Chapter 10: Adolescents My Nursing Test Banks

Chapter 10: Adolescents

Multiple Choice

1. A mother and daughter are at the well-child clinic for the daughters yearly checkup. The daughter is concerned because she is of shorter stature than most of her friends. She asks the nurse if she will continue to grow like her friends. A question the nurse should ask the girl to identify if growth will continue is:

1. What was the date of your last menstrual cycle?

2. At what age did you start menarche?

3. What is the height of your mother?

4. What type of food do you like to eat in a 24-hour period?

ANS: 2

Feedback
1. The date of the last menstrual cycle does not indicate the growth rate for the teen.
2. From the onset of the first menarche to the stopping of growth is 18 to 24 months.
3. Genetics can be part of the height, but it needs to be evaluated from both parents.
4. Nutrition is important, but not the main indication for the final height.

KEY: Content Area: Sexual Development | Integrated Processes: Communication/Documentation | Client Need: Health Promotion and Maintenance | Cognitive Level: Evaluation | REF: Chapter 10 | Type: Multiple Choice

2. A mother of a 16-year-old boy states that her son is sleeping all the time. The nurse knows that at this age, an adolescent tends to increase in all of the following areas except:

1. Metabolism.

2. Rapid growth.

3. Staying up later at night.

4. Academic requirements.

ANS: 4

Feedback
1. Puberty is a time for increased metabolism because of the rate of growth for teen boys.
2. Rapids growth is occurring during this age.
3. Teens attempt to exert independence in choices and social aspects, such as staying up later at night.
4. Academic requirements are not as important as the social aspect for most teen boys.

KEY: Content Area: Growth | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 10 | Type: Multiple Choice

3. Identify a characteristic of formal operations in a teenager.

1. Believes that they are the center of the world

2. Whatever I want, I get.

3. Planning on attending a university after graduation

4. Wants to feel accepted by the teachers

ANS: 3

Feedback
1. A teen is beyond this thought process.
2. This is an example of a younger child.
3. A teen is planning for the future to set goals.
4. This is an example of a younger child.

KEY: Content Area: Cognitive Development | Integrated Processes: Nursing Process | Client Need: Psychological Integrity | Cognitive Level: Comprehension| REF: Chapter 10 | Type: Multiple Choice

4. An age-appropriate activity for an adolescent would be all of the following except:

1. Coloring.

2. Creating music.

3. A job.

4. Reading.

ANS: 1

Feedback
1. Coloring is appropriate for a younger child.
2. Creating music empowers teens to think abstractly.
3. A job creates responsibility and expectations from people outside of the immediate family.
4. Reading enables the teen to think abstractly and become inquisitive about the environment.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

5. A teenage girl is trying on a skirt that her mother does not approve of wearing. The girl is exhibiting:

1. Intimacy vs Isolation.

2. Identity vs Role Confusion.

3. Industry vs Inferiority.

4. None of the above.

ANS: 2

Feedback
1. The teen has not reached this stage in life yet.
2. The teen is attempting to find herself, thus attempting to test the parents boundaries.
3. A teen is beyond this stage.
4. The teen is exhibiting the process of identifying who she is and the boundaries her mother has set.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

6. Parents of a 15-year-old girl are speaking about the difficulties their daughter has in following the household rules. Which response by the nurse would be the most appropriate?

1. Mood swings are more common in boys than girls, so this is normal.

2. Your daughter is testing the limits. This is a part of normal development. Make sure that you are consistent with your rules, and she will learn to follow them.

3. Girls tend to be more difficult than boys because they want to be the center of attention.

4. She is attempting to get your attention because something is bothering her.

ANS: 2

Feedback
1. Mood swings can occur in both male and female teens.
2. The daughter is attempting to identify herself, and the boundaries that her parents set will demonstrate love for the child.
3. This behavior is not demonstrating a need to have all the attention.
4. Not following the rules does not indicate that something is bothering the child, other than having boundaries.

KEY: Content Area: Growth and Development | Integrated Processes: Teaching/Documentation | Client Need: Psychosocial Integrity | Cognitive Level: Analysis | REF: Chapter 10 | Type: Multiple Choice

7. A nurse is evaluating a 17-year-old boys comprehensive cholesterol laboratory work. The result is 132 mg/dl. The nurse knows that:

1. This is too high, and the boy should get a referral for a nutritionist.

2. This is too high because of the types of foods teens prefer to eat.

3. This is within normal limits, and the boy should continue with the same eating style.

4. This is within normal limits because of the higher level of metabolism in teens.

ANS: 3

Feedback
1. A nutritionist intervention is not needed.
2. The cholesterol level is within normal limits for a teenager.
3. The cholesterol level is within normal limits for a teenager.
4. An overall cholesterol level of 132 mg/dl is adequate at any age range.

KEY: Content Area: Nutrition | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Evaluation| REF: Chapter 10 | Type: Multiple Choice

8. A 15 year old has been an inpatient for the last 24 hours due to dehydration and vomiting. The nurse calculates the adolescents urine output for the shift at 0.3 ml/kg/hour. What does this result indicate?

1. The result is low for this age range, and the patient needs more fluid intake.

2. The result is normal, and the patient needs to maintain the level of fluid intake.

3. The result is high, and an order for fluid restriction should be received.

4. The result is higher than normal, but because of the diagnosis, the same fluid intake is adequate.

ANS: 1

Feedback
1. The urine output is low, and the child needs more fluid intake.
2. The output is not normal. More fluids are needed.
3. The results are low, and the patient should not be fluid restricted.
4. The output is lower than normal, and the patient should have more fluid intake.

KEY: Content Area: Renal | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Analysis | REF: Chapter 10 | Type: Multiple Choice

9. A 14-year-old girl is speaking to the school nurse about getting a belly button piercing. The nurse should educate the girl on:

1. Getting permission from her parents.

2. State laws for piercings.

3. The influence this may have on peers.

4. The nerve damage and infection that can occur with piercings.

ANS: 4

Feedback
1. Permission from her parents can be a decision made by the girl. The nurse needs to provide information on what could occur with a piercing.
2. The piercing establishment is responsible for informing the client.
3. A teen is seeking acceptance from peers, and this would not be appropriate.
4. The side effects of the piercing and teaching on the signs and symptoms of infection should be provided by the nurse.

KEY: Content Area: Growth and Development | Integrated Processes: Teaching/Documentation | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

10. During puberty, all of the following hormones are secreted at an increased rate except for:

1. Estrogen.

2. Androgens.

3. Progesterone.

4. ADH.

ANS: 4

Feedback
1. Estrogen is produced at a higher rate in females.
2. Androgens are produced at a higher rate for sexual maturation.
3. Progesterone is produced at a higher level in females.
4. ADH is not influenced by the execrated growth period.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

11. A growth spurt for boys usually occurs between which ages?

1. 10 to 12 years of age

2. 12 to 14 years of age

3. 14 to 16 years of age

4. 16 to 18 years of age

ANS: 2

Feedback
1. Growth spurts for girls occur during this time.
2. The average age is between 12 to 14 years of age for a large growth spurt for boys.
3. Most boys have started their growth spurt before this time.
4. Most boys have started their growth spurt before this time.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 10 | Type: Multiple Choice

12. In the physical development of a boy, it is common to see:

1. An increase in lean body mass and an increase in adipose body mass.

2. An increase in adipose body mass and a decrease in lean body mass.

3. An increase in lean body mass and a decrease in adipose body mass.

4. A decrease in lean body mass and adipose body mass.

ANS: 3

Feedback
1. Adipose body mass is not common in boys.
2. Lean body mass increases and the adipose tissue decreases during this time for boys.
3. Lean body mass increases and decreased adipose tissue are noted during this time for boys.
4. Lean body mass increases and adipose body mass decreases during this time for boys.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 10 | Type: Multiple Choice

13. A 13-year-old boy presents with gynecomastia. The nurse knows this occurs because of:

1. The increase in adipose tissue at this age.

2. The increase in lean body mass.

3. The increase in sex hormone production.

4. The rapid metabolism at this age.

ANS: 3

Feedback
1. Teenage boys have a decreased amount of adipose tissue.
2. Lean body mass does not influence the occurrence of gynecomastia.
3. Increased sexual hormone production in males can cause an increase in the breast tissue.
4. Gynecomastia is influenced by hormones, not metabolism.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Choice

14. A 13-year-old girl is crying in the nurses office at school because she has thick, white, odorless, discharge in her underwear. She is afraid she has some type of infection. The most appropriate question for the nurse to ask would be:

1. Have you started menstruating yet?

2. When was the last time you had a shower?

3. Have you had sexual intercourse?

4. Do you take birth control pills?

ANS: 1

Feedback
1. The girl is exhibiting signs of leucorrhea, which can occur 3 to 6 months prior to menses.
2. The nurse has not assessed the hygiene of the patient.
3. Assessment of sexual history is important, but the nurse should prioritize the menses cycle because of her age.
4. Assessment of sexual history is important, but the nurse should prioritize the menses cycle because of her age.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Synthesis | REF: Chapter 10 | Type: Multiple Choice

15. A 15-year-old, sexually active teenage girl comes to the outpatient clinic because she did not have her period this month. Upon assessment, the girl is not pregnant. The nurse says that irregular periods:

1. Usually occur because of pregnancy.

2. Can occur for 1 to 2 years after your first menses.

3. Occur because of low stress situations.

4. Are normal and should not be of concern.

ANS: 2

Feedback
1. Periods do not occur if the patient is pregnant.
2. Irregular periods are common for the first two years after a girl starts her menstrual cycle.
3. Irregular periods can occur because of high stress situations, not low stress.
4. Irregular periods are not normal, and the patient should be evaluated if they continue after the first two years after she starts her menstrual cycle.

KEY: Content Area: Growth and Development | Integrated Processes: Teaching/Documentation | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Choice

16. A school nurse is leading a discussion about secondary sex characteristic development. Common characteristics for the adolescent age range are:

1. Development of underarm and lower leg hair.

2. Development of an Adams apple in girls.

3. Enlargement of breast tissue in females.

4. Increasing in height rapidly.

ANS: 1

Feedback
1. Hair growth is a sign of secondary sexual characteristics.
2. Adams apples occur in boys.
3. Enlargement of breast tissue is known as a primary sexual characteristic.
4. Height is not a secondary sexual characteristic.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 10 | Type: Multiple Choice

17. During an assessment, the nurse notes Russells sign on a 15-year-old girl. The nurse should:

1. Report this to the doctor because of possible eating disorder issues.

2. Do nothing. This is a normal sign of development in girls.

3. Document the lacerations and speak to the parents.

4. Ask the teen if she is being abused.

ANS: 1

Feedback
1. A positive Russells sign is a strong indication of an eating disorder.
2. The Russells sign gives indication of the need for medical and psychiatric intervention.
3. Documentation is needed, along with medical intervention.
4. The teen may not be forthright with information, and the doctor needs to be notified.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

18. When administering medication to children and adolescents, it is important for the nurse to remember:

1. Most medications have been tested on adults, not children, so there could be side effects that are not known with a medication.

2. Medication should only be given in pill form for a child.

3. Children should only take less than the prescribed amount of antibiotics for safety.

4. Adolescents understand medication warnings best if written.

ANS: 1

Feedback
1. The metabolism of children is different than adults, thus the nurse should watch for signs and symptoms of the side effects closer.
2. Medication may be given in a variety of forms for children to consume.
3. The fully prescribed amount of medication should be taken.
4. Adolescents understand the medication better if discussed.

KEY: Content Area: Pharmacology | Integrated Processes: Nursing Process | Client Need: Safe and Effective Care Management | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Choice

19. The acronym HEADSS for assessing adolescents stands for:

1. Health, education, activities, sexuality, and safety.

2. Home, education, activities, drugs, sexuality, suicide.

3. Health, education, acne, diet, sexual preference, suicide.

4. Home, education, activities, drugs, sexuality, safe sex.

ANS: 2

Feedback
1. Home and drugs are included in the assessment.
2. All are part of the assessment.
3. Health, acne, and diet are not part of the assessment.
4. Safe sex is not part of the assessment.

KEY: Content Area: Safety | Integrated Processes: Communication | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge| REF: Chapter 10 | Type: Multiple Choice

20. When speaking with a teen about his/her home environment, the assessment should consist of:

1. Review of the relationship with the parents and siblings.

2. Assessing where the child sleeps.

3. Assessing the types of food provided.

4. Assessing school performance.

ANS: 1

Feedback
1. Interactions between family members enable the nurse to assess the primary circle of support.
2. Sleeping arrangements do not give an indication as to the support of the teen.
3. Food is not a part of the primary support.
4. School performance is not part of the home environment assessment.

KEY: Content Area: Safety | Integrated Processes: Communication/Documentation | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

21. A higher incidence in concussions occurs during adolescence. The reason for this increase is:

1. The lack of knowledge about brain trauma.

2. Inadequate use of a helmet during contact sports.

3. A feeling of being invincible.

4. A teen does not care about health.

ANS: 2

Feedback
1. There is significant research about brain trauma in adolescents.
2. Adolescent players do not take safety seriously, thus do not wear the safety devices correctly.
3. Teens feel invincible, but it is not the reason for higher incidence of concussions.
4. Teens generally have a sense of their personal health.

KEY: Content Area: Safety | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

22. The nurse has assessed a 16-year-old for cigarette smoking. The adolescent admits to smoking several times a day. A priority question to follow up with is:

1. How often does the patient cough?

2. How long has the patient been smoking?

3. How does the patient obtain the cigarettes?

4. How many other substances does the patient use?

ANS: 4

Feedback
1. Assessment of coughing does not relate to the amount of cigarettes consumed.
2. The length of time for smoking for a teen is not lengthy enough to cause long-term damage.
3. Identifying the source for the cigarettes is not a priority at this point.
4. Cigarettes are a gateway substance that can lead to the use of other substances and should be assessed at this time.

KEY: Content Area: Growth and Development | Integrated Processes: Communication/Documentation | Client Need: Health Promotion and Maintenance | Cognitive Level: Analysis| REF: Chapter 10 | Type: Multiple Choice

23. The nurse is working on a study of obesity in adolescents. The nurse knows that if a child is obese in the adolescent years, than in the adult years, the patient has a _________ percent chance of obesity.

1. 90

2. 20

3. 80

4. 60

ANS: 3

Feedback
1. The incidence is not this high.
2. 20 percent is too low of a rate.
3. 80 percent is the rate for a chance of obesity in adulthood.
4. The incidence is too low.

KEY: Content Area: Nutrition | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

24. Obese adolescents are at an increased risk for developing all of the following except:

1. Type 1 diabetes.

2. Gastro esophageal reflux.

3. Sleep apnea.

4. Hyperlipidemia.

ANS: 1

Feedback
1. Type 1 diabetes is not caused by obesity. Type 2 is caused by obesity.
2. Reflux is a common issue in individuals who are obese.
3. Sleep apnea occurs in obese individuals.
4. Hyperlipidemia can occur in obese adolescents because of fatty food choices.

KEY: Content Area: Nutrition | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

25. When speaking to a group of 16-year-old boys about sexual intercourse, the nurse should include information about:

1. Birth control options.

2. Oral sex is a form of sex and should not be considered safer.

3. Vaginal and oral sexual intercourse are safer than rectal sexual intercourse.

4. HIV testing should only occur after the age of 20.

ANS: 2

Feedback
1. A teenage boy should be concerned about birth control, but this is not the priority answer.
2. Explaining the difference and the risks for oral sex is the priority teaching.
3. One form of intercourse is not safer than the other.
4. HIV testing needs to be done if the teen is sexually active with multiple partners.

KEY: Content Area: Sexuality/Reproduction | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application| REF: Chapter 10 | Type: Multiple Choice

26. The leading cause of death in adolescent males is:

1. Suicide.

2. Motor vehicle accidents.

3. Falls.

4. Homicide.

ANS: 4

Feedback
1. The leading cause is not suicide.
2. The leading cause is not MVAs.
3. The leading cause is not falls.
4. The leading cause of death is homicide.

KEY: Content Area: Safety | Integrated Processes: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge | REF: Chapter 10 | Type: Multiple Choice

27. A nurse is assessing a 14-year-old boy who has been admitted for an exacerbation of sickle cell disease. The nurse is assessing the cognitive ability of the teen. The nurse must remember to include all of the following except:

1. Assessing the developmental age, not the chronological age.

2. Assessing the interactions between the patient and peers.

3. Assessing how the child responds to the physical assessment.

4. Assessing the physical maturation of the teen.

ANS: 4

Feedback
1. Developmental age determines the cognitive ability of the teen. The chronological age does not take the cognitive ability into account.
2. Interactions will indicate the cognitive ability of the teen.
3. The physical assessment will give the nurse a chance to use questions and responses to assess the cognitive ability of the teen.
4. The physical maturation will not give an indication as to the cognitive ability of the teen.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Assessment | Client Need: Physiological Integrity | Cognitive Level: Analysis | REF: Chapter 10 | Type: Multiple Choice

28. A school nurse is giving information about the use of alcohol and partying activities for teen girls. The nurse should include which of the following in her teaching?

1. Oral sexual encounters increase with the use of alcohol.

2. A teen girl increases her chance for sexual assault when using alcohol.

3. Boys have a higher sex drive when alcohol is being consumed.

4. Alcohol causes teen girls to be outgoing.

ANS: 2

Feedback
1. Oral sex can occur with or without the use of alcohol.
2. Alcohol can inhibit cognitive reasoning and can cause a woman to be seen as easy.
3. Sexual drive in boys versus girls is the same when using alcohol.
4. Alcohol can cause teenage girls to have increased mood swings and become weepy.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

29. Common drugs used for date rape in teens include all of the following except:

1. Hydroxybutyrate.

2. Ketamine.

3. Flunitrazepam.

4. Diazepam.

ANS: 4

Feedback
1. A common drug used in date rape.
2. A common drug used in date rape.
3. A common drug used in date rape.
4. Not seen often as a date rape drug.

KEY: Content Area: Pharmacology | Integrated Processes: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge |  REF: Chapter 10 | Type: Multiple Choice

30. Cessation of menstrual periods after an established pattern of regularity could be an indication of:

1. Too much meat in the diet.

2. Deliberate food restriction.

3. Venereal diseases.

4. Late onset puberty.

ANS: 2

1. Could indicate a drop in body fat due to excessive exercising, deliberate food restriction/eating disorder, or illness
2. Could indicate a drop in body fat due to excessive exercising, deliberate food restriction/eating disorder, or illness
3. A venereal disease will not cause a difference in menstrual periods.
4. Late onset puberty will not cause a cessation of menstrual periods.

KEY: Content Area: Nutrition | Integrated Processes: Teaching/Learning | Client Need: Physiologic Integrity | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

31. During puberty, expected male anatomical changes include:

1. Growth plates closing by age 16.

2. Gynecomastia.

3. Enlargement of the scrotum.

4. Decrease in lean body mass.

ANS: 3

Feedback
1. Growth plates close by age 20.
2. Gynecomastia refers to abnormal breast development in boys.
3. The scrotum and penis enlarge in boys during puberty.
4. During adolescence, lean body mass will increase in boys.

KEY: Content Area: Growth and Development | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

32. Russells sign in an adolescent is a strong indication of:

1. Scoliosis.

2. Anorexia.

3. Bulemia.

4. STDs.

ANS: 3

Feeback
1. Scoliosis affects the back and does not have the Russells sign.
2. Anorexia is an eating disorder characterized by food restriction.
3. Russells sign is abrasions or cuts on the knuckles from sticking fingers down throat to induce vomiting.
4. STDs are not related to the Russells sign.

KEY: Content Area: Nutrition | Integrated Processes: Teaching/Learning | Client Need: Physiologic Integrity | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

33. An accurate cultural assessment during a physical exam by the practitioner would include being knowledgeable about which of the following developmental characteristics of African American girls?

1. Breast development starts earlier than in girls of other cultures.

2. Native tongue language is always spoken among family members.

3. African American girls reach puberty by age 10.

4. Adipose tissue decreases at the onset of puberty.

ANS: 1

Feedback
` Breast development starts in African American girls earlier than in girls of other cultures.
2. African American girls speak English.
3. Breast development may begin earlier, but full puberty does not occur at this age.
4. Adipose tissue may increase in some girls that are African American.

KEY: Content Area: Wellness/Cultural Diversity | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Choice

34. Parent education on Internet safety states that parents should be concerned if their teen:

1. Gets unexplained phone calls late at night.

2. Quickly changes the monitor screen when you enter the room.

3. Receives gifts from an unknown person.

4. All of the above.

ANS: 4

Feedback
1. Signs that an adolescent is engaging in risky online behavior include initiating or receiving calls from individuals unknown to the caregiver.
2. Signs that an adolescent is engaging in risky online behavior are quickly changing the monitor screen when the caregiver approaches the computer.
3. Signs that an adolescent is engaging in risky online behavior include receiving mail/gifts from an unknown person.
4. Signs that an adolescent is engaging in risky online behavior include initiating or receiving calls from individuals unknown to the caregiver, receiving mail/gifts from an unknown person, and quickly changing the monitor screen when the caregiver approaches the computer.

KEY: Content Area: Wellness | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Synthesis | REF: Chapter 10 | Type: Multiple Choice

35. A student nurse verbalizes understanding of medication administration in adolescents when she states:

1. Teens absorb medication at the same rate as adults.

2. Most approved medications are safe for kids too.

3. Medications are metabolized faster by a patient in puberty.

4. Puberty has no effect on the elimination of medications.

ANS: 3

1. After puberty, medication metabolism decreases to adult levels. Until that time, the teen will have a higher metabolism.
2. Over 75percent of medications are not approved for use in pediatric patients.
3. Most medications are metabolized faster by a patient in puberty.
4. Metabolizing medications is affected by puberty.

KEY: Content Area: Pharmacological | Integrated Processes: Teaching/Learning | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Choice

36. A worrisome concern identified by the nurse during a social assessment of a teen at a routine appointment would be which response from the teen?

1. Constantly wanting to be with friends

2. Verbalizing that the mom is the teens best friend

3. Wanting independence from family/caregivers

4. Exploring different religious venues

ANS: 2

1. Social development includes socializing in cliques of the same sex and striving for peer acceptance.
2. Normal social development includes conflict between adolescents and caregivers.
3. Social development includes wanting independence from caregivers.
4. Adolescents may start to question/disagree with the religious beliefs of the family.

KEY: Content Area: Family Dynamics/Support Systems | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Choice

37. You are preparing your 12-year-old patient for surgery tomorrow. Important concepts to remember regarding procedures include:

1. Maintaining confidentiality.

2. Educating the patient on the pain scale and comfort measures.

3. Providing explanations and rationale to the patient and parents.

4. All of the above.

ANS: 4

1. Nursing care procedures include maintaining patient confidentiality.
2. Nursing care procedures being honest about the potential for discomfort/pain.
3. Nursing care procedures include explaining rationales to the family and patient.
4. All of the above are appropriate nursing concerns regarding procedures.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

38. When assessing home safety of the adolescent, it is essential to ask about all of the following except:

1. Living arrangements.

2. If they feel safe at home.

3. Family income.

4. Relationships with siblings.

ANS: 3

1. Assessment of the home includes asking where the adolescent lives.
2. Assessment of the home includes asking about violence in the home.
3. Assessment of the home does not include family income because all levels of income can have an unsafe living environment.
4. Assessment of the home includes asking about the relationships with siblings.

KEY: Content Area: Safety | Integrated Processes: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Analysis | REF: Chapter 10 | Type: Multiple Choice

39. Leading causes of mortality in adolescents include:

1. Homicide and suicide.

2. Drowning.

3. Cancer.

4. Sports-related injuries.

ANS: 1

Feedback
1. Leading causes of death in adolescence are motor vehicle accidents, homicide, and suicide.
2. Drowning is not the leading cause of mortality in this age range.
3. Cancer is not the leading cause of mortality in this age range.
4. Sports-related injuries rarely result in death.

KEY: Content Area: Accident/Injury Prevention | Integrated Processes: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

40. As a nurse, you are asked to educate your daughters sixth grade class on injury prevention. Which topic would not be appropriate to discuss in this setting?

1. Seat belts

2. Protective sports gear, such as helmets

3. Safe sex

4. Water safety

ANS: 3

Feedback
1. Activities to provide information on regarding knowledge of safety prevention include wearing a seatbelt.
2. Activities to provide information on regarding knowledge of safety prevention include wearing protective gear, such as helmets, in order to prevent sports injuries.
3. Safe sex would not be appropriate to discuss. Activities to provide information on regarding knowledge of safety prevention include wearing a seatbelt, water safety, and wearing protective gear, such as helmets, to prevent sports injuries.
4. Activities to provide information on regarding knowledge of safety prevention include water safety.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Choice

41. CRAFFT is the most reliable and valid screening tool used in adolescents to assess for:

1. Alcohol and substance abuse.

2. Mental health emergencies.

3. High-risk behaviors.

4. Eating disorders.

ANS: 1

Feedback
1. CRAFFT was founded to be the most reliable and valid screening tool with adolescents for alcohol/substance use.
2. The assessment tool is not used for mental health emergencies.
3. The tool may identify abuse issues, but not risks.
4. Eating disorders are not identified using this scale.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

42. In establishing a nurse-patient relationship, the following boundaries should be observed except: 

1. Being nonjudgmental.

2. Using humor appropriately.

3. Developing trust.

4. Being a friend.

ANS: 4

Feedback
1. Establishing boundaries in a nurse-patient relationship includes being nonjudgmental.
2. Establishing boundaries in a nurse-patient relationship includes using humor appropriately.
3. Establishing boundaries in a nurse-patient relationship includes developing trust.
4. In establishing boundaries in a nurse-patient relationship, the nurse is not the adolescents friend, but a professional helper.

KEY: Content Area: Communication | Integrated Processes: Communication/Documentation | Client Need: Psychosocial Integrity | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Choice

43. Assessing the Hospital Environment of Care for the adolescent should include:

1. Personalizing their room.

2. Decorating the walls with Toy Story prints.

3. Allowing for privacy.

4. Removing all chairs and extra furniture from the room.

ANS: 3

Feedback
1. Environment of Care includes being aware that pediatric inpatient units are often geared toward younger children.
2. Posters with rock stars, popular actors, and famous athletes are preferred decorations over cartoon characters.
3. Allow for privacy by implementing curtains between bed spaces and locks on the bathroom door.
4. Comfortable furniture should be provided, with extra chairs for when family and peers visit.

KEY: Content Area: Therapeutic Environment | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Choice

44. Activities appropriate for the adolescent care unit might include all except:

1. Access to snacks and beverages if there are no dietary restrictions.

2. 5-year-old roommate.

3. Private telephone conversations.

4. Availability to games, such as pool tables.

ANS: 2

Feedback
1. If not on a diet or activity restriction, offer kitchen access so that the adolescents can obtain beverages and snacks independently.
2. Adolescents prefer other adolescents as roommates. Avoid wide variation in ages during roommate selection.
3. Offer private telephone access.
4. Offer access to games that release physical energy, such as pool tables.

KEY: Content Area: Therapeutic Environment | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Choice

45. The most effective method for teaching adolescents is:

1. One-on-one verbal discussion.

2. Written handouts.

3. Web site access.

4. Review content with parent only.

ANS: 1

Feedback
1. Adolescents prefer one-to-one verbal dissemination of health education by a nurse rather than written materials, videos, or websites.
2. Written handouts are not effective and are often discarded.
3. Web sites may not offer the correct information, and the adolescent may not want to be seen on the Web sites.
4. Adolescent education includes providing education to both the patient and family.

KEY: Content Area: Wellness | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Choice

46. When educating parents on the care of their chronically ill child, the nurse should:

1. Encourage the childs dependence on the parents.

2. Coordinate services between health-care providers, school, and home.

3. Discourage the use of Internet resources.

4. Address chronological age factors.

ANS: 2

Feedback
1. Care for the chronically ill adolescent includes promoting self-care and functional independence.
2. Care for the chronically ill adolescent includes coordinating services between health-care providers, school, and home. Nurses should facilitate the transition from hospital to home.
3. Care for the chronically ill adolescent includes referring families and adolescents to appropriate Internet resources.
4. Psychosocial developmental care for the chronically ill adolescent includes using developmental, rather than chronological, age, as there may be some developmental delays.

KEY: Content Area: Wellness | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Choice

47. A potential barrier to effective home care for a chronically ill child would be:

1. Home care increases family satisfaction.

2. Home care provides increased opportunities for socializing.

3. Home care decreases financial costs, travel costs, and caregiver burden.

4. Home care providers may feel anxious regarding administration of medications and treatments.

ANS: 4

Feedback
1. Home care does increase family and adolescent satisfaction.
2. Adolescents may have increased opportunities for socializing with peers and participating in school/extracurricular activities as a result of having health-care needs met in the home.
3. Homecare does decrease financial costs, travel costs, and caregiver burden.
4. This is a potential barrier. Caregivers may feel anxious about having to administer treatments/medications.

KEY: Content Area: Illness Management | Integrated Processes: Nursing Process | Client Need: Physiologic Integrity | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Choice

48. Which of the following statements is true regarding the use of complimentary/alternative medicines (CAM) and adolescents?

1. Adolescents openly discuss their use of CAM.

2. CAM interactions with prescription and over-the-counter medications can lead to toxic effects.

3. Half of adolescents have used CAM.

4. Family and peer use of CAM has no influence on adolescent use.

ANS: 3

Feedback
1. Adolescents are often reluctant to discuss their use of CAM.
2. Interactions with prescription and over-the-counter medications can lead to toxic or sub-therapeutic effects.
3. Nearly 80% of adolescents have used CAM therapies in their lifetime.
4. If an adolescent reports use by a close family member or peer, then he/she is more likely to also use CAM.

KEY: Content Area: Chemical Dependencies | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

49. Items considered to be complimentary/alternative medicines (CAM) include all of the following except:

1. Dietary and herbal supplements.

2. Prescribed medications.

3. Home remedies.

4. Yoga.

ANS: 2

Feedback
1. Dietary and herbal medications are considered CAM. They are not regulated by the FDA and have wide variations in content and dosage across manufacturers.
2. Prescribed medications are not CAM. These are regulated by the FDA.
3. Common home remedies used by adolescents, such as honey, lemon, and green tea, are considered CAM.
4. Yoga is a commonly used alternative therapy among adolescents.

KEY: Content Area: Chemical Dependency | Integrated Processes: Learning/Teaching | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

50. When caring for an adolescent, all of the following are helpful safety strategies for avoiding sexual assault except:

1. Staying in public areas.

2. Avoiding alcohol.

3. Traveling with a group of friends.

4. Engaging in risky behaviors.

ANS: 4

Feedback
1. Nurses should reinforce safety strategies for avoiding sexual assault, such as staying in public places.
2. Nurses should reinforce safety strategies for avoiding sexual assault, such as avoiding alcohol/substance use.
3. Nurses should reinforce safety strategies for avoiding sexual assault, such as going out with a group of friends.
4. Engaging in risky behaviors in not a safety strategy for avoiding sexual assault.

KEY: Content Area: Abuse | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Choice

51. The American Academy of Pediatrics recommends yearly health maintenance visits with a primary care physician (PCP) for adolescents starting at age 11:

1. until 15 years old.

2. until 18 years old.

3. until 21 years old.

4. only when ill.

ANS: 3

Feedback
1. The recommendation is up to 21 years of age.
2. The recommendation is up to the 21 years of age.
3. The American Academy of Pediatrics recommends yearly health maintenance visits with a primary care provider for adolescents between ages 11 and 21.
4. The American Academy of Pediatrics recommends yearly health maintenance visits with a primary care provider for adolescents between ages 11 and 21.

KEY: Content Area: Wellness | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

52. Leukorrhea, a thick, white vaginal discharge, is seen

1. Prior to each menstrual cycle.

2. 3 to 6 months before menarche.

3. In sexually active teens.

4. In early teen pregnancy.

ANS: 2

Feedback
1. Leukorrhea, a thick, white discharge from the vagina, is seen 3 to 6 months before menarche.
2. Leukorrhea, a thick, white discharge from the vagina, is seen 3 to 6 months before menarche.
3. Leukorrhea can occur when an adolescent is sexually active, depending on if menarche has occurred.
4. Discharge during pregnancy should not occur.

KEY: Content Area: Growth and Developmental | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

53. When assessing a 15 year old, a practitioner would place her in which Erickson psychosocial development stage?

1. Identity vs Role Confusion

2. Intimacy vs Isolation

3. Industry vs Inferiority

4. Impulsivity vs Self-conflict

ANS: 1

Feedback
1. Ericksons psychosocial development stage for ages 12 to 18 is Identity vs Role Confusion.
2. Ericksons psychosocial development stage for the age of 19 is Intimacy vs Isolation.
3. Ericksons psychosocial development stage for ages 10 to 12 is Industry vs Inferiority.
4. Ericksons psychosocial development for ages 12 to 18 is Identity vs Role Confusion.

KEY: Content Area: Growth and Developmental | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Multiple Choice

54. TB screenings for at risk adolescents would not include those who:

1. Have been incarcerated.

2. Test positive for HIV.

3. Are from non-U.S. countries.

4. Live with their grandparents.

ANS: 4

Feedback
1. Tuberculosis screenings for at risk adolescents include those who have been incarcerated.
2. Tuberculosis screenings for at risk adolescents include those who are HIV positive.
3. Tuberculosis screenings for at risk adolescents include those who are from countries outside of the United States.
4. Tuberculosis screening for at risk adolescents would not include those living with their grandparents.

KEY: Content Area: Wellness | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Choice

Matching

55. When viewing physical development, an adolescent boy will reach Tanners stage 5 of sexual maturation in which order? (Number the following in the correct order)

__ Growth of axillary hair

__ Change in voice

__ Appearance of pubic hair

__ Downy hair on the upper lip

__ Increase in size of the testes and scrotum

__ Rapid growth of genitalia

ANS: 4, 6, 2, 5, 1, 3

KEY: Content Area: Sexual Development | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Synthesis | REF: Chapter 10 | Type: Matching

Fill in the Blank

56. A teen is being influenced by a peer to smoke marijuana. This teen is in the ___________________ vs ___________________ stage of psychosocial development.

ANS: Identity, Role Confusion

Feedback: The teen is attempting to identify with his/her peers and follow the role that parents have previously set.

KEY: Content Area: Growth and Development | Integrated Processes: Psychosocial | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | REF: Chapter 10 | Type: Fill in the Blank

Multiple Response

57. The rapid growth of teens makes it important for them to receive increased amounts of which of the following minerals in their diet? Select all that apply.

1. Iron

2. Zinc

3. Calcium

4. Sodium

5. Potassium

ANS: 1, 3

Feedback
1. A higher metabolism needs the increased amount of iron.
2. Zinc needs are minimally affected by higher metabolism rates.
3. A higher metabolism needs the increased amount of calcium.
4. Sodium needs are minimally affected by higher metabolism rates.
5. Potassium needs are minimally affected by higher metabolism rates.

KEY: Content Area: Nutrition | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 10 | Type: Multiple Response

58. Common reactions of teen girls with premenstrual syndrome are: (Select all that apply.)

1. Crying.

2. Hallucinations.

3. Breast tenderness.

4. Weight gain.

5. Feeling bloated.

ANS: 1, 3, 5,

Feedback
1. Common in teens with premenstrual syndrome.
2. Not common in teens with premenstrual syndrome.
3. Common in teens with premenstrual syndrome.
4. Not common in teens with premenstrual syndrome.
5. Common in teens with premenstrual syndrome.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 10 | Type: Multiple Response

59. The nurse is assessing the education of a 17-year-old girl. The nurse knows the influence of school can: (Select all that apply.) 

1. Create a sense of well-being and success if in a positive environment.

2. Determine career choices.

3. Determine the need for peer acceptance.

4. Create anxiety for the girl and should be avoided.

5. Cause self-doubt if not socially accepted by peers.

ANS: 1, 2, 3, 5

Feedback
1. Positive environments increase the teens responses.
2. Specific courses aid in finding an area of interest for teens.
3. Peer acceptance is important at this age.
4. Avoiding situations because of anxiety does not lead to a positive influence.
5. Self-doubt can occur if the teen does not develop a group of friends.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | REF: Chapter 10 | Type: Multiple Response

True/False

60. A 17 year old needs guardian consent for medical procedures.

ANS: T

Feedback
1. A teen must be 18 years old to be classified as an adult for medical procedures, thus a guardian must consent for procedures.
2. A teen must be 18 years old to be classified as an adult for medical procedures, thus a guardian must consent for procedures.

KEY: Content Area: Legal | Integrated Processes: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | REF: Chapter 10 | Type: True/False

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