PEDS: Chapter 29 - Adolescent

The school nurse is conducting a health class with a group of high school students on the topic of sex and sexuality issues. The nurse determines the session is successful when the students correctly choose which aspect as most important?

"Adolescents need to know how to use condoms correctly to avoid sexually transmitted infections."

The nurse is measuring the height of a 13-year-old girl who was 56 in (142.24 cm) tall at age 9. The nurse predicts the girl will be approximately how tall if following the normal pattern of growth?

68 in (172.72 cm)

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

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 would give him the best career options. The nurse recognizes which developmental aspect in this young man?

Formal operational thought

The parents of a 16-year-old male are worried about recent changes in his behavior, ignoring his schoolwork and sports, and spending almost all of his free time interacting with his girlfriend. Which suggestion should the nurse point out would best address this situation?

He 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 client tells the nurse that she has noticed an increase in her 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

The nurse is teaching a nutritional class to a group of Asian adolescents who are lactose-intolerant. Which food should the nurse point out will help these adolescents consume the calcium they need for proper nutrition?

Soybean curd

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 caring for a 13-year-old girl. The child has been identified as overweight with no underlying psychological or secondary causes. The nurse is reviewing the child's weight-loss progress and nutrition at a follow-up visit. What finding indicates a need for further discussion and teaching?

"Her goal is to be a size smaller by our vacation in two weeks."

The school nurse is meeting with a group of 11-year-old girls to discuss expected puberty changes in their bodies. When one of the girls states, "I just feel like my whole body is changing and I don't know why" what should the nurse point out to this group?

"You have lots of hormone changes going on right now."

The nurse is assessing a 16-year-old girl at an annual well-clinic visit and notes the girl started menses at 13 years of age and grew 1 inch (2.5 cm) over the past year. When questioned by the young lady if this is normal, which answer should the nurse prioritize?

"You're following expected patterns of growth."

A 16-year-old adolescent is talking with the nurse at a local health clinic about skin care. Which comments by the teen does the nurse determine require additional conversation? Select all that apply.

- "I only tan before going on spring break to get a base tan so I won't burn." - "My favorite time of day to be outside is the middle of the day, around noon." - "The more exposure and burns I get now will toughen my skin so I won't get skin cancer when I'm older."

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

What anticipatory guidance can the nurse provide the girl who has noted the development of breast buds?

Menarche should follow in about 2 years.

An 18-year-old 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 nurse is preparing to participate in a community discussion on the needs of the adolescents in the local school. The nurse should point out which goal is the primary concern for these young individuals as the committee makes plans?

Teens are busy developing their own personal identity.

The school nurse is preparing for a career fair at the local high school. Which factor should the nurse point out when presenting various medical career options to the students?

The individual's sex no longer decides which career options are available

The nurse instructs an adolescent on the hazards of body piercings and tattoos. Which outcome indicates that teaching has been effective?

The patient refuses to get eyebrow pierced with girlfriends.

The mother of an adolescent has called to talk to the pediatric nurse over concern that her daughter is not getting proper nutrition now that she has started following a vegetarian diet. Which response should the nurse prioritize for this mother?

Vegetarian diets can be healthy; ensure she includes whole-grain products, legumes, nuts, seeds, and soy dairy substitutes

During a physical assessment, a 15-year-old male expresses concern about being short in height. Which should the nurse respond to this patient's concern?

The epiphyseal lines of long bones close at about 18 to 20 years of age in males.

According to Erikson, the adolescent develops his or her own sense of being an independent person with individual thoughts and goals. This stage is referred to as:

identity vs. role confusion

An adolescent is concerned that although he has pubic hair, he has no facial hair yet. He wishes facial hair would grow to cover acne lesions. You would advise him that facial hair

usually follows pubic hair growth.

A male nurse is meeting with a group of high school boys to discuss various health topics. After the session on testicular self-exam, the nurse determines the session is successful when one of the students responds with which comment?

"I am almost 15 now, so that means I could possibly get this disease."

The mother of an African-American adolescent voices concern to the nurse because her daughter, "has gotten her period before all of her friends." How should the nurse respond?

"That must be difficult, but on average African-American girls start their period earlier than other ethnicities."

A 16-year-old female adolescent reports to the nurse that she is trying to improve her diet to lose weight. When assessing her dietary intake for adequacy, which findings indicate the need for further education? Select all that apply.

- 1,000 mg calcium intake per day - Average caloric intake is 2,500 per day - Consumes 8 to 10 mg of iron each day

A nurse is admitting a 16-year-old male to the floor for an appendectomy. How can the nurse prepare this client for hospitalization? Select all that apply.

- Encourage him to keep his cell phone nearby to communicate with his friends. - Interview the adolescent separately from the parent to allow expression of information that he may not be comfortable sharing in front of the parent. - Provide privacy when client is changing into the hospital gown or going to the bathroom.

The school nurse is preparing health promotion presentations regarding unintentional injuries for a high school health fair. On which topic should the nurse place as the priority when preparing the presentation?

Motor vehicle safety

The nurse is caring for a 16-year-old adolescent who was arrested for driving while intoxicated. Which teaching method is most effective in changing the client behavior?

Stressing that the driver's license can be lost if drinking continues

A 16-year-old client has been hospitalized 100 miles from home for 1 week to repair a fractured patella suffered in a skateboarding accident. 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 nursing intervention should the nurse prioritize for this client?

Take her to the teen lounge so she can meet other teens, use a phone, and check her e-mail

The nurse is assessing the psychosocial development of an an adolescent. The nurse determines that the client is in the middle post-conventional phase with which observation?

The adolescent tells the nurse, "I'm starting to think that some of my friends care a lot more about what other people think of them than what I do."