Peds Adolescent
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?
Chicken, whole-wheat bread, watermelon
During an office visit for a sports injury, 16-year-old Derek's caregivers tell the nurse they are worried about changes in Derek's behavior. He has always been industrious in his schoolwork and very focused on sports. Now he has a girlfriend and seems to spend almost all of his time with her or on the phone with her and little or no time on his schoolwork. What information might the nurse offer these caregivers about Derek's behavior?
Derek has developed his own identity by now; being able to establish close relationships with girls is important preparation for all of his adult relationships. They should honor his need to be with or talk to his girlfriend as long as he has completed his schoolwork for the day.
A 17-year-old boy chats excitedly with the nurse about his plans for college and a career. He says he has checked out every college in the region and determined which one is the best fit for him and which one offers the best career options for him. The nurse recognizes which developmental aspect in this young man?
Formal operational thought
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.
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
According to Erikson, the adolescent develops their own sense of being independent people with their own thoughts and goals. This stage is referred to as which of the following?
Identity vs. role confusion
A nurse is addressing a group of school teachers on the importance of sex education for children. What should the nurse emphasis as the highest primary source of sex education information for adolescents?
Parents
According to Erikson's theory at each stage of development, a significant person or group exerts a lasting influence on the ongoing development of the child. Who exerts the most lasting influence on the ongoing development of the adolescent?
Peer group
The period in which physical changes relating to sexual maturation take place is called:
Puberty
The time period known as adolescence usually begins with which of the following occurrences.
The beginning of puberty.
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
Adolescents must be given
privacy, individualized attention, confidentiality, and the right to participate in decisions about their health care.
The nurse in a school-based clinic is discussing sex and sexuality issues with a group of sexually active adolescents. From a public health standpoint, which of the following statements made by the nurse would be most appropriate to make to this group?
"Adolescents need to know how to use condoms correctly to avoid sexually transmitted diseases."
An adolescent is concerned that he is going to be unusually short. You would advise him that the epiphyseal lines of long bones in boys that govern growth usually close between ages
17 and 18 years.
In discussing the psychosocial development of the adolescent, it is important to understand that in order for adolescents to be in intimate relationships in which feelings are mutually shared, both persons must have which of the following?
A sense of trust and of identity
A 16-year-old girl with acne has been prescribed tretinoin , Retin-A cream. Which of the following instructions should the nurse give this girl related to prevention of a common side effect of this medication?
Avoid prolonged sun exposure
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
A nurse is attending to a group of boys at a school. The nurse is required to document for the sexual development in boys on a regular basis. The nurse would anticipate which clients of having the highest incidence of experiencing nocturnal emissions?
Clients who are showing pubertal changes
Which intervention would probably be most effective in preventing an adolescent from attempting suicide with an overdose again?
Helping him learn better problem solving
A 13-year-old girl has recently begun menstruating. She is active in sports at school. Increased intake of which of the following nutrients should the nurse recommend to the girl to prevent anemia associated with menstruation?
Iron
The nurse is admitting a 15-year-old to the pediatric unit. Which of the following does the nurse recognize as a priority for this child?
The child's need for privacy should be respected.
Hazing is a form of organized bullying.
True. Hazing, a form of organized bullying, refers to demeaning or humiliating rituals prospective members have to undergo to join sororities, fraternities, adolescent gangs or sports teams
A 15-year-old is seen at a health care facility for facial acne. When counseling him, you would teach him that the basic cause of his acne is
activation of androgen hormones.
The final stage of cognitive development, the stage of formal operational thought, begins at
age 12 or 13 years and grows in depth over the adolescent years although may not be complete until about 25. This step involves the ability to think in abstract terms and use the scientific method -deductive reasoning- to arrive at conclusions.
The developmental task of the adolescent period, according to Erikson, is to form a sense of
identity versus role confusion.
Nurses work to prevent tobacco use by teens because: (Select all that apply.)
• 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).
An adolescent shares with you that she wishes her breasts would grow larger. Which of the following would be the best response initially?
"Breast growth usually stops by the age of 16 years. What is the reason you were hoping yours would grow more?"
When discussing the growth and development of an adolescent, the nurse refers to various theories and phases of development. A nurse is discussing Erikson's theory of psychological development with an adolescent client. Based on Erikson's theory of psychosocial development, which should the nurse identify as the major priority challenge faced by adolescents?
Achieving their own identity
What anticipatory guidance can the nurse provide the girl who has noted the development of breast buds?
Menarche should follow in about 2 years.
Jamie, an 18-year-old, comes to the clinic. In the health history she reveals that she has a nipple ring and is looking to get a tattoo in the next few months. What is the most important thing that the nurse can teach her at this time?
Tattooing carries risks such as infection, disease, and nerve damage.
The mother of a 15-year-old boy expresses sadness to the nurse that her son is "much more connected to his friends than his family." What understanding would benefit this parent? (Select all that apply.)
• Peers are needed for emotional security while stepping away from family. • Peers provide opportunity to learn and practice social roles. • Peers can be positive or negative influences. • Adolescents need parental support and guidance as they move toward greater peer involvement.
The nurse is caring for an 11-year-old girl. The girl's mother complains that the girl does not want to play team sports like soccer or volleyball anymore. Her daughter insists she does not enjoy them. The mother is concerned that her daughter will not get enough physical activity and asks the nurse for guidance. How should the nurse respond?
"Give her some options; it's important to find something she enjoys."
A 14-year-old boy is far quieter than usual when he visits his physician's office. The nurse asks him if anything is wrong, and the boy replies that he did not make the cut for the football team. Which of the following would be most appropriate for the nurse to say?
"I'm really sorry; I know that must be a big disappointment."
An adolescent asks you what the term "puberty" means. What is your best response?
"It is the age at which one first becomes capable of sexual reproduction."
The mother of a 13-year-old boy confides to the pediatric nurse practitioner that her son has recently had a nocturnal seminal emission. The mother is concerned and the nurse reviews "wet dreams" and the other male traits of puberty to the mother. Which of the following responses indicates a need for further discussion?
"My son must be sexually active or having overly sexual thoughts to have a nocturnal emission."
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."
Evan, a 14-year-old, and his mother are in the office for an annual visit and his mother jokes openly in front of you about the changes in Evan's voice and the hair under his armpits. What is an appropriate response from the nurse when she is talking with the mother?
"Remember that he can become modest and self-conscious and teasing may cause embarrassment."
Jenny is a 15-year-old who is being seen today in the clinic and her mom comments on the fact that Jenny seems to always choose the opposite of what everyone else wants and that her mood swings are a common occurrence. What statement below shows the nurse that Jenny's mom understands these changes?
"This is common for this age group and it will get better with time."
For reasons of anticipatory guidance, nurses should be aware that menarche appears earlier in some ethnic groups than others. In which ethnic group is menarche likely to appear first?
African-American. Menarche begins, on average, at 12.06 years in African-American girls, 12.25 years in Mexican-American girls, and 12.55 years in Caucasians.
A nurse is explaining cognitive development in children to a client, with the help of Piaget's theory of cognitive development. What would be the best explanation by the nurse about the formal operations level of cognitive development?
After age 12 children can think in the abstract including complex problem solving.
A nurse is taking care of a teenager who complains about involuntary discharge of semen while sleeping. The nurse observes that the client is confused and does not know about the pubertal changes that are taking place in his body. Based on this information, what is the highest priority area that should be reviewed with the client?
Educate the client about the changes that occur during adolescence
A 17-year-old writes a suicide note and then swallows aspirin. Which of the following factors would make you think that he might do this again?
His parents were recently divorced. Suicide may be triggered by the result of a loss, such as a girlfriend, a parent, or self-esteem. Some degree of depression is considered common among adolescents.
The nurse is talking with parents of a depressed 16-year-old boy. Which question is of most importance?
Is there a gun in your home?
Based on the most frequent cause of death in adolescents, what preventive measure would you most want to teach an adolescent?
Motor-vehicle safety
A client tells the nurse that she has noticed an increase in weight and fat deposits during the last year. The nurse reviews the client's chart and recognizes that the client is most likely going through puberty. Which nursing action is most appropriate at this time?
Provide reassurance that these are normal changes.
Sixteen-year-old Bettina has been hospitalized 100 miles from home for a week. She is recovering from surgery to repair a broken kneecap, an injury incurred while skateboarding. She was cheerful and chatty when she first arrived, but the nurse notes in recent days she has become increasingly quiet and seems lonely. Which of the following nursing interventions would be most appropriate for Bettina? The nurse should
Show Bettina where the teen lounge in the hospital is so she can meet other teens, use a phone, and check her e-mail.
Computer use at home and at school has increased adolescents' comfort in gaining access to and using the Internet. This has expanded their exposure to risks. What potential risks are there for an adolescent to be exposed to?
Teens can be exposed to inappropriate materials, harassment, threats, and potential for molestation.
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
Long-term side effects of marijuana can include
pulmonary disorders such as sinusitis, bronchitis, emphysema, and perhaps lung cancer , which can develop after only 1 year of continual use compared with 20 years of cigarette use, as well as lack of sperm formation or subfertility in males.
A 16-year-old who drives a car he bought with money earned from working after school is seen in an emergency room after being arrested for driving while intoxicated. The teaching method that probably will be most effective in getting him to discontinue alcohol use is to
stress that he will lose his driving license if he does not stop.
The activity that would best foster the developmental task of an adolescent who is physically challenged would be
talking to another adolescent who has a similar disorder.
During the annual physical examination, a teenage client tells the nurse that she is anxious as well as frustrated because of the acne on her face. Which is the best response for the nurse?
"This is one of the most common physical changes during adolescence."
Peak height velocity (PVH) in girls occurs
6 to 12 months following menarche. It does not follow immediately. Breast development progresses through several stages and will not be complete until late puberty. Adult height is not reached at the time of menarche but about 6 to 12 months following menarche.
