OB Chapter 35; The Adolescent and Family

Research has shown that the most successful smoking cessation programs among teens include (select all that apply): a. Peer-led education and support. b. Information on the long-term effects of smoking. c. Programs including the media. d. School-based programs. e. Information on the immediate effects of smoking.

A, C, D, E

Injuries claim many lives during adolescence. Which factors contribute to early adolescents engaging in risk-taking behaviors (select all that apply)? a. Peer pressure b. A desire to master their environment c. Engagement in the process of separation from their parents d. A belief that they are invulnerable e. Impulsivity

A, D, E

Which screening tests should the school nurse perform for the adolescent (select all that apply)? a. Glucose b. Vision c. Hearing d. Cholesterol e. Scoliosis

B, C, E

An adolescent girl tells the nurse that she has suicidal thoughts. The nurse asks her if she has a specific plan. Asking this should be considered: a. An appropriate part of the assessment. b. Not a critical part of the assessment. c. Suggesting that the adolescent needs a plan. d. Encouraging the adolescent to devise a plan.

a; An appropriate part of the assessment

Which aspect of cognition develops during adolescence? a. Capability to use a future time perspective b. Ability to place things in a sensible and logical order c. Ability to see things from the point of view of another d. Progress from making judgements based on what they see to making judgements based on what they reason

a; Capability to use a future time perspective

Which is the most commonly used method in completed suicides? a. Firearms b. Drug overdose c. Self-inflected laceration d. Carbon monoxide poisoning

a; Firearms

According to Piaget, the adolescent is in the fourth stage of cognitive development, or period of: a. Formal operations b. Concrete operations c. Conventional thought d. Postconventional thought

a; Formal operations

A young adolescent boy tells the nurse he feels gawky. The nurse should explain that this occurs in adolescents because: a. Growth of the extremities and neck precedes growth in other areas. b. Growth is in the trunk and chest. c. The hip and chest breadth increases. d. The growth spurt occurs earlier in boys than it does in girls.

a; Growth of the extremities and neck precedes growth in other areas.

Which statement is correct about childhood obesity? a. Heredity is an important factor in the development of obesity. b. Childhood obesity in the United States is decreasing. c. Childhood obesity is the result of inactivity. d. Childhood obesity can be attributed to an underlying disease in most cases.

a; Heredity is an important factor in the development of obesity.

The nurse is caring for an adolescent brought to the hospital with acute drug toxicity. Cocaine is believed to be the drug involved. Data collection should include the: a. Mode of administration b. Actual content c. Function the drug plays in the adolescents life d. Adolescents level of interest in rehabilitation

a; Mode of administration

Which statement is true about smoking in adolescence? a. Smoking is related to other high-risk behaviors. b. Smoking is more common among athletes. c. Smoking is less common when the adolescents parent(s) smokes. d. Smoking among adolescents is becoming more prevalent.

a; Smoking is related to other high-risk behaviors.

A nurse is teaching adolescent boys about pubertal changes. The first sign of pubertal change seen with boys is: a. Testicular enlargement b. Facial hair c. Scrotal enlargement d. Voice deepens

a; Testicular enlargement

Matt, age 14 years, seems to be always eating, although his weight is appropriate for his height. The best explanation for this is: a. This is normal because of increase in body mass. b. This is abnormal and suggestive of future obesity. c. His caloric intake would have to be excessive. d. He is substituting food for unfilled needs.

a; This is normal because of increase in body mass.

A 14-year-old boy and his parents are concerned about bilateral breast enlargement. The nurses discussion of this should be based on knowing that: a. This is usually benign and temporary. b. This is usually caused by Klinefelters syndrome. c. Administration of estrogen effectively reduces gynecomastia. d. Administration of testosterone effectively reduces gynecomastia.

a; This is usually benign and temporary.

The mean age of menarche in the United States is: a. 11.5 years b. 12.5 years c. 13.5 years d. 14 years

b; 12.5 years

A school nurse is conducting a class with adolescents on suicide. Which true statement about suicide should the nurse include in the teaching session? a. A sense of hopelessness and despair are a normal part of adolescence. b. Gay and lesbian adolescents are at a particularly high risk for suicide. c. Problem-solving skills are of limited value to the suicidal adolescent. d. Previous suicide attempts are not an indication of risk for completed suicides.

b; Gay and lesbian adolescents are at a particularly high risk for suicide.

According to Erikson, the psychosocial task of adolescence is developing: a. Intimacy b. Identity c. Initiative d. Independence

b; Identity

A 17-year-old tells the nurse that he is not having sex because it would make his parents very angry. This response indicates that the adolescent has a developmental lag in which area? a. Cognitive development b. Moral development c. Psychosocial development d. Psychosexual development

b; Moral development

The psychologic effects of being obese during adolescence include: a. Sexual promiscuity. b. Poor body image. c. Memory having no effect on eating behavior. d. Accurate body image but self-deprecating attitude.

b; Poor body image

The nurse is completing a health history with a 16-year-old male. He informs the nurse that he has started using smokeless tobacco after he plays baseball. Which information regarding smokeless tobacco would be most correct for the nurse to provide to this teen? a. Not addicting. b. Proven to be carcinogenic. c. Easy to stop using. d. A safe alternative to cigarette smoking.

b; Proven to be carcinogenic

Which predisposes the adolescent to feel an increased need for sleep? a. An inadequate diet b. Rapid physical growth c. Decreased activity that contributes to a feeling of fatigue d. The lack of ambition typical of this age group

b; Rapid physical growth

Which behavior suggests appropriate psychosocial development in the adolescent? a. The adolescent seeks validation for socially acceptable behavior from older adults. b. The adolescent is self-absorbed and self-centered and has sudden mood swings. c. Adolescents move from peers and enjoy spending time with family members. d. Conformity with the peer group increases in late adolescence.

b; The adolescent is self-absorbed and self-centered and has sudden mood swings.

Which statement is most descriptive of central nervous system stimulants? a. They produce strong physical dependence. b. They can result in strong psychologic dependence. c. Withdrawal symptoms are life threatening. d. Acute intoxication can lead to coma.

b; They can result in strong psychologic dependence.

Which statement is the most appropriate advice to give parents of a 16-year-old girl who is rebellious? a. You need to be stricter so that your teen stops trying to test the limits. b. You need to collaborate with your daughter and set limits that are perceived as being reasonable. c. Increasing your teens involvement with her peers will improve her self-esteem. d. Allow your teenager to choose the type of discipline that is used in your home.

b; You need to collaborate with your daughter and set limits that are perceived as being reasonable.

A teen asks a nurse, What is physical dependence in substance abuse? Which is the correct response by the nurse? a. Problem that occurs in conjunction with addiction b. Involuntary physiologic response to drug c. Culturally defined use of drugs for purposes other than accepted medical purposes d. Voluntary behavior based on psychosocial needs

b; b; Involuntary physiologic response to drug

A nurse is reviewing hormone changes that occur during adolescence. The hormone that is responsible for the growth of beard, mustache, and body hair in the male is: a. Estrogen b. Pituitary hormone c. Androgen d. Progesterone

c; Androgen

Young people with anorexia nervosa are often described as being: a. Independent b. Disruptive c. Conforming d. Low achieving

c; Conforming

The parents of a 15-year-old girl are concerned that their adolescent spends too much time looking in the mirror. Which statement is the most appropriate for the nurse to make? a. Your teenager needs clearer and stricter limits about her behavior. b. Your teenager needs more responsibility at home. c. During adolescence this behavior is not unusual. d. The behavior is abnormal and needs further investigation.

c; During adolescence this behavior is not unusual.

The school nurse tells adolescents in the clinic that confidentiality and privacy will be maintained unless a life-threatening situation arises. This practice is: a. Not appropriate in a school setting. b. Never appropriate because adolescents are minors. c. Important in establishing trusting relationships. d. Suggestive that the nurse is meeting his or her own needs.

c; Important in establishing trusting relationships.

A nurse is caring for an adolescent hospitalized for cellulitis. The nurse notes that the adolescent experiences many mood swings throughout the day. The nurse interprets this behavior as: a. Requiring a referral to a mental health counselor. b. Requiring some further lab testing. c. Normal behavior. d. Related to feelings of depression.

c; Normal behavior.

The nurse is explaining Tanner staging to an adolescent and her mother. Which statement best describes Tanner staging? a. Predictable stages of puberty that are based on chronologic age b. Staging of puberty based on the initiation of menarche and nocturnal emissions c. Predictable stages of puberty that are based on primary and secondary sexual characteristics d. Staging of puberty based on the initiation of primary sexual characteristics

c; Predictable stages of puberty that are based on primary and secondary sexual characteristics

The school nurse is discussing testicular self-examination with adolescent boys. Why is this important? a. Epididymitis is common during adolescence. b. Asymptomatic sexually transmitted diseases may be present. c. Testicular tumors during adolescence are generally malignant. d. Testicular tumors, although usually benign, are common during adolescence.

c; Testicular tumors during adolescence are generally malignant.

The parents of a 14-year-old girl express concerns about the number of hours their daughter spends with her friends. The nurse explains that peer relationships become more important during adolescence because: a. Adolescents dislike their parents. b. Adolescents no longer need parental control. c. They provide adolescents with a feeling of belonging. d. They promote a sense of individuality in adolescents.

c; They provide adolescents with a feeling of belonging.

Which statement by the nurse is most appropriate to a 15-year-old whose friend has mentioned suicide? a. Tell your friend to come to the clinic immediately. b. You need to gather details about your friends suicide plan. c. Your friends threat needs to be taken seriously and immediate help for your friend is important. d. If your friend mentions suicide a second time, you will want to get your friend some help.

c; Your friends threat needs to be taken seriously and immediate help for your friend is important.

By what age should concerns about pubertal delay be considered in boys? a. 12 to 12.5 years b. 12.5 to 13 years c. 13 to 13.5 years d. 13.5 to 14 years

d; 13.5 to 14 years

Steve, 14 years old, mentions that he now has to use deodorant but never had to before. The nurses response should be based on knowledge that: a. Eccrine sweat glands in the axillae become fully functional during puberty. b. Sebaceous glands become extremely active during puberty. c. New deposits of fatty tissue insulate the body and cause increased sweat production. d. Apocrine sweat glands reach secretory capacity during puberty.

d; Apocrine sweat glands reach secretory capacity during puberty.

In girls, the initial indication of puberty is: a. Mearche b. Growth spurt c. Growth of pubic hair d. Breast development

d; Breast development

An adolescent teen has bulimia. Which assessment finding should the nurse expect? a. Diarrhea b. Amenorrhea c. Cold intolerance d. Erosion of tooth enamel

d; Erosion of tooth enamel

When planning care for adolescents, the nurse should: a. Teach parents first, and they, in turn, will teach the teenager. b. Provide information for their long-term health needs because teenagers respond best to long-range planning. c. Maintain the parents role by providing explanations for treatment and procedures to the parents only. d. Give information privately to adolescents about how they can manage the specific problems that they identify.

d; Give information privately to adolescents about how they can manage the specific problems that they identify.

Which symptoms should the nurse expect to observe during the physical assessment of an adolescent girl with severe weight loss and disrupted metabolism associated with anorexia nervosa? a. Dysmenorrhea and oliguria b. Tachycardia and tachypnea c. Heat intolerance and increased blood pressure d. Lowered body temperature and brittle nails

d; Lowered body temperature and brittle nails

The most common cause of death in the adolescent age-group involves: a. Drownings b. Firearms c. Drug overdoses d. Motor vehicles

d; Motor vehicles

Anorexia nervosa may best be described as: a. Occurring most frequently in adolescent males. b. Occurring most frequently in adolescents from lower socioeconomic groups. c. Resulting from a posterior pituitary disorder. d. Resulting in severe weight loss in the absence of obvious physical causes.

d; Resulting in severe weight loss in the absence of obvious physical causes.

An adolescent boy tells the nurse that he has recently had homosexual feelings. The nurses response should be based on knowledge that: a. This indicates that the adolescent is homosexual. b. This indicates that the adolescent will become homosexual as an adult. c. The adolescent should be referred for psychotherapy. d. The adolescent should be encouraged to share his feelings and experiences.

d; The adolescent should be encouraged to share his feelings and experiences.

The weight loss of anorexia nervosa is often triggered by: a. Sexual abuse b. School failure c. Independence from family d. Traumatic interpersonal conflict

d; Traumatic interpersonal conflict

Which statement is most descriptive of bulimia during adolescence? a. Strong sense of control over eating behavior b. Feelings of elation after the binge-purge cycle c. Profound lack of awareness that the eating pattern is abnormal d. Weight that can be normal, slightly above normal, or below normal

d; Weight that can be normal, slightly above normal, or below normal