
While working with young college aged students, the counselor would identify increased risk for which of the following students?
A 21 year old male who is raising 2 children under the age of 4
The school nurse is evaluating children for signs and symptoms of depression. Which of the following children may be most at risk for depression? (select all that apply)
A. 11-year-old girl who has been involved in fighting during the past month B. 10-year-old boy who no longer wants to play on the school's soccer team D. 9-year-old girl who visits the nurse on a daily basis for vague complaints
According to the American Heart Association, at what age should blood pressure screening begin?
A. 3
A nurse is conducting a school-wide in-service program about child abuse and is asked to describe common indicators of abuse. Which of the following signs would the nurse include? (select all that apply)
A. Caregivers and parents who are reluctant to take the child for treatment for an injury B. Statement by the day care provider that the child was injured by falling off a chair D. Lack of emotional response from child to a playground injury
The school nurse teaches which of the following dietary guidelines to the parents of children and adolescents? Select all that apply A. Children should consume at least 3 cups of fruits and vegetables per day. B. Children require 4 cups of whole milk products per day. C. Children should consume 5 ounces of steak daily. D. Children should consume 5 ounces of lean meat or beans each day. E. Children and adolescents should consume 4 to 6 ounces of grains each day.
A. Children should consume at least 3 cups of fruits and vegetables per day C. Children should consume 5 ounces of lean meat or beans each day E. Children and adolescents should consume 4 to 6 ounces of grains each day
Parents and caregivers who teach and model health-promotion concepts to school-age children can expect which of the following behaviors? Select all that apply. A. Children who develop good personal hygiene and dental care B. Children who become passive health care consumers C. Children who obey authority figures and do as they are told D. Children who make a link between behavior and improved health E. Children who develop health values as part of education
A. Children who develop good personal hygiene and dental care D. Children who make a link between behavior and improved health E. Children who develop health values as part of education
A nurse is planning activities to help children learn about good nutritional practices. Which of the following strategies should the nurse implement?
A. Coordinate a "Try This" food day offering a variety of nutritious snacks.
The school nurse is developing an information pamphlet on prevention of obesity in school-age children. Interventions stated on the pamphlet would include which of the following? A. Encourage child to participate in food preparation. B. Eating permitted in front of television but only for educational programs. C. Serve healthy food at breakfast and dinner; child is unrestricted for lunch. D. Reward the child with fast food but only for school achievement. E. All of the above.
A. Encourage child to participate in food preparation.
Eugenia is involved in a partnership with the local air pollution control district that alerts schools about air quality indicators. Reducing exposure to unhealthful air in the asthmatic student would have which of the following impacts on health? (Select all that apply.) A. Improved overall health B. Increased absenteeism C. Improved socialization D. Improved scholastic achievement E. Decreased absenteeism
A. Improved overall health C. Improved socialization D. Improved scholastic achievement E. Decreased absenteeism
A child who has a BMI of 34 visits the school nurse. Which of the following factors does the nurse recognize that the child may be experiencing?
A. Increased bullying by peers
A school nurse is assessing the child's social environment. Which of the following strategies would the nurse implement?
A. Interview family members.
A nurse is planning a flu prevention fair for 9- to 11-year-old children. Which of the following activities should be included? (select all that apply)
A. Microscopes set up to show bacteria on common objects B. Games such as "find the germs" in a cartoon picture D. Hand-washing booth with colored soap
What is the primary health promotion and disease prevention emphasis for young adults over the age of 25?
A. Modifying coronary disease risk factors
Which of the following children may have difficulty with Erikson's "industry versus inferiority" stage of development? (select all that apply)
A. Poor motor skills and is rarely chosen for team play during recess C. Difficulty making friends D. Cannot speak his or her native language fluently
Which of the following elements can play a key role in the development of social competence in the school age child? A. Positive relationships with peers B. Development of attitudes toward race development C. Television, videos and computer games D. Maintaining at least average grades or better
A. Positive relationships with peers
Which of the following is responsible for ensuring that children are up-to-date on their immunizations? (select all that apply)
A. School nurse B. Parent or caregiver
The parents of a school-age child report that their 9-year-old son walks in his sleep almost every night. The school nurse includes which of the following elements of education? Select all that apply. A. Sleep disturbances are more common in the preschool and school-age years. B. Sleep disturbances occur most often in the first 1 to 2 hours after going to sleep. C. Girls are more prone to sleep disturbances than boys. D. Problems may be influenced by fatigue and stress within the child. E. Sleep disturbances are usually related to respiratory problems.
A. Sleep disturbances are more common in the preschool and school-age years. B. Sleep disturbances occur most often in the first 1 to 2 hours after going to sleep. D. Problems may be influenced by fatigue and stress within the child.
Which of the following is true about the health patterns of adolescents? A. Teens have fewer acute illnesses than younger children. B. Teens have more acute illnesses than younger children. C. Teens have more chronic illnesses than adults. D. Teens seek preventive health care.
A. Teens have fewer acute illnesses than younger children.
A school nurse is planning a series on nutrition. Which of the following factors should the nurse take into account?
A. Television commercials frequently advertise food-related products.
The nurse assessing conventional level moral development in 12-year-old children would expect to see which behaviors? A. The child looks to others for approval. B. The child views behavior as completely right or wrong. C. The child behaves because there is a fear of punishment. D. The child's moral development is characterized by self-interest.
A. The child looks to others for approval.
Which of the following statements concerning hearing in school-age children is correct?
A. The rate of otitis media infections met Healthy People 2010 targets.
Which of the following educational topics should Jasmine provide when discussing health hazards associated with the migrant population? (Select all that apply.)
A. Trauma and injury prevention?? B. Chemical exposure?? D. Motor vehicle safety E. HPV immunization
Carmen Cordoba should utilize which of the following techniques when dealing with her students? (Select all that apply.) A. Treat the teen as a partner in care. B. Allow the teen to make all decisions about his or her health needs. C. Recognize that parental influence is primary. D. Recognize that peers are more important than parents, from the perspective of the adolescent. E. Make the teen feel respected.
A. Treat the teen as a partner in care. D. Recognize that peers are more important than parents, from the perspective of the adolescent. E. Make the teen feel respected
hyperopic
Able to see objects at a distance clearly but having trouble seeing things up close; farsighted
identity vs. role confusion
Adolescence (12 - 20 y/o) -developing sense of identity -sense of personal identity -unsure about ones identity, weak sense of self, experience role confusion, are confused about the future (unsuccessful)
Young adult screenings
Basic goals of preventive care are to maximize the period of optimal health status and detect incipient health problems at an early stage.
From the nurse's knowledge about the emerging adult according to Arnett's theory, which behavior by a 21-year-old hospitalized male patient is most appropriate for his age group? a. Talking about college courses that he is taking while working part-time at a restaurant b. Requesting that his mom be present when his IV line is started c. Stating that he cares for his disabled father and his 2-year-old daughter d. Becoming upset that he is not giving back to his community
Answer: a According to Arnett (2006), emerging adults are shifting their choices, and many are unstable; they explore more possibilities and move gradually toward enduring choices. The young adult is often slow in transitioning due to pursuing higher education. This 21-year-old is pursuing education while working part-time, which fits within Arnett's theory for this age group. A 21-year-old male would be exhibiting regression if he needed his mom with him during an intravenous (IV) start. Caring for his father and daughter would be more typical of middle adults, who are called the sandwich generation. Giving back to one's community is generativity, which is Erikson's middle adult developmental task.
A teenage girl faces a long hospitalization after surgery. How can the girl's continued development be fostered? a. Encourage her to write her feelings in a journal. b. Divert her attention by playing video games. c. Encourage her to work on craft projects. d. Make sure her parents are constantly by her side.
Answer: a Teenagers are capable of abstract thought and often find it helpful to verbalize their feelings either by talking or by journaling. Diverting her attention by playing video games and encouraging her to work on craft projects are measures that may be used to help her pass the time but are not methods of fostering teen development. Teens usually do not wish parents to be at their side constantly and may want some private time away from them.
While assessing a patient for domestic violence, the nurse knows that which statement is true regarding domestic violence? a. It is a health risk factor only during young adulthood. b. It occurs across age, socioeconomic levels, and cultural boundaries. c. Young women aged 20 to 24 have the lowest incidence of rape and sexual assaults. d. Women are the only victims of domestic violence.
Answer: b All socioeconomic levels and cultures are affected by domestic violence. It is a health risk for adults of all ages—from young to older adulthood. Young women have the highest rate of rape and sexual assault. Women are not the only victims of domestic violence. Men also may be victims of domestic violence and sexual assaults, although they are less likely to report it or to seek care.
Which behavior by the young adult patient indicates an understanding of patient education aimed at reducing the health risks for that age group? a. Smoking only one pack of cigarettes per day b. Limiting alcohol use to an occasional drink c. Using drugs found in a roommate's drawer for anxiety d. Having a relationship with a partner who was threatening in the past
Answer: b Having an occasional drink shows control and moderation. Smoking any amount is damaging to the lungs, and education for cessation is needed. Using any drugs that are not directly prescribed for the person shows a lack of understanding of the risks of drugs. Staying in a relationship that has been dangerous in the past increases the risk of intimate partner violence.
The nurse is performing a health assessment on a 15-year-old female patient. Which is the best way to obtain accurate information regarding her sexual activity? a. Ask the mother about the girl's sexual activity. b. Privately ask the girl about her sexual activity. c. Warn the girl about the dangers of sexual activity. d. Ask the girl if she wants birth control.
Answer: b Privately asking the girl about her sexual activity in an open and nonjudgmental fashion is the best way to obtain accurate information. Asking the mother about the girl's sexual activity may be embarrassing for the teen and her mother and may not provide accurate information. Warning the girl about the dangers of sexual activity is making a judgment. It is important to provide a nonjudgmental approach with teens. The teen may have additional questions about sexuality beyond the topic of birth control; thus, it is important to approach the teen in a manner that encourages open discussion.
Which term indicates a mental health disorder that is frequently seen in older adults? a. Schizophrenia b. Bipolar disorder c. Depression d. Posttraumatic stress disorder (PTSD)
Answer: c Depression is one of the psychiatric illnesses appearing frequently in the older adult population. Schizophrenia typically is seen in younger adult populations. Bipolar disorder is usually identified before age 65 years. PTSD can be seen in any age group and usually is related to previous experience of a traumatic event.
For which person seen at the primary care provider's (PCP's) office appointment would patient and family education be most critical? a. A 24-year-old male patient with a cold virus and on no medications b. A 45-year-old male patient on metformin for type 2 diabetes for the past 3 years c. A 75-year-old female patient just prescribed the anticoagulant warfarin d. A 40-year-old male asthmatic patient diagnosed 10 years ago and on albuterol
Answer: c Educating the patient and family members to the side effects of the anticoagulant warfarin and its potential for bleeding is a critical part of care for the 75-year-old female patient who has just started taking this medication. A 25-year-old male patient is young, and his immune system has the potential to fight off a cold virus. Education about a cold versus the flu would be helpful but is not critical. A middle adult who has had diabetes and has been maintained on this medication for 3 years would have had education when he was first started on the medication. A patient who has been using asthmatic medication for the past 10 years is likely to be knowledgeable about the medication from previous use.
The president of the Parent-Teacher Association asks the school nurse about the appropriateness of sponsoring a health fair that focuses on oral health for school-age children. Which of the following statements indicates the nurse's correct understanding of this issue?
B. "Over 40% of children age 2 to 11 have dental caries, so a health fair that focuses on oral care is very appropriate."
Which group is referred to as the sandwich generation? a. Older adults who are caretakers for their elderly parents b. Younger adults who are reexamining their life choices c. Middle adults who are caretakers for multiple generations of their family d. Younger adults who are changing employment constantly
Answer: c Middle adults who are caretakers for multiple generations of their family tend to be sandwiched in between the needs of children, grandchildren, and elderly parents, all of whom need their attention and care. This situation can lead to many health and financial problems for the middle adult. Although older adults caring for their elderly parent also may experience significant stresses, they would not be called the sandwich generation unless they also were caring for younger members of their family. Younger adults may change jobs or middle adults may reexamine choices they have made, but these factors do not reflect the concept of the sandwich generation.
What is the best activity for a hospitalized school-age child to encourage continued appropriate development? a. Watching favorite television shows for 2 hours per day b. Keeping a journal of feelings while in the hospital c. Working on a paint-by-number project that can be completed in an afternoon d. Playing a favorite video game each afternoon
Answer: c The school-age child is in Erikson's stage of industry. He needs to work on projects that build a sense of accomplishment. A painting project that can be completed in one afternoon gives a sense of accomplishment. Although the other options are activities, they do not contribute to the primary developmental task of the school-age child—developing a sense of industry.
The nurse knows that which patient is an example of the Wear-and-Tear Theory of Aging? a. A patient who is dying of cancer at age 35 b. A 55-year-old who runs half-marathons c. A patient with depression and suicidal thoughts who is 65 d. An 88-year-old with heart failure, kidney failure, and osteoarthritis
Answer: d Dr. Weisman believed that aging occurred because of overuse and abuse to body and cells, and that this takes place on the cellular and organ-systems level. An 88-year-old with multiple body systems failure and damage would be exhibiting signs of wear and tear. A 35-year-old patient dying of cancer would not have overuse. A 55-year-old running in half marathons is not exhibiting wear and tear, although signs of overuse may emerge later in life. A 65-year-old person with depression is not exhibiting wear and tear. Emotional stressors are only one group of factors that can lead to aging and are not a component of the Wear-and-Tear Theory of Aging.
Which factor(s) is/are likely to influence the transition from adolescence to adulthood? (Select all that apply.) a. Cultural beliefs b. Societal values c. Personal beliefs and expectations d. Governmental rules e. Peer influences
Answers: a, b, c, e Cultural beliefs, societal values, personal beliefs and expectations, and peer influences are all factors that influence an individual's transition into adulthood. Although governmental rules may influence certain societal values and beliefs, they are not directly responsible for the transition through adulthood.
When an injury to a child is suspicious for abuse, which is/are important to document? (Select all that apply.) a. Size and location of bruising b. Distinguishing characteristics of injuries c. Height and weight of the child d. Time of last meal e. General state of health of the child
Answers: a, b, c, e The size and location of the bruising, distinguishing characteristics of injuries, height and weight of the child, and the general state of health of the child all are considerations in determining possible child abuse or neglect. The exact location and the nature of the injury are important to document. A child who has been abused over time may be small and have other health problems stemming from the abuse. The time of the last meal may be important information but usually is not related to suspected abuse.
The nurse is assessing data for a group of older adults. Which patient(s) in this group is/are exhibiting normal signs of aging? (Select all that apply.) a. The patient with knee pain and wrinkles around the eyes b. The patient who needs reading glasses and states that the food tastes bland c. The patient who is confused and does not know the current year d. The patient who states that constipation is an increasing problem e. The patient who is showing signs of depression and hopelessness
Answers: a, b, d Normal aging includes signs of decline in many organ systems. Knee pain, skin wrinkles, need for reading glasses, decline in taste buds, and constipation all can occur with aging. Normal aging does not include dementia or depression, even though these can both be diagnosed in the older adult population.
Which step(s) can nurses and health care providers take to remove barriers to identifying and treating victims of domestic violence? (Select all that apply.) a. Call the police. b. Ask about abuse. c. Ask for proof of domestic violence. d. Screen for domestic violence with all patients. e. Disregard reported abuse in spouses.
Answers: b, d Screening for domestic violence with all patients and asking about abuse will help identify patients who may be victims. Calling the police is a step that may be taken when abuse is confirmed but is not a step in identifying victims. Taking this step will be decided on with the involvement of both health care providers and the patient. Asking for proof may cause the victim to mistrust the health care provider. Never disregard a report of abuse. Abusers often are related to or married to the victim.
Each of the following children visits the school nurse on a regular basis. Which of these children would the nurse identify as being at risk for educational difficulty and suggest follow-up care?
B. 10-year-old who cannot sit still longer than 15 minutes
A parent asks the nurse working in a pediatric clinic how she can help her 6-year-old child feel good about himself. Which of the following statements should be made by the nurse?
B. "Having your child help around the house with tasks such as setting the table will increase self-esteem."
Which of the following statements made by a parent is most helpful when discussing rules of the household?
B. "I was upset when you did not feed the dog like you promised. We all need to help take care of him because he depends on us. Let's talk about what happened."
Which of the following children should the school nurse monitor closely for hypertension (HTN)? (select all that apply)
B. 9-year-old White female whose maternal grandfather has HTN C. 6-year-old Black child with no family history of HTN D. 10-year-old Mexican American child with known family history of HTN
During a school gift fair, a parent asks the school nurse what gift would be most appropriate for her 6-year-old child. Which of the following should the nurse encourage the parent to purchase?
B. A jar of sea shells in various shapes, colors, and textures
According to Piaget, which of the following operations are displayed as the child begins to add flexibility and control to their thinking? A. Formal B. Concrete C. Abstract D. Egocentric
B. Concrete
The school nurse has been asked to conduct a community awareness program about accidents that impact the school-age child. Which of the following facts should be included in the program?
B. Drowning and motor vehicle accidents are the leading causes of fatality.
The school nurse has been asked to plan play and recess activities for children in grades 2 through 6. Which of the following activities should be developed by the nurse? (select all that apply)
B. Family activity days that promote nature walks and biking D. Library outings
Which of the following would be categorized as a moderate physical activity?
Confidently pursing individual actives related to expressed career goals
The nurse discusses discipline for school-age children with a group of parents at a parent-teacher association meeting. Principles include: Select all that apply. A. focusing on the misbehavior in an attempt to eliminate it. B. using distraction or substitution to avoid a problem situation C. ignoring the child's whining after a decision has been made. D. using humor to decreases the intensity of the situation. E. modeling appropriate behavior. setting age-relevant limits.
B. using distraction or substitution to avoid a problem situation D. using humor to decreases the intensity of the situation. E. modeling appropriate behavior. setting age-relevant limits.
Which of the following initiatives related to childhood nutrition outlined in Healthy People 2010 was most successful?
C. Adequate food supplies at home
A child's parents ask the school nurse if there is any help available to help their child receive health insurance. They state they earn too much money to qualify for Medicaid but not enough to purchase health insurance. Which of the following recommendations should the nurse provide?
C. "The state has an insurance program to assist you."
A third grade teacher asks the school nurse what she can reasonably expect from children in her classroom related to language ability. Which of the following statements would be the best response from the nurse?
C. "You can expect that the children will write 'b' and 'd' without reversing them, and all of the letters in a word will be about the same size."
The school nurse has seen several students in the health office. For which of the following students should the nurse suggest a follow-up exam?
C. A 10-year-old girl who has gained 11 pounds in a year
Which of the following children is at risk for developing encopresis?
C. A 5-year-old child who has been in four foster care homes since age 3
A nurse has recently accepted a position as a school nurse at a middle school and plans to offer sex education to the students and parents. Which of the following should be in the initial action taken by the nurse?
C. Determine how this education has been provided in the past.
Which of the following statements about smoking is true?
C. Each day over 6000 children try smoking.
Which of the following elements is most likely deficient in a school-age child's diet?
C. Iron
During a parent-nurse conference, the parent tells the nurse that her child sleeps approximately 7 hours per night. Which of the following potential health problems would be of concern to the nurse?
C. Obesity
The nurse is teaching the parents of 8- and 9 year-old children about safe bicycling. The nurse emphasizes the principles of transportation safety, to include which of the following? A. Riding on the side of the road traveling opposite to the traffic B. Observing rules for pedestrians vs vehicular traffic C. Wearing an approved helmet when bicycling D. Encouraging a backpack for carrying objects to promote back and shoulder strength.
C. Wearing an approved helmet when bicycling
During a well-child visit, parents report to the nurse that they are concerned that their 8-year-old son has started wetting the bed at night. Which of the following statements should the nurse make to the parents?
D. "I'm going to collect a urine sample from him and then we will talk about bed wetting."
The school nurse conducting an in-service program for teachers is asked about general growth and development of school-age children. Which of the following statements would be the best response by the nurse?
D. "Overall growth in school-age children is slower than during infancy and adolescence."
Parents of an 8-year-old boy tell the nurse that they are concerned about their son because he occasionally sleepwalks. Which of the following is the best response from the nurse?
D. "This is not abnormal for a child of this age. He will most likely outgrow this tendency as his nervous system matures."
During orientation, the new school nurse asks his preceptor about the role of the school nurse. Which of the following statements is the best response by the nurse?
D. "We are an important part of the team that helps to maintain and improve children's health in a variety of ways from screenings to advocacy."
The school nurse has written a grant to obtain funding for a vision screening program and glasses for children in his pre-K to 6th grade elementary school. Which of the following statements should be included with the rationale for the need for funding?
D. Approximately one in four children has a vision problem.
A school nurse is caring for a child with an upper respiratory tract infection. Which of the following nursing interventions should the nurse implement?
D. Ask the parent of a child with a mild fever and mild sore throat to take the child to his or her health care provider.
Eugenia is aware that prevention of overweight and obesity is critically important during the school-age years. Which interventions are important for school nurses to incorporate into educational topics? A. Encourage eating while watching television to that parents can monitor intake. B. Encourage parents to conduct all meal-planning and preparation C. Educate families that the school nurse is the only role model for healthy behaviors. D. Incorporate discussion of healthy food intake and daily activities into daily school life.
D. Incorporate discussion of healthy food intake and daily activities into daily school life.
Which of the following statements is correct?
D. Overweight children have muscle pain more often than average-weight children.
A nurse is discussing sleep patterns in school-age children. Which of the following should be stressed by the nurse?
D. School-age children generally agree with and adhere to a regular bedtime.
The most common childhood school-age cancer is: A. retinoblastoma. B. neuroblastoma. C. Wilms' tumor. D. leukemia.
D. leukemia.
Parents of a 7-year-old boy request a discussion with the school nurse on how they can resolve the child's nighttime enuresis. The nurse advises that nighttime enuresis: A. is an intentional act with a psychological basis. B. should have consequences to eliminate the behavior. C. is often treated with fluid restriction. D. treatment might include an alarm and waking schedules.
D. treatment might include an alarm and waking schedules.
Young Adult anticipatory guidance
Identity and cognitive function have reached the level that allows intimate sharing Influenced by culture, customs, and environment May be more difficult or delayed if relationship with parents did not produce a healthy, secure attachment intimacy One of the major tasks of young adulthood Ability to develop a warm, trusting, honest relationship with another person Lack of a clear sense of identity may contribute to isolation Schools play significant roles in helping the adolescent prepare for the developmental tasks and challenges of young adulthood Intellectual and creative skills and abilities peak Piaget believed that the development of the formal operation of thinking extends into adulthood Postformal operational thought Levinson described four seasons of life Taking responsibility for the care of others, handling the differing points of view of others, and understanding how their own actions affect others Most proactive development of parental skills begins at the time conception is confirmed Successful learning for adults always involves relating the information they are learning to the appropriate developmental tasks they are experiencing Should be interactive, problem oriented, and related to daily psychosocial tasks at work, home, or school
they focus more on fact rather than fantasy. School-age children interact with teachers and others outside the family who will have a significant impact. Middle childhood includes children between the ages of 6 and 12 years. positive self-esteem from internal sources. The ability to develop close peer relationships will affect the development of new ideas, skills, and tools that will enhance the child's advancement toward maturity. changing from concrete thinking to abstract thinking, developing secondary sex characteristics, and accepting more responsibility.
Important middlechildhood tips
A nurse is assessing an adolescent client who has ADHD. Which of the following should the nurse expect?
Impulsiveness emotional numbing - depression Elevated mood- mania Anxiety - anxiety
While observing adolescents which of the following is most likely to be noted?
Increasing amounts of time are spent with peers
pediculosis
Infestation on lice
The nurse is caring for several clients who are at various developmental stages. The nurse should explain that, according to Erikson, acceptance of death is a primary task of which of the following stages of development?
Integrity and Despair
In teaching heal seminar, the nurse would include which of the following instructions related to set breast examinations?
It is important to examine the breasts in front of the mirror
Which of the following therosrs beloved that an individual must be capable of the formal operational level of thought before achieving mature moral reasoning?
Kohlberg
The type of play activities typical in the middle-childhood age group include: a. parallel play. b. competitive games. c. solitary play. d. reading and fantasy.
b. competitive games.
Adolescence
Piaget - Concrete operational thought (7 - 11 yrs) ; Formal Operational stage (11 yr - ) Concrete stage: Their rules of thinking still seem very basic by adult standards and usually operate unconsciously, but they allow children to solve problems more systematically than before, and therefore to be successful with many academic tasks. ability to decenter, or focus on more than one feature of a problem at a time. reversibility and decentration. Formal stage: able to reason not only about tangible objects and events, but also about hypothetical or abstract ones. Analyze all combo of possibilities and hypothesize Erikson - Industry v inferiority (5 yrs - 12 yrs) ---- identity v role confusion (12 - 18 yrs) If children are encouraged and reinforced for their initiative, they begin to feel industrious (competent) and feel confident in their ability to achieve goals. If this initiative is not encouraged, if it is restricted by parents or teacher, then the child begins to feel inferior, doubting his own abilities and therefore may not reach his or her potential. Peer group and teachers begin to be a big influence. It is during this stage that the adolescent will re-examine his identity and try to find out exactly who he or she is. Erikson suggests that two identities are involved: the sexual and the occupational. What should happen at the end of this stage is "a reintegrated sense of self, of what one wants to do or be, and of one's appropriate sex role". During this stage the body image of the adolescent changes. may feel uncomfortable about their body for a while until they can adapt and "grow into" the changes. Success in this stage will lead to the virtue of fidelity. Kohlberg - conventional conventional: begin to internalize the moral standards of valued adult role models. Authority is internalized but not questioned, and reasoning is based on the social/peer group norms
Young Adult
Piaget - Formal operational thought Formal stage: able to reason not only about tangible objects and events, but also about hypothetical or abstract ones. Analyze all combo of possibilities and hypothesize Erikson - Intimacy v isolation (18 - 40 yrs) Successful completion of this stage can result in happy relationships and a sense of commitment, safety, and care within a relationship. Avoiding intimacy, fearing commitment and relationships can lead to isolation, loneliness, and sometimes depression. Success in this stage will lead to the virtue of love. Kohlberg - post-conventional level of moral reasoning differentiate the self from rules and expectations of other and to define principals regarding rights in terms of chosen principals. interests of individuals are weighed against needs of society and state. Violations of law can be justified when individual interests are in accord with principals.
School Aged Child
Piaget - Preoperational Thinking (2 - 7 yrs) --- Concrete operational thought (7 - 11 yrs) Preoperational stage, children use their new ability to represent objects in a wide variety of activities, but they do not yet do it in ways that are organized or fully logical. Concrete stage: Their rules of thinking still seem very basic by adult standards and usually operate unconsciously, but they allow children to solve problems more systematically than before, and therefore to be successful with many academic tasks. ability to decenter, or focus on more than one feature of a problem at a time. reversibility and decentration. Erikson - Industry v inferiority (5 yrs - 12 yrs) If children are encouraged and reinforced for their initiative, they begin to feel industrious (competent) and feel confident in their ability to achieve goals. If this initiative is not encouraged, if it is restricted by parents or teacher, then the child begins to feel inferiour, doubting his own abilities and therefore may not reach his or her potential. Peer group and teachers begin to be a big influence. Kohlberg - preconventional (9 yrs) preconventional level children don't have a personal code of morality, and instead moral decisions are shaped by the standards of adults and the consequences of following or breaking their rules.
The process of integrating various points of view to develop knowledge and understanding is referred to as which of the following?
Postformal operational thought
What can the nurse do to decrease the incidence of pelvis inflammatory disease in young adulthood?
Promote health behaviors related to safe sex practices
One of Carmen's female students confides in Carmen that she fears she may be pregnant. What is Carmen's first priority? A. Report the information to the student's parents. B. Encourage the student to make an appointment with her physician. C. Educate the student about pregnancy prevention. D. Refer the student to a local abortion clinic.
Rationale: Adolescent pregnancy is a high-risk situation. If a teen girl thinks she may be pregnant, she should seek prenatal care as soon as possible.
Carmen Cordoba should utilize which of the following techniques when dealing with her students? (Select all that apply.) A. Treat the teen as a partner in care. B. Allow the teen to make all decisions about his or her health needs. C. Recognize that parental influence is primary. D. Recognize that peers are more important than parents, from the perspective of the adolescent. E. Make the teen feel respected.
Rationale: Health care providers will be more successful in assisting teens with their health care needs if the teens are treated with respect, and as joint partners in their decisions. Teens often reject the input of their parents and are more influenced by peers.
Carmen Cordoba is a school nurse working in a small private high school. She provides comprehensive care to the students and staff at the school. She coordinates the health education program of the school and consults with the administration to identify the educational and health promotion needs of the population.Ms. Cordoba works in a Catholic high school. She meets resistance about providing health education about some of the topics typically taught to the adolescent age group. Substance abuse prevention; HIV, AIDS, and sexually transmitted disease prevention; and pregnancy prevention are topics that are highly controversial at her school. However, Ms. Cordoba realizes that it is imperative that she reach the teens about these difficult topics.1. Which of the following is true about the health patterns of adolescents? A. Teens have fewer acute illnesses than younger children. B. Teens have more acute illnesses than younger children. C. Teens have more chronic illnesses than adults. D. Teens seek preventive health care.
Rationale: Teens have fewer acute illnesses than do younger children. They are seen in health care facilities less frequently than younger children and adults.
The highest rate of smoking during adolescence is seen in ___________. A. African American males B. White males C. White females D. Hispanic females
Rationale: The highest rate of smoking is among white females; chewing tobacco is more popular with white males.
The definition of puberty is: a. exhibiting secondary sex characteristics. b. having the ability to reproduce. c. the decrease of gonadotropic hormones. d. becoming fertile.
b. having the ability to reproduce.
Industry vs inferiority
School aged b/w 6 - 10 or 12 y/o. -Developing social, physical, and learning skills -competence: ability to learn and work -sense of inferiority; difficult learning and working
The nurse working with adolescents would base interactions on which of the following principles?
The belief of peers play a dominant role in adolescent behavior
To promote positive health habits for young adults, the nurse will:
Use cultural stereotypes to guide the written materials
In preparing to teach sex education to adolescents, which of the following would the nurse do first|?
Use personal story telling to establishing trust with the participants
Snellen chart
Visual acuity chart.
A nurse is instructing a group of clients about nutrition and eating foods high in iron. The nurse should include that which of the following aids in the absorption of iron?
Vitamin C
When does ovulation occur? a) 14 days before the menstrual period b) 7 days before menstrual period begins c) The day the menstrual period begins d) 7 days after the menstrual period ends
a) 14 days before the menstrual period
At what age do secondary sex characteristics first appear in males? a) Ages 10 to 13 c) Ages 16 to 18 b) Ages 12 to 15 d) Ages 18 to 21
a) Ages 10 to 13
Which of the following are age appropriate toys for middle childhood? (choose all that apply) a) Bicycle c) Roller skates b) Jump rope d) Large print boo
a) Bicycle c) Roller skates b) Jump rope
Which of the following are benefits of physical activity? (select all that apply) a) Decreased risk of heart disease b) Decreased cholesterol levels c) Decreased insulin sensitivity d) Increased muscle mass
a) Decreased risk of heart disease b) Decreased cholesterol levels d) Increased muscle mass
What is the most effective educational method for most school-age children? a) Hands-on learning c) Auditory learning b) Visual learning d) Self-learning
a) Hands-on learning
Children in the late adolescent period are in which of Erikson's stages of psychosocial development? a) Intimacy versus isolation b) Trust versus mistrust c) Autonomy versus shame and doubt d) Identity versus role confusion
a) Intimacy versus isolation
Which of the following theorists believed that an individual must be capable of the formal operational level of thought before achieving mature moral reasoning? a) Kohlberg c) Freud b) Erikson d) Maslow
a) Kohlberg
What can the nurse do to decrease the incidence of pelvic inflammatory disease? a) Promote health behaviors related to safe-sex practices b) Encourage hysterectomy in early adulthood c) Encourage use of oral contraceptives d) Promote use of spermicides
a) Promote health behaviors related to safe-sex practices
What hormone is partially responsible for the production of male secondary sex characteristics? a) Testosterone c) Progesterone b) Thyrosine d) Thyroxin
a) Testosterone
Which of the following would be categorized as a moderate physical activity? a) Water aerobics c) Walking at 4 mph b) Aerobics d) Competitive basketball
a) Water aerobics
Which social group form is typical during the teenage years? a. Cliques b. Same-sex peers c. Heterosexual peers d. Parallel groups
a. Cliques b. Same-sex peers
Which method of contraception, if used properly, can prevent the transmission of sexually transmitted diseases? a. Condoms b. Birth control pills c. Intrauterine devices d. Spermicides
a. Condoms
A major developmental task of middle childhood includes: a. developing positive self-esteem and a positive self-image. b. eruption of permanent teeth. c. ability to play video games. d. prevention of injury.
a. developing positive self-esteem and a positive self-image.
Effective teaching techniques for the young adult should include information that: a. is realistic and helps solve problems. b. is exciting and dramatic. c. relates to world problems. d. is already understood.
a. is realistic and helps solve problems.
The nurse notes that a 6 y/o does not recognize that object exist when the objects are outside of the visual field. Based on this observation, which action would the nurse take? a.) report the observation to the pediatrician b.) move objects in the child direct field of vision c.) teach child how to visually scan the enviornment d.) provide additional lighting for the child during play activities
a.) report the observations to the pediatrician according to Piaget, it is normal for the infant and toddler not to recognize objects out of the visual field. At 6 y/o, the child is not progressing normally through development stages. The nurse would report these findings to the doctor so both a medical and psychological follow-up can be initiated.
The nurse is explaining to staff that which charateristic is a description of Piagets formal operational stage? a.) the childs basic abilities to think abstractly and problem-solve are similar to an adult's b.) the child learns to think in a concrete fashion and expects other to view the world in the same way. c.) the child begins to understand the enviornment and conceptualize objects that are no longer visible d.) the child is able to classify, order, and sort facts and is able to see a variety of solutions to a problem
a.) the child's basic abilities to think abstractly and problem-solve are similar to an adult's b. think concrete fashion describes preoperational, and expects everyone to view the world in the same way = egocentric c. describes sensorimotor stage, object performance at around 9 mths and can conceptualize objects that are no longer visible d. identifies operational stage
The nurse would explain to a group that which characteristic relates to the Anal stage of Frueds psychosexual stage of development? a.) this stage is associated with toilet training b.) this stage is characterized by oral gratification c.) this stage is characterized by repression of sexuality d.) this stage is associated with identification with the same-sex parent
a.) this stage is associated with toilet training According to Freud, child gains pleasure from elimination of feces and from retention.
scabies
an infestation of the skin by the human itch mite (Sarcoptes scabiei var. hominis). The microscopic scabies mite burrows into the upper layer of the skin where it lives and lays its eggs. The most common symptoms of scabies are intense itching and a pimple-like skin rash.
IDEA- Individuals with Disabilities Education Act
any child with special needs aged 5 - 12 has the right to free appropriate public education in the least restrictive environment and evaluation by school or health professionals to identify learning needs.
How much physical activity is recommended for the school-aged child? a) 60 minutes per week c) 30 minutes per week b) 60 minutes per day d) 30 minutes per day
b) 60 minutes per day
A mother asks the school nurse what sport activity would be best for her son, who suffers from asthma. What sport would be most appropriate for the nurse to recommend? a) Tennis c) Football b) Baseball d) Soccer
b) Baseball
When do secondary sex characteristics often become apparent in females? a) Two years after menarche c) At 12 years of age b) Before menarche d) At puberty
b) Before menarche
What is the first step in effectively teaching health education to adolescents? a) Discussing options c) Confronting the adolescent b) Establishing trust d) Providing privacy
b) Establishing trust
What is the most common surgery performed on women during the reproductive years? a) Cholecystectomy c) Appendectomy b) Hysterectomy d) Tubal ligation
b) Hysterectomy
The process of integrating various points of view to develop knowledge and understanding is referred to as which of the following? a) Cognitive reasoning b) Postformal operational thought c) Structural thinking d) Transitional thought process
b) Postformal operational thought
In which stage of the partner choice process does the couple decide on a long-term commitment? a) The stimulus stage c) The value-comparison stage b) The role stage d) The marriage stage
b) The role stage
Hormones that regulate the menstrual cycle are released from where? a) The ovaries b) pituitary gland b) The thyroid gland d) The uterus
b) pituitary gland
A women's fertile period occurs: a. 14 days after the last menstruation. b. 14 days before the beginning of the next menstruation. c. midway between menstrual periods. d. right after menstruation ceases.
b. 14 days before the beginning of the next menstruation.
Middle childhood includes children between the ages of: a. 3 and 5 years. b. 6 and 12 years. c. 13 and 15 years. d. 16 and 19 years.
b. 6 and 12 years.
An ectopic pregnancy is a(n): a. unplanned pregnancy. b. pregnancy occurring outside the uterus. c. pregnancy occurring in early adulthood. d. pregnancy consisting of twins.
b. pregnancy occurring outside the uterus.
The major cause of death in the young-adult age group is: a. congenital malformation. b. preventable accidents. c. heart disease. d. sedentary lifestyles.
b. preventable accidents.
A developmental task of adolescence includes: a. concrete thinking. b. stabilizing identity. c. accepting competition. d. social interaction.
b. stabilizing identity.
The Wechsler intelligence test is used to determine: a. the overall intelligence of the child. b. verbal and nonverbal intelligence. c. presence of mental retardation. d. whether the child has college potential.
b. verbal and nonverbal intelligence.
What information describes Kohlberg Moral and Development theory? (Select all that apply) a.) Individuals move through all 6 stages in a sequential fashion b.) Moral development progresses in relationship to cognitive development c.) A persons ability to make moral judgements develops over a period of time d.) The theory provides a framework for understanding how individuals determine a moral code to guide their behavior e.) in stage 1, (punishment-obedience orientation), children are exposed to reason as mature members of society. f.) in stage 2, (instramental-relativist) the child conforms to rules to obtain rewards or have favors returned
b.) Moral development progresses in relationship to cognitive development c.) A persons ability to make moral judgements develops over a period of time d.) The theory provides a framework for understanding how individuals determine a moral code to guide their behavior f.) in stage 2, (instramental-relativist) the child conforms to rules to obtain rewards or have favors returned
Which car safety device should be used for a child who is 8 years old and is 4 feet tall? A. Seat belt B. Booster seat C. Rear-facing convertible seat D. Front-facing convertible seat
b.) booster seat - until 4ft 9in
1. An important component of a health history for young adults is a _________ health history.
behavorial
By what age can a child be expected to work on a task to completion? a) 3-years-old c) 9-years-old b) 6-years-old d) 15-years-old
c) 9-years-old
Which of the following is a major cause of death in young adulthood?a) Heart disease c) Accidents b) Cancer d) Diabetes
c) Accidents
At what time of the month should the adult female perform a self breast exam? a) On the first day of her period b) One week before the beginning of her period c) One week after the beginning of her period d) The day of the month does not matter
c) One week after the beginning of her period
Which of the following teaching techniques is most appropriate for the school-age child? a) Limit teaching sessions to a maximum 20 minutes b) Avoid group instruction c) Provide hands-on reinforcement d) Avoid verbal interactions
c) Provide hands-on reinforcement
During late adolescence, moral principles are based on which of the following? a) Parental beliefs c) The adolescent's own beliefs b) The beliefs of peers d) Societal norm
c) The adolescent's own beliefs
A teacher refers a child for the Wechsler Intelligence Scale test. Who should administer the test? a) The school nurse c) The licensed psychologist b) The principal d) Any of the above
c) The licensed psychologist
During which prenatal trimester would it be most appropriate for the nurse to provide detailed information regarding the breastfeeding and care of the newborn, based upon the growth and development of the parents? a) The first prenatal trimester c) The third prenatal trimester b) The second prenatal trimester d) The postpartum period
c) The third prenatal trimester
Young adulthood includes the ages between: a. 12 and 16 years. b. 17 and 19 years. c. 20 and 40 years. d. 41 and 60 years.
c. 20 and 40 years.
Middle childhood includes Erikson's stage of: a. trust. b. autonomy. c. industry. d. identity.
c. industry.
The young adult is in Erikson's stage of: a. industry. b. autonomy. c. intimacy. d. identity.
c. intimacy.
The parent of an 8 y/o child tells the clinic nurse of a concern that the child seems to be more attentive to friends than anything else. Using Erikson's psychosocial development theory, the nurse would plan to make which response? a.) "you need to be concerned" b.) "you need to monitor the child's behavior closely." c.) "At this age, children are developing their own personalities" d.) "you need to provide ore praise to the child to stop this behavior"
c.) "at this age, children are developing their own personalities." school-aged years 6 - 12 yr, the child begins to move toward peers and friends and away from the parents for support. The child also begins to develop special interests that reflect their own developing personality instead of the parents.
Dental caries
cavities
What is the most effective method of birth control? a) Oral contraceptives c) Intrauterine devices b) Condoms d) Abstinence
d) Abstinence
Which of the following relationships have an impact on the growth and development of the school-age child? a) The home c) The neighborhood b) The school d) All of the above
d) All of the above
Which of the following should be included in an education session for latchkey children? a) Keep a key within easy reach inside the door b) Learn several shortcuts to school c) Only admit a stranger into the house if they know your name d) Do not enter the house if the door is ajar
d) Do not enter the house if the door is ajar
Which of the following birth control methods also provides protection from sexually transmitted diseases? a) Intrauterine device c) Vasectomy b) Oral contraceptive d) Female condom
d) Female condom
Which of the following is not a developmental task of middle childhood? a) Changing from concrete thinking to abstract thinking b) Forming positive self-esteem from internal sources c) Developing secondary sex characteristics d) Relying on others more for assistance
d) Relying on others more for assistance
A 16 y/o is hospitalized for an acute appendicitis. Which intervention is most appropriate to facilitate normal growth and development postoperatively? a.) encourage client to rest and read b.) encourage parents to room in with the client c.) allow the family to bring in the clients favorite computer games d.) allow the client to interact with others in their same age group
d.) allow client to interact with other in their same age group separation from peers is a source of anxiety. Members of the peer group will support their ill friend
The clinic nurse is preparing to explain the concepts of Kohlberg theory of moral development with a parent. The nurse would plan to tell the parent that which factor motivates good and bad actions for the child at the preconventional level? a.) Peer pressure b.) social pressure c.) parents behavior d.) punishment and reward
d.) punishment and reward preconventional stages, morals are motivated by punishment and reward. If child is obidient is not punished, then the child is being moral. The child sees actions as good or bad. If childs actions not good, then the child is praised. If bad, then the child is punished.
Intimacy v. isolation
early adulthood 20 - 35 y/o -establishing intimate bonds of love and friendship -ability to love deeply and commit oneself -emotional isolation, egocentricity (unsuccessful)
Concrete operational stage
in Piaget's theory, the stage of cognitive development (from about 6 or 7 to 11 years of age) during which children gain the mental operations that enable them to think logically about concrete events. The individual can think about hypothetical and abstract concepts they have yet to experience. Abstract thought is important for planning regarding the future. The individual will approach problems in a systematic and organized manner, rather than through trial-and-error.
Otitis Media
infection of the middle ear
malocclusion
misaligned teeth that can lead to oral health complications like overbite, underbite, crossbite, and overcrowding.
Myopia
nearsightedness
Enuresis
o Involuntary urination = enuresis § Never achieved bladder control § Secondary enuresis - periods of dryness and wetness § Nocturnal enuresis (bedwetting at night) § Diurnal enuresis (day time wetting) § A variation of normal development
Menarche
onset of menses. Late in puberty as growth spert is subsiding
Dyslexia
tendency to reverse normal appearance of letters and numbers in writing
Encopresis
voluntary or involuntary passing stool in pants after age of 4 years old.
astigmatism
· blurred vision bc image of focused poorly on retina bc of changes in the surface of the cornea or lens
Adolescence anticipatory guidance
• Concrete phase of thinking• Formal operation stage• May try to manipulate rules, engage in risky behaviors, or deny their own mortality• Post-conventional stage of moral judgment • Major task of adolescence is achieving a stable self-identity• Role confusion• Family should offer support and guidance• Social skills and cognitive reasoning • May use violence because they have not been taught nonviolent techniques of managing conflicts• Episodes of fighting often precede homicides• Adolescents who are homeless, abused, or disadvantaged may not be able to cope with the other developmental tasks of adolescence Culture plays a role in how adolescents think and interactCultural competenceCulture affects health-care practices and modes of communicationCultural and religious traditions can help stabilize identity and involve rituals that celebrate the transition from childhood to the adult phase of life • Adolescents look forward to challenges and often feel humiliated when placed in the dependent role• Earn and learn to manage money• Important for the adolescent to be responsible for making decisions • Peer group affiliation has a major impact on adolescent growth and development• School provides the opportunity for social interaction, peer group association, and clique formation• Failure to connect in a clique or a peer group can contribute to lower self-esteem or to feelings of inadequacy • Developing a sexual identity is an important part of the adolescent's sense of self• Sexually active and exclusive relationships often develop during later adolescence• Sexual exploration creates risk for unplanned or unprotected sexual activity • The first step in effectively teaching adolescents involves establishing a trusting relationship• Communication must be supportive and not threatening to adolescents' sense of independence or autonomy
Adolescence G&D
• Early adolescence (10 to 13 years) • Middle adolescence (14 to 16 years) • Late adolescence (17 to 20 years) Weight Gain • Asynchronous• Active sweat glands• Stomach and intestines increase in size and volume• Increased appetite and food consumption• Weight and volume of the lungs increase• Improved eye-hand coordination and motor function • 60 minutes or more every day• At least three days per week should include vigorous exercise Boys• Hormonal changes between the ages of 10 and 13• Secondary sex characteristics• Spermatogenesis• Ejaculation• Nocturnal emissions Girls• Hormone secretions begin to establish a pattern within a monthly cycle• Ovulation• Menarche• Menstrual cycle• Secondary sex characteristics 400,000 teen pregnancies. • Sex education is important before adolescence
School-aged G&D
•Kindergarten and the beginning of adolescence, 6 to 10 years of age •Most body systems reach adult level of function •Thoracic muscles develop, RR decrease from 14-24 breaths per minute •Heart grows- HR 60-160 beats per minute •Head and brain reach adult circumference •GI, bladder, immune system, and endocrine system function at adult capacity •Accidents- leading cause of death in children under 1 year of age in the U.S. •Obesity •HTN- hypertension- among which ethnic groups? •Depression •Child abuse •the school-age level is a critical time when behaviors can be influenced before unhealthful patterns have become the standard. Healthy behaviors are taught and modeled by the nurse as well as the teachers in the school.
key points - young adult
•Young adulthood is most often defined as being from 18-35 years of age. •Physiological performance has a natural peak between 20 and 30 years of age. •Proper nutrition and exercise can prevent obesity and can contribute to health during the young-adult years and beyond. •Promoting healthy behaviors relating to safe-sex practices during adolescence and young adulthood can reduce the incidence of sexually transmitted diseases. •Piaget's formal operational thinking begins in adolescence and extends into young adulthood. •Formal operational thinking is necessary for the establishment of effective problem-solving skills. •Postformal operational thought involves integrating various points of view. •In most cultures there are established expectations of adulthood. •The task of generativity can be achieved by a means other than parenting. •When teaching young adults, the goals and how the new knowledge can be applied in the lives of the learners should be made clear.