Adolescent EAQs
After a teaching session a nurse determines that an adolescent with newly diagnosed type 1 diabetes has sufficient knowledge of the disorder. What is the next nursing action?
Setting goals with the client
A 16-year-old girl has been admitted to the pediatric eating disorders unit with a diagnosis of anorexia and is undergoing behavioral therapy. Unit privileges are based on weight gain and have been explained to the client. What is the most appropriate intervention for the nurse to use when taking the lunch tray to the client's room?
Setting the tray down and say nothing
A 14-year-old girl in whom scoliosis has been diagnosed undergoes spinal fusion. On the first postoperative day her face is red, she is rigid, and she is crying because she is in pain. She has prescriptions for morphine sulfate for severe pain and an acetaminophen-codeine compound for moderate pain. What information should influence the nurse's choice of analgesic?
Spinal fusion causes considerable pain during the early postoperative days, and morphine is the more effective analgesic
A nurse is conducting a health class for adolescents. What modifiable risk factor, most closely associated with the development of coronary heart disease (CHD) in both men and women, should the nurse discuss?
Cigarette smoking
What treatment should the nurse suggest to an adolescent with type 1 diabetes if an insulin reaction is experienced while the adolescent is at a basketball game?
"Buy a soda and hamburger to eat."
A nurse teaches an adolescent undergoing chemotherapy for cancer about the need for special mouth care because of the potential for oral lesions. What statement indicates to the nurse that the instructions have been understood?
"I can use foam-tipped applicators to wipe my teeth and gums."
A student in high school asks the school nurse why a classmate has been absent for so long. What is the best response by the nurse?
"I know you're concerned, but you'll need to ask your classmate for yourself.
A teenager has a prescription for oral solution levofloxacin (Levaquin) to treat a sinus infection, and the nurse explains when the medication should be taken. The nurse concludes that the teaching has been effective when the teenager says:
"I should take the medication 1 hour before a meal."
A 16-year-old client with full-thickness burns of the entire right arm states, "I'll never be able to use my arm again. I'll be scarred forever." What is the best initial response by the nurse?
"Minimizing scarring is the goal of the entire professional staff."
Penicillin G (Bicillin) and probenecid (Benemid) are prescribed for an adolescent who has syphilis. The adolescent asks the nurse why two medicines are needed. What should the nurse explain about the rationale for this combination therapy?
"Probenecid delays excretion of penicillin so the blood level of penicillin stays stable longer."
An adolescent is admitted to the unit with a tentative diagnosis of a bone tumor of the left femur. During the admission procedure the adolescent casually asks, "Do they ever have to cut off a leg if someone has bone cancer?" How should the nurse respond?
"Sometimes it's necessary. What do you think about that treatment?
A 17-year-old mother is to sign the consent for her son's myringotomy. What should the nurse say to the mother about this procedure?
"Tell me what you know about this procedure."
A 15-year-old high school student with hay fever has been taking a prescribed long-acting antihistamine/decongestant every 8 hours for the past 2 days. The adolescent tells the nurse, "This medicine is making me sleepy. Can you change it to something else?" How should the nurse respond?
"The drowsiness usually goes away after several days."
An adolescent is hospitalized for dehydration. An intravenous infusion of 1000 mL of 0.9% sodium chloride with 20 mEq/L of potassium chloride is prescribed. Hospital policy states that potassium should be mixed in a 500-mL bag of 0.9% sodium chloride. The potassium chloride label reads "2 mEq/mL." How many milliliters of potassium chloride should the nurse add to the 500 mL-bag? Record your answer as a whole number. ____ mL
5ml
A nurse is completing the discharge protocol for a 14-year-old adolescent with osteomyelitis. The nurse teaches the parents how and when to administer the intravenous antibiotic at home. The schedule for administration is four times a day. At what times should the parents administer the antibiotic?
6 am, 12 pm, 6 pm, 12 am
What clinical finding is most important for the nurse to identify when assessing an adolescent child with Reye syndrome?
Bleeding tendency
Loratadine (Claritin), 10 mg by mouth once a day in the morning, is prescribed for a 15-year-old girl with hay fever. The girl tells the school nurse that she is concerned that she will be sleepy for a quiz the next day. How should the nurse respond?
By explaining that this medication rarely causes drowsiness
An adolescent with Duchenne muscular dystrophy has received care at the pediatric clinic since early childhood. Of which body system should the nurse perform a focused assessment to identify life-threatening complications as the child ages?
Cardiopulmonary
An adolescent who is undergoing chemotherapy for the treatment of bone cancer has stomatitis as a result of chemotherapy. What should the nurse include when teaching the child about self-care? Select all that apply.
Clean the teeth with a swab Drink fluids through a straw Avoid foods served at extremes of temperature.
An adolescent is admitted with an acute hemophilia episode. Rest, ice, compression, and elevation will be most helpful in:
Controlling bleeding and retaining joint function
Chronic sinusitis develops in a 15-year-old girl with a history of allergies. The mother tells the nurse that she thinks that her daughter is becoming a hypochondriac. What is the nurse's best approach?
Discussing the developmental behaviors of adolescents
A nurse is teaching a high school student about scoliosis treatment options. On what should the nurse focus?
Effect on body image
A nurse is caring for a 15-year-old client who is undergoing chemotherapy for leukemia. The nurse expects that adolescents with health problems are most concerned about:
Feeling different regarding changes in body image
A 13-year-old girl is found to have idiopathic scoliosis. She is upset about the treatment regimen and is worried about being different from her friends. What should the nurse do to help the child maintain a positive self-image during treatment?
Help her investigate appropriate clothing to enhance her appearance.
An unconscious 16-year-old adolescent with type 1 diabetes is brought to the emergency department. The blood glucose level is 742 mg/dL. What finding does the nurse expect during the initial assessment?
Hyperpnea
A nurse in the clinic is taking the health history of a 16-year-old girl. When the nurse asks questions concerning sexual activity, the adolescent begins to perspire and hyperventilate. As her anxiety increases, she indicates that she feels dizzy and short of breath and that her heart is racing. What condition does the nurse identify?
Hyperventilation syndrome
A teenager with allergies is using oxymetazoline (Afrin) nasal spray. What effect should the nurse assess the client for if more than the recommended dose is taken?
Increased nasal congestion
Spinal fusion is performed in an adolescent with scoliosis. What postoperative nursing intervention is specifically related to surgery for scoliosis?
Log-rolling every 2 hours
The mother of a 17-year-old adolescent who is going to be a foreign exchange student asks the nurse why her child must have a tetanus toxoid immunization instead of tetanus immunoglobulin. The nurse responds that the tetanus toxoid immunization provides:
Longer-lasting active immunity
An adolescent arrives at the clinic reporting buzzing in the ears. What assessment data are essential for the nurse to obtain?
Music preferences
While providing nursing care for an adolescent undergoing chemotherapy for leukemia, a nurse notes blood on the child's pillowcase, as well as several bloody tissues. Which of the child's laboratory test results should the nurse review?
Platelet count
After an above-the-knee amputation for bone cancer, an adolescent boy is returned to his room. He is monitored closely because of the potential for hemorrhage from the residual limb. What should the nurse plan to keep at the bedside?
Pressure dressing
An adolescent child is admitted to a pediatric unit with the tentative diagnosis of acute poststreptococcal glomerulonephritis (APSGN). What diagnostic tests does the nurse expect will be performed to confirm this diagnosis?
Serum complement (C3) activity level and urinalysis
A 15-year-old adolescent with type 1 diabetes arrives at the diabetic outpatient clinic with a parent. The adolescent sits back in the chair with arms folded, frowns, and displays a withdrawn attitude. The adolescent and parent argue in front of the nurse. What is the best approach for the nurse to use?
Speaking separately with each of them, encouraging them to recognize and vent their anger
Etanercept (Enbrel) is prescribed for an adolescent with juvenile idiopathic arthritis. What route of administration should the nurse expect the practitioner to specify?
Subcutaneous
A 16-year-old adolescent sustains an ankle injury while playing soccer. Crutches and no weight-bearing are prescribed by the practitioner. What must the nurse ensure when adjusting the crutches?
That they extend to 6 inches from the side of each foot
A 14-year-old adolescent with diabetes has been self-administering insulin twice a day.. This morning the parents found their child lethargic and confused. After the adolescent's admission to the emergency department, laboratory testing reveals a hemoglobin A1c level of 10% and a blood glucose level of 200 mg/dL. What does the nurse suspect as the most likely cause of this client's condition?
Uncontrolled blood glucose leve
A nurse instructs the parents of an adolescent with asthma how to reduce the allergens in the child's bedroom. The mother tells the nurse what she plans to do to make the room hypoallergenic. Which idea indicates that further teaching is needed?
Using flat outdoor carpeting to cover hardwood floors
After 3 months of supplemental oral iron therapy, there is no significant increase in a female adolescent's hemoglobin level. Iron dextran (Imferon) is ordered. What is the best way for the nurse to administer this medication?
With the use of the Z-track method
An adolescent who has sickle cell anemia is recovering from a painful episode. What does the nurse see as the priority issue for this adolescent?
alteration in body image
A mother expresses concern that her adolescent daughter is not ingesting enough calcium because of her allergy to milk. What alternative foods or liquids should the nurse suggest? Select all that apply.
green leafy vegetables oranges beans salmon or sardines
Immediately after being placed in the supine position, an adolescent child experiences shortness of breath and must sit up to breathe. What term should the nurse use to document this clinical phenomenon?
orthopnea
A girl comes to the physician's office for her 14-year-old check-up. What is the most important anticipatory guidance that can be offered to the client?
ways to prevent accidents
An adolescent child is in the terminal stage of cancer. The parents ask how they will know when death is imminent. The nurse discusses the physical manifestations with the parents. What are the signs and symptoms of approaching death? Select all that apply.
weak pulse difficulty swallowing loss of bladder control
