Human development quiz 8 (chapter 21)

7. Which of the following behaviors is most reflective of a teenager? a. Riding an ATV without a helmet b. Not skiing for fear of falling and getting hurt c. Obeying a new parental rule without a challenge d. Walking away from a group of friends who are smoking cigarettes.

ANS: A A crucial component for understanding adolescent health is an adolescent's own perceptions of health, illness, and health care services. Too often, their sense of invincibility and ―Peter Pan‖ ideology couples with typical adolescent experimentation and risk-taking behaviors to produce deleterious health care choices and outcomes.Teens take unwise risks and they often do things because their friends do it. Therefore, riding an ATV without a helmet and risking a head injury is most reflective of a teenager's behavior. Choices B, C, and d reflect mature judgment regarding risks which characteristic is not particularly typical for teens.

9. During a physical exam, a teenager asks the nurse if she can have a stronger medication for her constipation because the laxatives she has been taking are not helping. During the physical exam, the nurse observes mild to moderate erosion of the tooth enamel. Which of the following disorders is the client most likely experiencing? a. Bulimia nervosa b. Binge eating disorder c. Idiopathic constipation d. Irritable bowel syndrome

ANS: A Bulimia nervosa is characterized by binge eating and then purging by self-induced vomiting and/or laxatives. Vomiting commonly leads to erosion of the tooth enamel. Bulimia nervosa occurs more commonly in females. A teenage girl asking for stronger laxatives combined with an observation of tooth enamel erosion should cause any health care provider to consider the possibility of bulimia nervosa.

According to Erikson, which of the following teenager is at risk for not meeting his developmental task? a. Arrested for petty theft b. Decided he wants to major in accounting c. Has recently broke up with his girlfriend d. Is a member of the varsity basketball team

ANS: A Erikson's theory of psychosocial development describes the central task of adolescence to be the establishment of identity, with the primary risk being role confusion. Teens make choices in social, recreational, volunteer, academic, familial, and occupational activities. The confusion and hesitation in making these choices arise from fears of participating in activities that will not afford them the opportunity to excel or win the approval of their peers. When the threat of identity confusion is exceedingly great, delinquent behavior and alterations in mental health can occur. This threat is enhanced by conditions of poverty, racism, and other social inequities. Choices B, C, and D are all normal teenage activities, which serve to foster identify formation. Petty theft is delinquent behavior and suggests identify confusion according to Erickson's constructs.

After offering a teenager the HPV vaccine, the teenager responds by saying, "I can't have the vaccine because I have already been sexually active." Which of the following statements is the best response by the nurse? a. "You can still benefit from the vaccine, but there is a chance it will not be as effective." b. "The best way to protect yourself now is to make sure all your future sexual partners have received the vaccine." c. "You are correct, the vaccine is only indicated for females who have never been sexually active." d. "It depends on the number of partners you have had. If you have had less than five partners, you are still eligible for the vaccine."

ANS: A HPV vaccination series is recommended for girls and boys at age 11 or 12 years. The vaccine is also recommended for all adolescent girls and women through age 26, who did not receive all three doses of the vaccine when they were younger, and for all adolescent boys and men through age 21 (age 26 if in a sexual relationship with other men) who also did not complete the vaccine series in their younger ages. Ideally, females should get the vaccine before they are sexually active. This is because the vaccine is most effective in girls/women who have not yet acquired any of the HPV types covered by the vaccine. Females who are sexually active may also benefit from the vaccine, but they may receive less benefit since the vaccine will have no effect on HPV types they acquired before vaccine administration. The vaccine protects against HPV-related cancers in both boys and girls.

8. Which of the following is NOT characteristic of anorexia nervosa? a. Increased frequency or heavy menses due to increased ovulation b. Co-morbid depression or anxiety c. Perfectionism d. Compulsive physical activity

ANS: A Most adolescents with an eating disorder experience comorbid psychiatric conditions, such as anxiety, depression or obsessive-compulsive disorder, and suicide ideation is not uncommon. Symptoms or warning signs include a relentless pursuit of thinness, self-starving with significant weight loss, lack of menstruation (in females) and decreased sexual interests (in males), compulsive physical activity, preoccupation with food portioning food carefully, eating only small amounts of only certain foods.

20. Which of the following statements is correct concerning tobacco use in adolescents? a. Smoking is most prevalent in Caucasian teenagers as compared to Blacks and Hispanics. b. Advertising has not been shown as effective in promoting smoking in teens. Rather peer pressure is effective. c. Electronic cigarettes involve flavored liquids with very low levels of actual smoke. d. All of the above statements are correct.

ANS: A Smoking is most prevalent in White males and females than in Black or Hispanic populations. Recently, adolescents have begun using electronic cigarettes (e-cigarettes, vaping). Electronic cigarettes, which are battery operated, vaporize liquid for inhalation through an appliance that resembles a cigarette; there is no smoke involved. Flavored liquid in cartridges, either with or without nicotine, are attractive and available to adolescents. Advertising by the tobacco industry directed at adolescents has been shown to encourage adolescent smoking.

16. Which of the following statements is correct concerning adolescent pregnancies? a. Low birth weight is associated with teen pregnancies. b. Teen pregnancies have increased over the last two decades. c. Blacks have the highest rate of teen pregnancies. d. All of the above statements are correct.

ANS: A The overall teen birth rate has dropped dramatically by approxiamtely 57% over the past two decades, and this has occurred in all ethnic groups. The birth rate is highest in Hispanic teens, followed by non-Hispanic Blacks, American Indian/Alaskan Natives, non-Hispanic Whites, and Asian Pacific Islanders.Adolescent pregnancy has a myriad of negative outcomes from both mother and child. For the mother, these include a significant decline in her future prospects, especially educational andeconomic; single parenthood; reliance on government-sponsored assistance, and poverty. Forthe child born to adolescent mothers there is a higher risk of low birth weight.

Which of the following are symptoms or warning signs of anorexia nervosa? (Select all that apply.) a. Lack of menstruation in females b. Preoccupation with food c. Eating only small amounts of certain foods d. Dramatic weight fluctuations

ANS: A, B, C, D Symptoms or warning signs of anorexia nervosa include the relentless pursuit of thinness, self-starving with significant weight loss, lack of menstruation in females, decreased sexual interests in males, compulsive physical activity, preoccupation with food, portioning food carefully, eating only small amounts of only certain foods, and a distorted body image. Dramatic weight fluctuations are seen with bulimia nervosa.

A teenager has been using acne medications for the last 14 days. Her acne is no better, and in fact, it is a little worse. What information should the nurse offer this girl? a. "Wash your face at least four times a day, making sure to scrub well." b. "The medications can make acne appear worse at first; try to give it a few more weeks" c. "Avoid all chocolate products." d. "Because it is summertime, it would be good for your skin if you lie out in the sun for a few hours each day."

ANS: B Acne is common in adolescents. Evidence indicates that dietary restrictions for acne are unnecessary. Although washing with soap and water is the best way to remove dirt, vigorous scrubbing should be discouraged. Furthermore, although sunlight can have a beneficial effect on acne, prolonged exposure should be avoided. Topical acne products make acne appear worse initially, and improvement occurs slowly over several months. Nurses should provide this information to teenagers planning to use acne products, so they are not discouraged early in therapy.

According to Piaget, which of the following developmental stages is applicable for the teenage years? a. Concrete operational b. Formal operations c. Abstract operations d. Inductive operational

ANS: B Adolescence is characterized by a shift in cognitive abilities to Piaget's stage of formal operations. Piaget's theory used the term formal to represent the emergence of ability to focus on the ―form‖ of thoughts, objects, and experiences rather than on the exact content, which in turn lays the groundwork for abstract thinking. These new cognitive abilities are reflected in adolescent behaviors in several ways. The first change is that, because of their new ability to ―think about their thinking,‖ adolescents become highly introspective.

Which of the following statements concerning sleep patterns in teenagers is correct? a. Adolescents need 7 to 8 h of sleep nightly. b. Electronic devises have been associated with sleep deprivation. c. Extra-curricular sports, like all exercise, help teens maintain adequate sleep. d. All of the above statements are correct.

ANS: B During adolescence, the amount of time needed each night for sleep declines in comparison to earlier childhood needs. Although their sleep patterns vary greatly adolescents need at least 9 h of sleep per night. Adolescents who are employed, those involved in extracurricular sports, and those who have ―too much on their plate‖ are at increased risk for sleep deprivation. They stay up late and are then forced to wake up before their sleep cycles have finished because the high school day has such an early start. Many adolescents send and receive text messages at bedtime after room lights are turned off, which can interfere with a good night's sleep. Even a moderate level of nighttime texting can greatly increase the likelihood of having long-term fatigue.

Which stage of female breast development is characterized by enlargement of the areolar diameter along with a small area of elevation around the papillae? a. 1 b. 2 c. 3 d. 4

ANS: B In stage 2, female breast development is characterized by enlargement of the areolar diameter along with a small area of elevation around the papillae.

Which of the following teenagers is exhibiting a behavior that cause for concern and requires further evaluation? a. Feels happy on most days but on some days she feels sad b. Is agitated and has trouble sleeping c. Has a lot of homework and stays up late to finish it d. Values his friend's opinion more than his parent's opinion

ANS: B Nurses should be aware that the problem of substance abuse exists. They should also be aware of what the signs and symptoms are. Agitation and insomnia are signs of substance abuse and should therefore be evaluated further.

A teenager has a family history of Type 2 diabetes mellitus. He asks the nurse what he can do to try to prevent developing it himself. Which of the following instructions should the nurse give this client? a. Tell him to avoid any and all sweets. b. Tell him to be active, eat a balanced diet, and maintain normal weight. c. Tell him he should talk to his physician about genetic testing. d. Tell him that very little can be done to avoid developing this disorder.

ANS: B Obesity is making Type 2 diabetes mellitus common among teens and young adults. Being overweight and inactive increases the risk. Therefore, encouraging activity, a balanced diet, and maintaining normal weight is the best information the nurse can give to the client. Telling him to avoid all sweets would be a highly impractical if not impossible suggestion. Genetic testing does not detect the development of this disorder.

Which of the following is the SECOND leading cause of death for teens and young adults, 15 to 24 years? a. Accidents b. Suicide c. Bone cancer d. Sport injuries, especially head trauma

ANS: B Suicide has become the second leading cause of death among adolescents, ages 15 to 24 years.

From the perspective of the parents of the teenager, which of the following is an adaptive and beneficial approach to the task of parenting teenagers? a. Set strict rules to prevent the teenager from getting into any trouble. b. Learning how to let go c. Transition from the role of parent to friend/peer d. Drop rules and limits so as to foster maturity and self-determination.

ANS: B The adolescent begins to spend increased time away from the family. Parents sense a narrowing of their influence as their teen not only begins to prefer the company of peers and other adults but also begins to question familial beliefs and values. Parents may respond by setting unreasonably strict limits and asking intrusive questions about their teen's activities, friends, and ideas or decide to drop all rules and limits and assume that the adolescent can now manage alone. Neither of these approaches works well. While adolescents strive for a sense of identity and independence, their parents try to learn how to let go. It is too early to drop the role of parent in favor of becoming a friend. The role of a friend may be appropriate when the child is much older and well into adulthood, possibly raising a family of his/her own. During the teenage years, however, the child still requires effective parenting. During this process, the parents need to increasingly let go as the teen will eventually transition into adulthood.

A nurse is discussing being a safe driver as part of a driver's education course. Which of the following recommendations would the nurse include in this presentation? (Select all that apply.) a. Driving mid-sized two door vehicles is recommended. b. Avoiding talking on cell phones c. Driving during daytime hours d. Wearing safety belt

ANS: B, C, D The risk of motor vehicle crashes is four times higher among 16- to 19-year-old adolescents than among any other age group. Research suggests that distractions, such as talking or texting on cell phones, eating, or playing with the radio, increase teen drivers' risk of being involved in a crash. Nurses should talk to teens about these distractions, which can also include riding with a car full of other teens. Teens have a much higher nighttime crash fatality rate as well. There are no recommendations for choice of cars.

15. Which of the following statements is NOT correct concerning adolescent sexual issues? a. Sexting is becoming an increasingly common practice among teenagers. b. Experimenting with same sex intimacy may put teens at risk for suicide. c. Fantasizing about sexual activities has been shown to lead to promiscuity. d. Anticipatory guidance appropriately includes information about contraception and STDs.

ANS: C Experimenting with same sex physical intimacy does not necessarily predict future sexual orientation, but feelings associated with the possibility of homosexual identity can give rise to anxiety, mood disorders, and heightened risk for suicide. Sexting has been recognized as an increasing occurrence for several years and is a global practice among teens and young adults. Sexting refers to sending a text message with sexually explicit content or a sexually explicit picture. Anticipatory guidance about the decision to become sexually active, to use contraception, and to obtain protection from STIs needs to be provided before adolescents encounter a situation in which they need this information. Fantasizing about sexual activities is a normal behavior for teenagers and does not portend promiscuity. They fantasize about relationships and sex and gradually experiment with dating and a myriad of coital and noncoital physical contacts.

When do females usually begin puberty? a. 1 year before males b. 1 year after males c. 2 years before males d. 2 years after males

ANS: C Females usually begin puberty 2 years before males and experience growth spurts earlier.

19. Which of the following statements is correct regarding substance abuse and teenagers? a. Marijuana is the most frequently abused substance by teenagers. b. Opioid overdosing is on the decline secondary to better education on the hazards. c. Heroin is now purer than in the past, sometimes laced with fentanyl. d. Opioids when legally prescribed are safe and rarely lead to the use of street drugs.

ANS: C Heroin is particularly dangerous because it is purer than in the past and is also frequently laced with fentanyl, a potent pain killer. Alcohol is the substance used most frequently by adolescents, with nearly 35% of adolescents reporting current use on a national survey. Alcohol is followed by marijuana. Opioid overdose is becoming a leading cause of death for people in these age groups. Evidence suggests that use of prescription pain medications can lead to heroin use, and many adolescents become addicted through indiscriminate pain management of a musculoskeletal or other injury.

Which Tanner stage of male genital development is characterized by initial enlargement of the penis, mainly in length along with further growth of the testes and scrotum? a. 1 b. 2 c. 3 d. 4

ANS: C In stage 3, male genital development is characterized by initial enlargement of the penis, mainly in length along with further growth of the testes and scrotum.

A teenager asks the school nurse for advice before getting a tattoo. Which of the following responses would be most appropriate for the nurse? a. "You should only get tattoos which can be covered by clothing on a job interview." b. "It is okay to get a tattoo providing that you only go to a licensed artist." c. "Tattoos are popular; however, they can lead to infection and/or bleeding." d. "A body piercing would be safer and less permanent."

ANS: C Tattoos and piercings carry similar risks, which include localized infection, bleeding, and dermatitis. In addition, tattoos carry a heightened concern for blood-borne disease such as hepatitis and HIV. When providing anticipatory guidance,nurses should offer information needed to make an informed decision. Whether the tattoo can be covered by clothing does not decrease the health risks involved. Not all states offer licensing for tattoo artists. Moreover, patronizing a licensed artist does not negate the risks associated with this potentially hazardous activity.

Parents recently discovered that their teenage daughter has been consuming alcohol on a regular basis. They ask the nurse for advice on how best to help their daughter. In addition to closer supervision to prevent such activity, which of the following recommendations should the nurse give to the parents? a. Talk to their daughter at length regarding the dangers associated with drinking. b. Have her favorite aunt, with whom she is very close, talk to her about drinking. c. Enroll their daughter in a peer support group focused on teenage drinking. d. Provide their daughter with literature regarding the dangers of drinking.

ANS: C Teens do not always consider the health risks of their behavior and have an overall sense of invulnerability to illness or injury. Peer influence is primary, an parental input often is rejected. Parents need, however, to be vigilant in order to recognize when their adolescent needs assistance with avoiding situations that could lead to irreparable harmIn this case, information coming from the parents (choices A and D) are likely to be rejected. Similarly, the favorite aunt, however close may be the relationship, represents anadult authority figure. Since peer influence is a primary motivating factor for teens, the parents should enroll her in a peer support group focused on teenage drinking.

3. The mother of a 13-year-old girl is concerned because her daughter has not started menstruating yet. The girl developed breast buds and started her height spurt at 12 years of age. Which of the following statements would be the most appropriate response from the nurse? a. "Usually, girls start menstruating when they develop breast buds; an endocrine evaluation might be warranted." b. "Everyone is different; it will happen in the near future." c. "Based on when the breast buds first appeared, she should start menstruating around in the age of 14." d. "She will not start menstruating until her breasts are of adult size and contour."

ANS: C The first sign of puberty in females is the appearance of breast buds, followed by a growth spurt. The onset of menstruation occurs approximately 2 years after the appearance of breast buds and near the end of the growth spurt. Thus, based on the age of breast bud appearance, the girl should start menstruating around age 14.

26. A 14-year-old female is in for a physical exam. Which finding requires further investigation? a. A height spurt since her last visit b. Facial acne c. The lack of breast buds or breast development d. Noticeable sweating and body odor with activity

ANS: C The onset of puberty usually begins around 11 to 13 years of age. Stage 2 is the usual time of peak height velocity for girls. Additionally, both sweat and sebaceous glands become more active during adolescence leading to sweat, body odor, and acne. Breast buds also usually appear during stage 2 of puberty. Females who have not begun pubertal development by age 14 should have an endocrine evaluation. Thus, the finding of lack of breast buds on a 14-year-old girl requires further investigation.

Which genetic disorder affecting the x chromosome is found in females? a. Gynecomastia b. Menstruation c. Turner syndrome d. Klinefelter syndrome

ANS: C Turner syndrome affects females and involves alternation of the x chromosome. Often, it is not diagnosed until puberty.

5. Which genetic disorder affecting the x chromosome is found in males and is often diagnosed at puberty? a. Gynecomastia b. Menstruation c. Turner syndrome d. Klinefelter syndrome

ANS: D A disorder affecting the x chromosome affecting males is Klinefelter syndrome. It is often diagnosed in puberty.

A teenager is expecting her menstrual period on May 14. On which of the following dates would the nurse recommend that she perform a self-breast exam? a. May 11 b. May 14 c. May 17 d. May 23

ANS: D The best day to perform a self-breast exam is 2 to 3 days after one's period when breasts are least likely to be tender or swollen. A typical period lasts about 6 days. Thus, a teenager who starts her period on May 14 should perform a breast self-exam on May 23 (14 + 6 = 20 + 3 = 23).