Growth and Development: Adolescent (Practice Questions)
Based on Erikson's developmental theory, what is the major developmental task of the adolescent? -Mastering motor skills -Gaining independence -Coordinating information -Finding an identity
-Finding an identity Explanation: According to Erikson, it is during adolescence that teenagers achieve a sense of identity. The toddler developed a sense of trust in infancy and is ready to give up dependence and to assert his or her sense of control and autonomy. The psychosocial task of the preschool years is establishing a sense of initiative versus guilt by mastering skills. In the school-age years the child develops concrete operations and is able to assimilate and coordinate information about the world from different dimensions.
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 explains "wet dreams" and the other male traits of puberty to the mother. Which response indicates a need for further discussion? -"My son must be sexually active or having overly sexual thoughts to have a nocturnal emission." -"My son is not doing anything to cause the nocturnal emissions; they occur spontaneously." -"My son is developing normally and the traits of puberty vary from child to child." -"My son's spontaneous erections and nocturnal emissions are very normal."
-"My son must be sexually active or having overly sexual thoughts to have a nocturnal emission." Explanation: Spontaneous erections and nocturnal seminal emissions do not mean that the child is sexually active or having overactive sexual thoughts. Parents need to be instructed that these occurrences are spontaneous and that the child is not doing anything to cause them.
The nurse is discussing an adolescent's development with the client's parents. Which statement by the parents indicate an understanding of the nurse's teaching? -"Our adolescent is working toward achieving a sense of personal identity." -"We will work toward ensuring our adolescent is developing trusting relationships." -"It is vital our adolescent learns to help others achieve their goals." -"It is most important for our adolescent to achieve independence from our dominance."
-"Our adolescent is working toward achieving a sense of personal identity." Explanation: According to Erikson's theory of psychosocial development, the major challenge of adolescence is the achievement of identity. Achieving independence from parental domination is another task of adolescence, but not the ultimate one. Helping other adolescents achieve higher goals is not a part of Erikson's theory of psychosocial development. Developing trust occurs in infancy.
The school nurse is preparing a program on sexuality and birth control for a class of 14- to 16-year-olds. Which behavior will have the most influence on how the information is presented? -Adolescents understand that actions have consequences. -Teenagers are able to think in the abstract. -Adolescents tend to take risks. -Teens are adjusting to new body images.
-Adolescents tend to take risks. Explanation: Adolescents are risk takers. This tendency enables them to overcome common sense and their own better judgment. Although adolescents are capable of abstract thinking and understand that actions have consequences, they are not yet committed to these attributes. Changing body image would not have significant influence on the presentation.
The nurse is providing anticipatory guidance for violence prevention to a group of parents with adolescents. Which parental action should the nurse include as the most effective in preventing suicide? -Monitoring video games, TV shows, and music. -Becoming acquainted with the teen's friends. -Checking for signs of depression or lack of friends. -Watching for aggressive behavior or racist remarks.
-Checking for signs of depression or lack of friends. Explanation: Checking for signs of depression or lack of friends would be most effective for preventing suicide. All other choices are more effective for preventing violence to others.
What anticipatory guidance can the nurse provide the girl who has noted the development of breast buds? -The growth spurt will begin immediately with menarche. -Adult height will be reached at the time of menarche. -Menarche should follow in about 2 years. -Breast development will be complete with 12 months.
-Menarche should follow in about 2 years. Explanation: Menarche usually follows within 2 years of the first signs of breast development. 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.
The nurse teaches parents of adolescents that teenagers need the support of parents and nurses to facilitate healthy lifestyles. What should be a priority focus of this guidance? -Teaching personal hygiene routines -Promoting adequate physical growth -Maximizing learning potential -Reducing risk-taking behavior
-Reducing risk-taking behavior Explanation: The adolescent experiences drastic changes in the physical, cognitive, psychosocial, and psychosexual areas. With this rapid growth during adolescence, the development of secondary sexual characteristics, and interest in the opposite sex, the adolescent needs the support and guidance of parents and nurses to facilitate healthy lifestyles and to reduce risk-taking behaviors. Promoting physical growth, maximizing learning potential, and teaching hygiene are secondary to reducing risky behavior.
A client has confided in a nurse that her 13-year-old daughter has recently changed dramatically in her social interactions with others. What is a social behavior most likely to be exhibited by a girl at this age? -Hanging out with girls but maintaining her own unique style -Banding together with boys and girls but maintaining her own unique style -Hanging out primarily with boys her own age -Banding together with other girls and dressing like them
-Banding together with other girls and dressing like them Explanation: In early adolescence, girls tend to band together with girls. They dress identically with other members of their group: jeans and sweatshirts, special jackets, or whatever the fashion may be. On the surface, this makes adolescents appear to be losing their identities rather than finding them.
The nurse is working with a 12-year-old who has recently experienced family instability and family violence. When assessing this client in the context of Erikson's developmental theory, the nurse should recognize that the adolescent has a risk of which negative outcome? -development of an antisocial identity -dissociative identity disorder -physical and emotional aggression in relationships -confusion about role in the world
-confusion about role in the world Explanation: Erikson identifies the primary developmental task of early adolescence as identity versus role confusion. That is, unsuccessful development results in confusion about role and identity. This does not necessarily result in aggression or antisocial behavior. Dissociative identity disorder is a specific psychiatric disorder.
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 will feel better about yourself as you get older." -"You may feel like you are changing, but you still look the same." -"You have lots of hormone changes going on right now." -"Your other friends are feeling like this too."
-"You have lots of hormone changes going on right now." Explanation: Preadolescents need information about their changing bodies and feelings. Sex education that includes information about the hormonal changes that are occurring or will occur is necessary to help them through this developmental stage. Although adjustments will occur as the child gets older and friends are important, these responses are not the most direct and appropriate.
The nurse is talking to a 13-year-old boy about choosing friends. Which function do peer groups provide that can have a negative result? -developing stability -negotiating differences -following role models -sharing problems
-following role models Explanation: Peers serve as role models for social behaviors, so their impact on an adolescent can be negative if the group is using drugs, or the group leader is in trouble. Sharing problems with peers helps the adolescent work through conflicts with parents. The desire to be part of the group teaches the child to negotiate differences and develop loyalties and stability.
A male nurse is meeting with a group of 12-year-old boys to discuss expected bodily changes. After one of the boy's says, "My older brother told me my bed might be wet and that means I had a wet dream. Is that true?" What is the best response from the nurse? -"When you are thinking about people you find sexually attractive or dating those people you might have a wet dream." -"It is not common to wet the bed or urinate when you have a wet dream." -"It will be several years before you will start having wet dreams." -"Having wet dreams indicates that your body is going through a process of maturing."
-"Having wet dreams indicates that your body is going through a process of maturing." Explanation: In boys, the appearance of nocturnal emissions ("wet dreams") is often used as the indication that the preadolescent period has ended and that the adolescent is maturing into an adult. Nocturnal emissions usually occur at about the age of 11 in boys. Wet dreams are not associated with urination. Boys at this age start thinking of relationships with people they find sexually attractive, but this is not the best response.
An adolescent confides in the nurse about a current sexual relationship with a same-sex classmate. The adolescent states, "I am not sure if I am really gay?" What is the best response by the nurse? -"Maybe your parents could help you figure out if you are gay. They know you better than anyone." -"It would probably be best for you to talk with your health care provider about this. Your health care provider may be able to help you determine if you are gay." -"Some adolescents experiment with same-sex relationships at this age. It may take some time before you determine if you are gay." -"It is too early for you to determine if you are gay or not. A lot of adolescents experiment with same-sex relationship behavior."
-"Some adolescents experiment with same-sex relationships at this age. It may take some time before you determine if you are gay." Explanation: Adolescents may experiment with same-sex relationship behavior, though this behavior as an adolescent does not necessarily indicate that the adolescent will maintain a gay sexual orientation. Since the adolescent feels comfortable talking about sexuality with the nurse, beginning the conversation by providing information allows the adolescent to express oneself further. Telling the adolescent that it is "too early" to determine if he or she is gay discards the adolescent's concerns and blocks communication. The adolescent has confided in the nurse so telling the adolescent to discuss this topic with others, such as the health care provider or parents, would block communication and possibly convey that the nurse is not supportive of the concerns.
Which nursing action will best assist a 15-year-old client accomplish the developmental task according to Erikson? -Praise the client for correctly performing self-care -Provide the client with crafts and puzzles to complete independently -Permit the client to make decision regarding one's care -Allow the client's friends to visit while the client is hospitalized
-Allow the client's friends to visit while the client is hospitalized Explanation: The developmental task of adolescence is to develop a sense of identity, or deciding who and what kind of person one is. Friends and peers are important to facilitating the adolescent in determining one's identity. Permitting the client to make decisions assists in developing autonomy, which is a toddler task. Praising facilitates initiative, which is a preschool task. Independently performing tasks assists in developing industry, which is a school-age task.
The physician has made a notation in the medical record of a 17-year-old that the teen is not demonstrating successful completion of Erikson's stages of development. What behavior would be consistent with this assessment? -The teen is uncertain and frequently unable to make decisions. -The teen is distrustful of others. -The teen is anxious to move away from his parent's home. -The teen is sexually promiscuous.
-The teen is uncertain and frequently unable to make decisions. Explanation: According to Erikson's stages of development, the teen develops a sense of identity. Failure to successfully complete this stage will result in a lack of self confidence and an inability to see one's self as in independent being. The establishment of the ability to trust is completed in an earlier stage of psychosocial development. A desire to move away from the parental home is not uncommon and is not a sign of impaired navigation of this level of psychosocial development.
According to Erikson, the adolescent develops their own sense of being an independent person with individual thoughts and goals. This stage is referred to as: -autonomy vs. doubt and shame. -industry vs. inferiority. -identity vs. role confusion. -intimacy vs. isolation.
-identity vs. role confusion. Explanation: Adolescents must develop their own personal identity—a sense of being independent people with unique ideals and goals. This is the period Erikson calls identity versus role confusion. Erikson believes during this time the adolescent goes back through all previous developmental periods to achieve this identity. The stage of autonomy versus shame and doubt occurs between 18 months and 3 years. Industry versus inferiority occurs between 5 to 12 years. Intimacy versus isolation occurs in adulthood between the ages of 19 to 40 years.
During a complete physical assessment of a preteen boy, the nurse correctly recognizes which finding as being the first change of puberty? -deepening voice -increase in height -testicular enlargement -development of axillary hair
-testicular enlargement Explanation: The first sign of pubertal changes in boys is testicular enlargement in response to testosterone secretion, usually occurring in Tanner stage 2. As testosterone levels increase, the penis and scrotum enlarge, hair distribution increases, and scrotal skin texture changes.
The nurse is collecting data from a 15-year-old boy who is being seen at the ambulatory care clinic for immunizations. During the initial assessment, he voices concerns about being shorter than his peers. What response by the nurse is indicated? -"Boys your age will often continue growing for a few more years." -"Being short is nothing to be ashamed of." -"Are the other men in your family short?" -"I am sure you are not the shortest guy in your class."
-"Boys your age will often continue growing for a few more years." Explanation: Teenage boys can experience growth in height until age 18 or even later. The nurse should reassure the teen that this may happen for him. Telling the client not to be ashamed or assuring him that he's not as short as his peers fails to provide information or support. Determining the height of the other men in the family may be indicated at a later time but is not the most appropriate initial comment.
The nurse is performing a health surveillance visit with a 12-year-old boy. Which characteristic suggests the boy has entered adolescence? -shows growing interest in attracting girls' attention -understands that actions have consequences -feels secure with his body image -experiences frequent mood changes
-experiences frequent mood changes Explanation: If the boy has just entered adolescence, he is likely to exhibit frequent mood changes. A growing interest in attracting girls' attention and understanding that actions have consequences are typical of the middle stage of adolescence. Feeling secure with his body image does not occur until late adolescence.
The mother of a 9-year-old female voices concern to the nurse about her daughter developing breasts "at such a young age." How should the nurse respond? -"Do the females in your family typically develop at an early age?" -"I understand your concern, but girls typically enter puberty around the age of 9 or 10." -"I am sure you are concerned but children develop at different rates." -"This is rather young to be developing breasts. I will be sure to let the doctor know."
-"I understand your concern, but girls typically enter puberty around the age of 9 or 10." Explanation: Voicing empathy regarding the mother's concern conveys support, and letting her know that this is normal growth and development helps ease her concerns. The other responses don't address her concerns or show genuine empathy.
During a visit to the school nurse, an adolescent confides in recently having feelings of attraction to a member of the same gender. How should the nurse best respond to the adolescent? -"Would you like to talk about these feelings?" -"These feelings are normal for your age." -"Do these feelings make you feel bad about yourself?" -"How long have you been having these feelings?"
-"Would you like to talk about these feelings?" Explanation: The task of forming an identity is for adolescents to decide who they are and what kind of person they will be. One of the challenges of identity is to accept their changed body image. During adolescence, individuals begin to explore their sexual preferences and may question their gender identity. Encourage an open dialogue with adolescents to assist them to process their feelings and establish their own identity. The nurse should not be judgmental. Because the adolescent has had feelings does not mean the adolescent is gay, nor does it imply there is something wrong that needs to be "fixed."
The nurse is educating an adolescent's parents on the importance of self-esteem. Which factor will the nurse include as being most important to an adolescent's self-esteem? -Body image -Strong authority figures -Friends selected by the adolescent -Morals and values
-Body image Explanation: Self-esteem in a teenager is often tied to body image. Adolescents who perceive their bodies as being different than peers or as less than ideal may view themselves negatively. Sexual characteristics are important to the adolescent's self-concept and body image. Authority figures, friends/peers, and morals and values play a role in development of self-esteem, but body image is most influential in the development of self-concept/self-esteem.
The nurse is performing an assessment of the reproductive system of a 17-year-old girl. What would alert the nurse to a developmental delay in this girl? -Mature distribution and coarseness of pubic hair -Lack of occurrence of first menstrual period -Developed breast tissue -Areola and papilla separate from the contour of the breast
-Lack of occurrence of first menstrual period Explanation: The first menstrual period usually begins between the ages of 9 and 15 years (average 12.8 years). Breast budding (thelarche) occurs at approximately ages 9 to 11 years and is followed by the growth of pubic hair.
The nurse is planning a presentation to an adolescent group. What recommendations would the nurse include in the presentation? -Participate in 60 minutes of moderate to vigorous physical activity each day. -Engage in aerobic exercise for 30 minutes, three days per week. -Engage in at least one competitive sport during the school year. -Participate in weekly physical activities that cause sweating and rapid breathing.
-Participate in 60 minutes of moderate to vigorous physical activity each day. Explanation: The U.S. Department of Health and Human Services and the Canadian Physical Activity Guidelines recommend that adolescents participate in 60 minutes of moderate to vigorous physical activity each day. Aerobic exercise for 30 minutes, three times weekly, is not the recommended amount of exercise. The other recommendations lack adequate activity or specificity.
The nurse is assessing an adolescent's risk for harm from guns being present in the home. What question would be best to ask during the assessment? "Have you been taught how to use a gun?" "Are the guns in your home locked in a safe?" "Do you understand that it is important for you not to handle a gun?" "Do you and your dad hunt?"
"Are the guns in your home locked in a safe?" Explanation: Common causes of death in adolescents are homicide and self-harm. These are related to the easy accessibility of guns, especially when added to depression, binge drinking, and impulsivity. Gang violence and the desire to protect themselves are additional factors. Having the gun locked in a safe provides a way for limited access. Knowing how to use a gun and going hunting demonstrate expertise, but the safest way to prevent harm is to have the gun locked when not in use for these purposes. Telling the adolescent it is important not to use a gun provides no explanation why and comes across as a rule to be broken.
While speaking to the caregiver of a 13-year-old girl, the nurse learns the client is struggling to accept the changes occurring to her body as a result of puberty. Which statement will the nurse include while responding to the client's caregiver? -"Adolescents are often uncomfortable with their new body images and must learn to accept it." -"These are feelings all adolescent girls experience. Have your daughter talk to her peers." -"Be sure to tell your daughter she is beautiful often to promote a positive self-image." -"Once puberty ends, your daughter will feel more confident in her body changes."
-"Adolescents are often uncomfortable with their new body images and must learn to accept it." Explanation: According to Erikson, the developmental task in early and mid-adolescence is to form a sense of identity versus role confusion. Adjustment to changes in body image is part of forming this sense of identity. The nurse would let the caregiver know this is a normal finding. Adolescents must learn to accept the changes; it is not an immediate acceptance at the end of puberty. Promoting a positive self-image is important; however, telling the child she is beautiful does not address the caregiver's concern. Encouraging the client to speak with peers does not address the caregiver's concern.
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. -He is not developmentally mature enough to have an intimate relationship with one girl; they should encourage him to spend time with groups of friends rather than time alone with his girlfriend. -He is not developmentally mature enough to make healthy choices about the ways in which he spends his time, so it would be helpful if they would make a schedule for him that includes about a half-hour per day to talk with his girlfriend. -He has chosen a girl who is overly dependent on him. They should talk to him about making sure he meets his own needs, including doing the schoolwork he enjoys, in any relationship.
-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. Explanation: When identity has been established, generally between the ages of 16 and 18 years, adolescents seek intimate relationships, usually with members of the opposite sex. Intimacy, which is mutual sharing of one's deepest feelings with another person, is impossible unless both persons have established a sense of trust and a sense of identity. Intimate relationships are a preparation for long-term relationships, and people who fail to achieve intimacy may develop feelings of isolation and experience chronic difficulty in communicating with others.
The clinic nurse is assessing a 14-year-old client. The client states "I am worried I have a brain tumor. I am so clumsy when I play sports now that it is totally embarrassing." Which response by the nurse is appropriate? -"Have you noticed any changes in your vision or hearing lately?" -"You are experiencing rapid and uneven growth now which can interfere with coordination." -"I understand why you are worried. Has anyone else in your family had a brain tumor." -"I will request the primary health care provider prescribe a magnetic resonance image (MRI)."
-"You are experiencing rapid and uneven growth now which can interfere with coordination." Explanation: Uneven growth of soft tissues and bones during growth spurts can cause decreased coordination for boys. The age of 14 years is usually the time of peak height velocity (PHV). The nurse would let the client know this is expected to alleviate the client's fears. There is no need to request an MRI. The nurse would not ask yes/no questions as these do not provide insightful information. Stating the nurse understands why the client is worried indicates the client has reason to fear a brain tumor.
During an examination, an adolescent client tells the nurse about being anxious and frustrated because of the facial acne. Which nursing response is appropriate? -"This is one of the most common physical changes during adolescence." -"Consuming fried foods and chocolate can cause acne to develop." -"I will tell your primary health care provider about your acne." -"Most people get acne during adolescence. It will go away as you get older."
-"This is one of the most common physical changes during adolescence." Explanation: It is important for the nurse to inform the client that acne is a normal physical changes that characterizes adolescence as a result of increased glandular activity. The nurse should address the client's concern and not refer the client to the primary health care provider. The client's worries should not be trivialized or ignored as this is a situation that is worrisome for the adolescent. The type of foods consumed do not cause acne.
While caring for a 16-year-old client expected to be hospitalized for several months, the nurse will perform which action to assist the client in meeting the current stage of psychosocial development? -Explain medical concepts by providing handouts and brochures. -Allow the client to touch equipment before procedures. -Provide video games for the client to play. -Permit peers to visit during open visitation hours.
-Permit peers to visit during open visitation hours. Explanation: In each stage of development, a significant person or group exerts a lasting influence on the ongoing development of the child. An adolescent striving for self-identity and increased independence spends more time with peers than with family. It is important for the hospitalized adolescent to still be able to visit with peers. Video games may be enjoyed by the adolescent and limit boredom; however, this action would not facilitate psychosocial development. Allowing the client to touch equipment and to explain medical concepts/procedures are methods used to teach toddlers and preschoolers. Providing handouts and brochures are not effective methods to explain medical concepts; the nurse would verbally explain using models, pictures, and diagrams. Handouts and brochures can be used as supplements to teaching.
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. What would be most appropriate for the nurse to say? -"Don't let it get you down; sports are a waste of time, anyway." -"It's not that big of a deal; a lot of kids don't make the football team." -"I'm really sorry; I know that must be a big disappointment." -"That's okay; you can try out for basketball in a few months."
-"I'm really sorry; I know that must be a big disappointment." Explanation: It is important for adolescents to have immediate successes such as making the high school football team or having a date for the senior prom. Comments such as "When you're older, these things won't be so important," are not likely to erase the hurt that comes from being 16 and not being included in such major events. Compassionate understanding ("I'm really sorry; I know that must be a big disappointment") is a better communication technique. The other responses dismiss the client's feelings rather than acknowledging and validating them.
The nurse is providing education on adolescent safety to a group of caregivers. Which statement by a caregiver indicates additional teaching is needed? -"Taking a course on driving safety is sufficient to teach safe driving skills." -"Firearms should be kept in locked boxes, closets, or cabinets." -"Teenagers should not cook on the stove when home alone." -"Setting limits is beneficial when rearing teenagers."
-"Taking a course on driving safety is sufficient to teach safe driving skills." Explanation: Motor vehicle accidents are the number one cause of death in adolescents. Taking one course on safe driving is not enough to ensure safe driving skills are mastered by a new driver. Adolescents should not cook on the stove or in the oven when home alone to limit fire risks. Firearms should be kept in a locked area, where children do not have access. Limits, such as curfews, are beneficial during the adolescent years.
During a health check-up without the parents present, a 17-year-old adolescent tells the nurse about being gay. Which statement from the nurse is best? -"You are not gay; you are confused." -"This puts you in an at-risk category." -"We need to talk about safe sex." -"Tell me what makes you think you are gay."
-"Tell me what makes you think you are gay." Explanation: The nurse needs to get more information from the adolescent (assessment) before making any comment and then proceeding in a sensitive and caring way. Comments about being at risk or needing to know about safe sex are negative and should be replaced with health promotion comments. Denying the statement shows the adolescent that the nurse is not an ally.
A 15-year-old client's parent comments on the fact that the adolescent seems to always choose the opposite of what everyone else wants and that mood swings are a common occurrence. What statement shows the nurse that the client's parent understands these changes? -"This is common for this age group and it will get better with time." -"I know that my adolescent is doing this because of all the hormones." -"My adolescent will never find anyone to live with if the adolescent acts like this." -"This is my adolescent's temperament, and we will have to learn how to deal with it."
-"This is common for this age group and it will get better with time." Explanation: During middle adolescence, the adolescent spends more time ignoring adult authority and becomes more reliant on peer relationships. Adolescents might choose a stance directly opposite that of their parents and use peer support to back their ideas. Mood swings are a common occurrence during the adolescent period. They tend to smooth out and the adolescent will become more introspective. By late adolescence emotions become more consistent. Making statements such as "my adolescent will never find anyone to live with" or "we will have to learn to live with [my adolescent's temperament]" does not demonstrate the parent has a good idea of what is happening during the adolescent period.
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? -Up to age 2, children learn by touching, tasting, and feeling. They learn to control body movement. -After age 12 children can think in the abstract, including complex problem solving. -From ages 7 to 11 years, children internalize actions and can perform them in the mind. -Children from ages 2 to 7 years investigate and explore the environment and look at things from their own point of view.
-After age 12 children can think in the abstract, including complex problem solving. Explanation: The nurse should explain that there are four levels of cognitive development in Piaget's theory. The sensorimotor level is up to age 2 where children learn by touching, tasting, and feeling. They learn to control body movement. Preoperational level takes place in children ages 2 to 7 years who investigate and explore the environment and look at things from their own point of view. At the concrete operations level, from ages 7 to 11 years, children internalize actions and can perform them in the mind. At the formal operations, after age 12, children can think in the abstract. Complex problem solving is included in this category.
The nurse is performing an admission assessment of an adolescent with the teen and the parents. During the assessment the nurse suspects that the teen may be pregnant. What is the best way for the nurse to address this situation? -Ask the teen's physician to talk to the parents and the teen about the possibility of pregnancy. -Ask the parents to step out of the room and tell them the nurse's suspicion. -Ask the teen's physician to talk to the parents and the teen about the possibility of pregnancy. -Ask the teen, with the parents present, if she might be pregnant.
-Ask the teen's physician to talk to the parents and the teen about the possibility of pregnancy. Explanation: During health care visits the adolescent or parent may have concerns that they are hesitant or uncomfortable talking about in front of each other. Asking the parents to wait in the lounge while completing the assessment allows the nurse to talk with the teen. This allows time for the teen to confide in a nonjudgmental adult. Asking the child in front of the parents or asking the parents without speaking to the teen first may cause unnecessary conflict. While it is important to speak with the client's physician, the best opportunity to discuss the concerns is at the present time.
The nurse is discussing ways to promote discipline with parents who are becoming increasingly frustrated with their adolescent. What would the nurse suggest to the parents? -Avoid discussing situations of misbehavior and instead praise appropriate behavior. -Determine the consequences for misbehavior and explain them to the adolescent. -Make a chore chart and add stickers for completed chores and activities. -Develop consistent expectations and use consistent responses each time.
-Develop consistent expectations and use consistent responses each time. Explanation: Consistency and predictability are the cornerstones of discipline. The use of a chore chart with stickers would be more appropriate for a preschool-aged or young middle-school-aged child. The parent should include the adolescent in establishing consequences rather than determine them without input. While appropriate behavior should be praised, when occurrences of misbehavior occur, they should be addressed and dealt with according to the agreed-upon consequences.
A nurse is taking care of a teenager who reports 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? -Review about sexually transmitted infections. -Educate the client about the changes that occur during adolescence. -Inform him that involuntary discharge of semen during sleeping needs immediate attention of the health care provider. -Provide information about sex and sexuality.
-Educate the client about the changes that occur during adolescence. Explanation: The highest priority areas of the nurse's teaching involves informing the client about the expected pubertal changes that take place in the body and convincing him that the involuntary discharge of semen while sleeping is a normal part of reproductive health. Once the adolescent has an understanding of bodily changes during puberty then further education about sex, sexuality and sexually transmitted infections can be discussed.
A 17-year-old adolescent chats excitedly with the nurse about plans for college and a career. The adolescent states having checked out every college in the region and determined which one is the best fit and would give the adolescent the best career options. The nurse recognizes which developmental aspect in this client? -Socialization -Identification of identity -Formal operational thought -Sensorimotor
-Formal operational thought Explanation: 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, though it may not be complete until about age 25. This step involves the ability to think in abstract terms and use the scientific method (deductive reasoning) to arrive at conclusions. With the ability to use scientific reasoning, adolescents can plan their future. They can create a hypothesis (What if I go to college? What if I do not?) and think through the probable consequences (In the long run, I will earn more money; I could begin earning money immediately). This scenario does not pertain to socialization, role identification, or sensorimotor development.
A female client tells the nurse about noticing an increase in weight and fat deposits during the past 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? -Share what foods can be eaten on a low-fat diet to prevent fat deposits. -Review dietary measures to assist in controlling weight gain. -Encourage increased exercise to control weight gain. -Provide reassurance that these are normal changes.
-Provide reassurance that these are normal changes. Explanation: Increased fat deposits and weight and height changes are normal as girls begin hormonal changes of puberty. During adolescence, girls are very sensitive about their appearance and experience a constant need for reassurance. Puberty is a period when children are very self-conscious about their overall appearance. Reassurance needs to be provided that increased fat deposits and weight and height changes are normal. Dietary management is indicated if a true weight problem is present, but healthy eating should be encouraged rather than dieting. Adolescents should be encouraged to participate in appropriate exercise programs. Dieting issues such as anorexia and bulimia can threaten the health of adolescents.
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? -Suggest that she read books and magazines from the hospital bookmobile. -Call the hospital's mental health unit to see if she can get some counseling. -Take her to the teen lounge so she can meet and interact with other teens. -Ask her caregivers to bring her siblings and friends to visit.
-Take her to the teen lounge so she can meet and interact with other teens. Explanation: Adolescents need access to their peers so they can keep up social contacts. Meeting other teens in the facility is one way to accomplish that. The client most likely also has an electronic device which will enable her to stay in contact with family and friends back home but meeting others can also help meet social needs. Recreation areas are important. In settings specifically designed for adolescents, recreation rooms can provide an area where teens can gather to do schoolwork, play games and cards, and socialize. Because she is 100 miles from home, a visit from friends might be difficult.
What activity would best foster the developmental task of an adolescent who uses a wheelchair to ambulate? -Having a teacher bring school work to the adolescent -Watching television on the set in the adolescent's room -Allowing the adolescent to decide when to bathe -Talking to another adolescent who has a similar situation
-Talking to another adolescent who has a similar situation Explanation: A sense of identity is developed by "trying on" roles and discussing values and goals with others. A sense of trust develops when an adolescent is able to find out whom (and what ideas) to have faith in. The adolescent period is also a time where past stages of development are revisited. The sense of autonomy is where the adolescent seeks ways to express individuality. The stage of initiative is where the adolescent develops vision of what he or she might become. Talking with another adolescent who also uses a wheelchair to ambulate will help the adolescent see possibilities and reassurances. Making decisions or having assistance from someone else does not allow the adolescent to "try out" roles.
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? -They want to successfully complete activities. -They understand and respond to discipline. -Teens are busy developing their own personal identity. -Each child is learning to do things on his or her own.
-Teens are busy developing their own personal identity. Explanation: According to Erikson, the central task of adolescence is to develop unique personality and identity. The developmental task for the school-age child is to develop a sense of industry, and completing activities builds that feeling of confidence. Erikson's psychosocial developmental task for toddlers is to achieve autonomy (independence) and do things on their own. Learning to speak and to understand and respond to discipline are not developmental tasks, according to Erikson.
What is the best explanation of Erikson's theory of psychosocial development during adolescence? -The adolescent develops many skills during the teen years that help them make educational and career choices. -Cognitive development is cumulative; that is, what is learned is based on what has been known before. -The adolescent thinks in the abstract and develops skills to participate in complex problem solving. -The adolescent faces many different decisions during the teen years concerning the future and the adult world.
-The adolescent faces many different decisions during the teen years concerning the future and the adult world. Explanation: The main point of Erikson's theory on which the nurse should focus is that the adolescent faces many different decisions during the teen years concerning the future and the adult world. Piaget states that cognitive development is cumulative; that is, what is learned is based on what has been known before. It is true that the adolescent develops many skills during the teen years, which help adolescents make educational and career choices, and that the adolescent thinks in the abstract and develops skills to participate in complex problem solving. These aspects, however, are not central to Erikson's theory.
The nurse is admitting a 15-year-old adolescent to the hospital pediatric unit. What does the nurse recognize as a priority for this adolescent? -The adolescent should be given freedom to participate in unit activities as desired. -The adolescent's need for privacy should be respected. -The adolescent's need for parental support should be discussed. -The adolescent should be encouraged to call friends often.
-The adolescent's need for privacy should be respected. Explanation: When an adolescent is ill or injured, it affects the body and body image. A hospitalized adolescent's primary concerns are pain and the loss of privacy. The adolescent is also anxious about being separated from friends and losing control of one's life. When an adolescent is hospitalized, it is very important the adolescent be given privacy. The adolescent needs individualized attention, confidentiality, and the right to participate in decisions about one's own health care. The adolescent should have contact with friends and be allowed in unit activities. Because the adolescent is under the age of 18, the parents should be involved and informed of the care. The nurse can talk with the adolescent and parents about care decisions and the adolescent's need for support from family.
A nurse is conducting an assessment of a 16-year-old's cognitive development. The nurse determines that the adolescent's cognitive development is within acceptable parameters for the adolescent's age based on which assessment finding? Select all that apply. -uses scientific methods to solve verbal problems -shows a beginning interest and concern with societal and political issues. -demonstrates thinking that the adolescent is invincible -exhibits limited abstract thought processes -able to develop career plans
-uses scientific methods to solve verbal problems -shows a beginning interest and concern with societal and political issues. -demonstrates thinking that the adolescent is invincible Explanation: An adolescent between the ages of 14 to 17 years of age is able to solve verbal and mental problems using scientific methods, thinks he or she is invincible, and becomes involved in and concerned with society and politics. An adolescent between the ages of 11 to 14 years of age has limited abstract thought processes. An adolescent between 17 to 20 years of age develops realistic goals and career plans.
