Pediatrics Chapter 7

A male nurse has been invited to speak with a group of boys who are 12 years old. The boys have been asked to write questions for the nurse to respond to. One of the questions states, "My older brother told me my bed might be wet and that means I had a wet dream, is that true?" The best response by the nurse would be

" Having wet dreams indicates that your body is going through a process of maturing."

A 16-year-old girl has arrived for her sports physical with a new piercing in her navel. Which response by the nurse is best?

"Be sure to clean the navel several times a day."

The nurse is promoting safe sex to a 14-yearold boy who is frequently dating. Which of the following points is most likely to be made during the talk?

"Contraception is a shared responsibility."

The nurse is counseling an overweight, sedentary 15-year-old girl. The nurse is assisting her to make appropriate menu choices. Which statement indicates the adolescent understands how to make appropriate dietary selections?

"I need to have 4 servings of fruit each day."

Billy's mother is with him at a visit for a sore throat. In the interview she states that she does not know what to do with him: He is taking two or three showers a day, when not that long ago she could barely get him to take a bath at all. What should the nurse's reply be to the mother?

"Reinforce the family rules but also allow him to develop his own routine."

The nurse is discussing psychosocial development of the adolescent with a group of family caregivers. Which of the following statements made by the caregiver is an example of the most effective way the caregiver can support the adolescent?

"The hairstyles she chooses are not what I think looks good on her, but I just let her do what she wants to with her hair."

A 13-year-old girl has grown rapidly in height over the past 2 years and is still taller than most of the boys in her class. She wonders when she will stop growing. Which of the following should the nurse tell her as a general guideline for the ages at which most girls stop growing?

16 to 17 years old

The nurse is meeting with a 16-year-old girl who reports being physically active on the track and basketball teams at school. The child reports a weight loss of 7 lb (3.2 kg) since she began training for the track season. When reviewing her caloric needs the nurse recognizes the diet should include how many calories?

2,200 calories per day

The school nurse is assessing a 16-year-old girl who was removed from class because of disruptive behavior. She arrives in the nurse's office with dilated pupils and is talking rapidly. Which drug might she be using?

Amphetamines

A client has confided in a nurse that her 13-year-old daughter has recently changed dramatically in her social interactions with others. Which of the following is a social behavior most likely to be exhibited by a girl at this age?

Banding together with other girls and dressing like them

The nurse is performing an assessment on a 12-year-old boy. Which finding is consistent with the child's age?

Curling pubic hair

The nurse is working with a teenage patient. He has relatively straight teeth, but his lower front teeth are slightly crossed over. The nurse suggests to the child's caregiver that an orthodontist see him. What is the reason the nurse might make this suggestion?

Even slight malocclusions make chewing and jaw function less efficient.

The nurse is performing a health surveillance visit with a 12-year-old boy. Which characteristic suggests the boy has entered adolescence?

Experiences frequent mood changes

Jordan is coming back to the office for a follow-up visit. He is 15 years old and he shows a pattern of gaining weight, not a large amount but a little more each visit. Jordan says that he is not active in any sports but that he and his father eat out a lot. What is the best way for the nurse to assess Jordan's eating pattern?

Have Jordan keep a food diary for one week.

Which intervention would probably be most effective in preventing an adolescent from attempting suicide with an overdose again?

Helping him learn better problem solving

What exercise recommendation should nurses give to adolescents?

Participate in 60 minutes of moderate to vigorous physical activity each day.

Linda and her mother are in the office. As Linda uses the restroom, her mother asks you about the changes that Linda is going through. She would like to talk to her about sexuality and its changes but she is unsure of how to do this. As the nurse, what reminders should you give her when she discusses sex?

Promote open lines of communication; listen instead of lecture; and share family values.

The father of a 15-year-old basketball player is following a very low carbohydrate diet. He realizes his daughter should not follow the same eating plan. Which of the following would be most advisable for this father to serve his daughter so that she can perform at her optimum level in a Friday basketball game that starts at 6 p.m.?

Three daily meals that include choices from each of the food groups; Friday's lunch should be eaten around 2 p.m. and include a small amount of fat and a somewhat larger than usual portion of complex carbohydrates

Which behavior by an 18-year-old is consistent with successful progression through the stages of Piaget's theory of development?

Uses critical thought processes to handle a problem

With summer approaching, the nurse discusses sun safety with a group of teen girls. Which suggestion is most likely to be followed?

Wear sunglasses.

The nurse is promoting nutrition to a teen who is going through a growth spurt. Which food should the nurse recommended for its high iron content?

Whole grain bread

The nurse knows that the 13-year-old girl in the exam room is in the process of developing her own set of values. Which activity will this child be experiencing according to Kohlberg's theory?

Wondering what is the meaning of life

The mother of a 15-year-old boy confides in the nurse that she is concerned because her son is about to turn 16 and is pressuring her and her husband to buy him a motorcycle. Her husband is okay with the idea, but she is concerned about his safety. Which of the following should the nurse mention to the mother regarding motorcycle safety?

• Require the son to wear a helmet • Require the son to wear long pants • Require the son to wear full body covering • Require the son to learn all relevant safety rules

The nurse is performing a physical assessment on an 11-year-old girl during a health surveillance visit. Which of the following findings would suggest the child has reached adolescence?

The child has higher blood pressure

While taking care of a teenager in the late adolescence stage, what behavior of the client will the nurse most likely observe during data collection for annual physical examination?

True attitude of maturity

Nurses work to prevent tobacco use by teens because:

• Smoking damages the respiratory system. • Smokeless tobacco damages gums and teeth. • Teens who smoke are more likely to use alcohol and drugs. • Smoking is associated with fighting and unprotected sex. • Tobacco use is addicting (nicotine).

By being honest and nonjudgmental with 15-year-old Tony, the nurse has built a relationship in which Tony feels he can talk about things that worry him. He has shared with the nurse that his parents believe he is too young to know about or think about sex. Tony tells the nurse that he has been having wet dreams and is ashamed and afraid he will get into trouble. Which of the following statements would be appropriate for the nurse to respond?

"Wet dreams are not the result of anything you are doing but are simply the body's way of ridding itself of excess semen."

A 17-year-old girl needs to increase her iron intake but is concerned about weight gain. The nurse will suggest which of the following?

Egg white omelet, broccoli, pear

A 13-year-old girl is struggling to accept the new changes that are occurring in her body as a result of puberty. After talking with this client, the nurse recalls that Erikson's primary developmental task of early and mid-adolescence is which of the following?

Identity versus role confusion

The school nurse is developing a school wellness program to promote healthy eating habits and regular physical activity. Each class will be engaging in lessons, contests, and goal setting to develop healthy habits. Which of the following is the most important element to maximize compliance and long-term change?

Include both parents and children in the wellness program.