PNU 135 PassPoint PrepU Adolescent

The nurse is planning care for an adolescent client who is scheduled for a left above-the-knee amputation for osteosarcoma of the distal femur. What does the nurse include in the plan of care? Select all that apply.

Arrange for occupational and physiotherapists to be involved in preoperative teaching. Assist the client in practicing transferring methods to be used in the post-operative period. Provide time during each shift to discuss the client's expectations and goals after amputation. Provide the client with education on various coping strategies and relaxation techniques.

The nurse is working with adolescents. Which developmental rationale explains risk-taking behavior?

Belief in their own invulnerability persuades adolescents that they can take risks safely.

A nurse is caring for an adolescent who underwent surgery for a perforated appendix. What should the nurse keep in mind regarding the main life-stage task for the adolescent when providing care?

Developing identity and independence is the objective.

The nurse is caring for an adolescent with cancer who is well informed about the medical condition and treatment. The adolescent refused the morning medications and states intentions of refusing all future medications. What is the best action by the nurse?

Document the adolescent's choice and offer to discuss feelings about the medication.

A 16-year-old client comes to the physician's office for a physical examination that's required to play sports. The mother reports that her son is unusually tired during the day. She explains that he works at a part-time job, is socially active, and gets about 7 hours of sleep each night. Physical examination reveals that the client grew 3" during the past year. Which intervention by the nurse is most appropriate?

Explaining that his sleep requirements have increased related to the increased metabolic demands of growth

The nurse is planning sex and contraceptive education for adolescents. Which factor should the nurse consider?

Most teenagers are open about contraception, but inconsistently use birth control.

A nurse observes a gun under the jacket of a 17-year-old client's visitor. Which action should the nurse perform first?

Notify security immediately.

The nurse is caring for a 15-year-old client admitted with suspected bacterial pneumonia. Which nursing action takes priority?

Obtain a sputum culture.

When planning a program to educate adolescents about acquired immunodeficiency syndrome (AIDS), which action might lead to better acceptance of the program?

Obtain peer educators to provide information about AIDS.

A child, age 14, is hospitalized for nutritional management and drug therapy after experiencing an acute episode of ulcerative colitis. Which nursing intervention would be appropriate?

Providing small, frequent meals

An adolescent client is admitted with nephrotic syndrome. Which manifestations would the nurse expect? Select all that apply.

hypercholesterolemia hypoproteinemia proteinuria periorbital edema

The nurse is caring for a 14-year-old child in skeletal traction for treatment of a fractured femur. The child is expected to be hospitalized for several weeks. When planning care, the nurse should take into account the client's need to achieve what developmental milestone?

identity

The nurse is reinforcing education on how to change a sterile dressing. The client is an older adolescent. During the education session, the nurse observes redness, swelling, and induration at the incision site. What does this indicate to the nurse?

infection

Which interview strategy contributes to a poor nurse-adolescent relationship?

interviewing adolescents with their parents present

A female adolescent client refuses to allow male nurses to care for her while she's hospitalized. Which of these health care rights is this adolescent exerting?

right to privacy

A 14-year-old is seen in the pediatrician's office with a history of mild sore throat, low-grade fever, a diffuse maculopapular rash, and reports swelling of the wrists and redness in the eyes. The nurse interprets these findings as indications of which condition?

rubella

A 14-year-old with type 1 diabetes is admitted with ketoacidosis for the second time in 3 months. The parent states, "I don't know why this keeps happening." Which response by the nurse is best?

"Adolescents sometimes become overwhelmed by adhering to dietary restrictions and taking medications."

The nurse is teaching a group of high school students about obesity. Which information will the nurse provide when discussing this topic?

"Calculating body mass index is preferred to weighing yourself on a scale."

A 15-year-old girl visits the neighborhood clinic seeking information on "how to keep from getting pregnant." What should the nurse say in response to her request?

"Can you tell me about the precautions you're taking now?"

An emancipated adolescent is pregnant and plans to raise her child. She has no income or health insurance. Which recommendation should the nurse make to help the client with her health care expenses?

Completing a Medicaid application

The nurse is teaching a 16-year old client who has menstruated for more than a year. Which client statement will the nurse respond to as the priority?

"I was having regular periods before but haven't had one for a couple of months."

A school nurse is planning a program on skin cancer prevention for a group of teenagers. Which instruction should the nurse emphasize during the program?

"Examine your skin once per month, looking for suspicious lesions or changes in moles."

A 15-year-old adolescent confides in the nurse that the adolescent has been contemplating suicide. The adolescent has developed a specific plan to carry it out and pleads with the nurse not to tell anyone. What is the nurse's best response?

"For your protection, I can't keep this secret. After I notify the physician, we will need to involve your family. We want you to be safe."

A nurse is caring for a 16-year-old female who is sexually active. The nurse is reinforcing education with the client about preventing sexually transmitted infections (STIs). What statement by the adolescent indicates a need for further instruction?

"I am protected from contracting HIV and other STDs because I am on oral contraceptives.

A nurse is conducting a health class at the local middle school about testicular self-examination. What statement by a student would indicate a need for further teaching?

"I do not need to perform testicular self-exams until I become sexually active."

The school nurse hears a rumor that an adolescent client who is prescribed dextroamphetamine and amphetamine has been selling some of this medication to other students. How should the nurse address this with the client? Select all that apply.

"I heard a rumor that you have been selling some of your medication to other students." "I am not saying I believe the rumor to be true, but I wanted to speak with you." "What do you know about how your medication can be misused and the about laws governing distribution?"

Which statement by a female adolescent reveals an early indicator of anorexia nervosa?

"I jog three times per day for a total of 5 hours per day."

The nurse has completed teaching about type 1 diabetes to a newly diagnosed adolescent client and the parent. Which client statement indicates an understanding of this teaching?

"It is important that I monitor myself carefully if I get sick."

The nurse is teaching a group of adolescent clients about personal hygiene. Which client statement indicates the need for further teaching?

"It's unsafe to swim during your period."

After a nurse reinforces education with an adolescent about syphilis, which statement by the adolescent indicates the need for further education?

"Syphilis is rarely transmitted sexually."

The parent of an adolescent diagnosed with Legg-Calvé-Perthes disease (LCPD) asks the nurse, "What caused this condition?" Which nursing response is appropriate?

"The hip joint has been damaged due to lack of blood supply."

An adolescent who is sexually active seeks counseling from the school nurse about the prevention of sexually transmitted infections (STIs). Which suggestion does the nurse make?

"Use condoms each time you have sexual intercourse."

The nurse is caring for an adolescent client after surgery for a perforated appendix. Which life stage task is important to this client's care?

Develop independence.

An adolescent with diabetes tells the community nurse they recently started drinking alcohol on the weekends. Which action would be most appropriate for the nurse to take?

Educate the adolescent about the effects of alcohol on diabetes.

The parents of an adolescent girl have recently learned that their daughter has a terminal illness. At first, as they try to cope, they display avoidance behaviors. Then they demonstrate behaviors that indicate possible acceptance of the diagnosis. Which of the following behaviors would indicate acceptance?

Expression of feelings, such as sorrow and anger, about the child's condition

A nurse is caring for a 17-year-old brought to the mental health facility by a family member who is concerned about the client's recent 20-lb (9 kg) weight loss, and weight loss total of 50 lb (22.7 kg) in the last year. What interventions are essential in the treatment of an adolescent diagnosed with an eating disorder? Select all that apply.

Provide a highly structured environment. Monitor the clients' weight, vitals, intake and output, caloric intake, and exercise. Assist the client in changing the negative perception to a positive one, and assist in setting realistic goals.

A girl, age 15, is 7 months pregnant. When teaching parenting skills to an adolescent, the nurse knows that which teaching strategy is most effective?

Providing a one-on-one demonstration and requesting a return demonstration, using a live infant model

A school nurse suspects that a 13-year-old has structural scoliosis. Asking the adolescent to perform which maneuver would be the nurse's priority when gathering data for this condition?

The child bends over and touches the toes while the nurse observes from behind.

The nurse is working with a group of adolescents reviewing information regarding the human immunodeficiency virus (HIV). What fact is important for the nurse to include in the review?

The virus can be spread through many routes, including sexual contact.

The nurse is reinforcing education with an adolescent about gonorrhea. Which information should be included?

Treatment of sexual partners is an essential part of treatment.

Which situation violates a hospitalized adolescent's right to confidentiality?

Two nurses talk about the adolescent on an elevator on their way to lunch.

An otherwise-healthy adolescent has meningitis and is receiving I.V. and oral fluids. The nurse should monitor this client's fluid intake because fluid overload may cause:

cerebral edema.

The nurse is caring for a teenage client involved in a motor vehicle accident. The client has a chest tube in place. If the chest tube is accidentally removed, the nurse should immediately:

cover the opening with sterile petroleum gauze.

The nurse has conducted a vision assessment for an adolescent client. Which term will the nurse use to document the finding of the client's nearsightedness?

myopia

The nurse is helping the adolescent deal with diabetes. What characteristic of adolescence should be considered?

need to be like peers

An adolescent is admitted to the adolescent unit with pain caused by sickle cell crisis. Who should be consulted first about this adolescent's care?

pediatric pain specialist

An adolescent with diabetes is learning to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the teen, would indicate the need for further instruction?

withdraws the NPH insulin first