Chapter 20: The Adolescent My Nursing Test Banks

Chapter 20: The Adolescent

Elsevier items and derived items 2007 by Saunders, an imprint of Elsevier Inc.

MULTIPLE CHOICE

1. When assessing a 13-year-old boy, the nurse would keep in mind physical changes in the pubertal male, beginning with:

a.

Development of axillary and facial hair

b.

Enlargement of pectoral muscles

c.

Enlargement of testicles

d.

Voice changes

ANS: C

In boys, pubertal changes begin with enlargement of the testicles and internal structures.

DIF: Cognitive Level: Comprehension REF: Text Reference: 447

OBJ: Objective: 4 TOP: Topic: Physical Development

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

2. A 13-year-old boy states, The girls in my class tower over me. The nurses most informative response would be:

a.

It may seem that way because girls have a growth spurt 2 years earlier than boys.

b.

Perhaps your parents are not exceptionally tall.

c.

Boys usually experience a growth spurt 1 year earlier than girls.

d.

You may feel short, but you are actually average height for your age.

ANS: A

Although the age for growth spurts during puberty varies, growth spurts occur 2 years earlier for girls than for boys.

DIF: Cognitive Level: Application REF: Text Reference: 445

OBJ: Objective: 4 TOP: Topic: Physical Development

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

3. A parent comments that her adolescent daughter seems to be daydreaming a lot these days. The nurse understands that this behavior indicates she is:

a.

Bored

b.

Not getting enough rest

c.

Trying to block out stress and anxiety

d.

Mentally preparing for real situations

ANS: D

Daydreaming allows adolescents to act out in their imaginations what will be said or done in certain situations. This helps them to prepare for and cope with interactions with others.

DIF: Cognitive Level: Analysis REF: Text Reference: 453

OBJ: Objective: 4 TOP: Topic: Development-Daydreams

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

4. The nurse planning a safety program for high school students should understand that most accidental deaths in adolescence are related to:

a.

Firearms

b.

Automobiles

c.

Drowning

d.

Diving injuries

ANS: B

The chief safety hazard for the adolescent is automobiles.

DIF: Cognitive Level: Knowledge REF: Text Reference: 458

OBJ: Objective: 11 TOP: Topic: Safety

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

5. A 16-year-old excitedly tells his parents that he was offered a part-time job. Which response represents an effective problem-solving approach for his parents?

a.

Your studies are too important for you to have a part-time job.

b.

When we went to high school, academics were the teenagers priority.

c.

We want you to put your earnings in a savings account.

d.

How do you think you will manage your school work and a job?

ANS: D

An effective approach to help adolescents learn to solve problems is for parents to guide them in exploring alternatives.

DIF: Cognitive Level: Application REF: Text Reference: 454

OBJ: Objective: 11 TOP: Topic: Parenting

KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

6. One psychosocial task of adolescence on which the nurse must focus when planning care, is the development of a sense of:

a.

Initiative

b.

Industry

c.

Identity

d.

Involvement

ANS: C

Psychosocial milestones that must be accomplished during adolescence include the five Isimage of self, identity, independence, interpersonal relationships, and intellectual maturity.

DIF: Cognitive Level: Knowledge REF: Text Reference: 445, Box 20-1

OBJ: Objective: 2 TOP: Topic: Psychosocial Development

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

7. A 13-year-old female tells the school nurse that she is getting fat, especially in her hips and legs. The understanding by the nurse that would best guide the response is:

a.

Many teenagers are unaware of proper nutrition.

b.

Teenagers of this age become less active and should eat fewer calories.

c.

Puberty is often preceded by fat deposits in these areas.

d.

As soon as menarche occurs, she will lose this excess weight.

ANS: C

Secondary sexual characteristics become apparent before menarche. Fat is deposited in the hips, thighs, and breasts, causing them to enlarge.

DIF: Cognitive Level: Analysis REF: Text Reference: 449, Box 20-2

OBJ: Objective: 4 TOP: Topic: Physical Development

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

8. The school nurse is planning a program for girls about the physical changes of puberty; this program should be directed to girls of the age:

a.

16 years

b.

14 years

c.

12 years

d.

10 years

ANS: D

Because puberty can occur in girls as early as age 10 years, instruction must be given by that age.

DIF: Cognitive Level: Comprehension REF: Text Reference: 454

OBJ: Objective: 4 TOP: Topic: Physical Development

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

9. The statement made by a parent indicating understanding about helping a 13-year-old manage allowance money is:

a.

I set amounts he can earn for particular chores.

b.

I give him a certain amount of money for each day.

c.

I put money into his bank account each month.

d.

I told him to ask me when he needs money.

ANS: A

If money is simply handed out as requested, it is difficult to develop responsibility for finances and money management. The older adolescent is able to get a job. The younger teen can earn money by doing particular chores.

DIF: Cognitive Level: Application REF: Text Reference: 453

OBJ: Objective: 4 TOP: Topic: Development-Responsibility

KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

10. The nurse suggests a good dietary source of zinc for an adolescent who is a vegetarian would be:

a.

Green, leafy vegetables

b.

Citrus fruits

c.

Nuts

d.

Enriched breads

ANS: C

Zinc is essential for growth and sexual maturation in adolescence. Good vegetable sources include nuts, legumes, and wheat germ.

DIF: Cognitive Level: Comprehension REF: Text Reference: 457

OBJ: Objective: 9 TOP: Topic: Nutrition

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

11. An adolescents parent comments, My son seems so preoccupied with his appearance these days. Is this normal? The nurses best response would be:

a.

It is his attempt to express his individualism.

b.

His preoccupation with his looks is quite normal.

c.

He is probably troubled with his physical changes.

d.

This shows that he has a positive self-image.

ANS: B

Preoccupation with self-image is normal and accounts for the constant primping of teenagers.

DIF: Cognitive Level: Application REF: Text Reference: 445

OBJ: Objective: 4 TOP: Topic: Development

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

12. Foods that would be a healthy choice for an adolescent who just finished playing in a strenuous game would be:

a.

Cheeseburger and soda

b.

Hot fudge sundae

c.

Two Egg McMuffins and orange juice

d.

Bagel and skim milk

ANS: D

A bagel provides a rapid supply of carbohydrates to the muscles, and skim milk provides a slow release of carbohydrates to the muscles.

DIF: Cognitive Level: Application REF: Text Reference: 457

OBJ: Objective: 9 TOP: Topic: Nutrition

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

13. When planning to answer a 16-year-old girls questions about menstruation, the nurse must consider cognitive development. According to Piaget, the cognitive aspect that is developed during adolescence is the ability to:

a.

View a situation from multiple perspectives

b.

Focus more on the past than present situations

c.

Exercise concrete reasoning

d.

Consider hypothetical situations

ANS: D

According to Piaget, in the formal operations stage adolescents have the ability to think abstractly.

DIF: Cognitive Level: Comprehension REF: Text Reference: 445, Box 20-1

OBJ: Objective: 4 TOP: Topic: Cognitive Development

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

14. A girl tells the nurse that she and her best friend belong to the popular clique. She states, I love Britney Spears and I want to be a singer. The nurse recognizes the girls statement as characteristic of peer relationships in:

a.

Early adolescence

b.

Middle adolescence

c.

Late adolescence

d.

Entire adolescent period

ANS: A

Cliques of unisex friends, having a best friend, and hero worship are characteristics of the early adolescent.

DIF: Cognitive Level: Comprehension REF: Text Reference: 452

OBJ: Objective: 4 TOP: Topic: Social Development

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

15. The nurse is leading a discussion group with parents of adolescents. One parent comments, My son cant do anything without checking with his friends first. My opinion doesnt count anymore. The nurse would formulate a response on the knowledge that this behavior is:

a.

Unusual for adolescent boys

b.

Often more apparent in boys than girls

c.

A normal phenomenon during adolescence

d.

Suggestive of feelings of low self-worth

ANS: A

Parents may need help understanding that the teenagers exaggerated conformity is necessary for moving away from dependence and obtaining approval from persons outside the nuclear family.

DIF: Cognitive Level: Application REF: Text Reference: 452

OBJ: Objective: 4 TOP: Topic: Peer Relationships

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

16. The nurse points out to a group of parents that the most positive developmental significance of a peer group to the adolescent is that the group serves as:

a.

A social outlet

b.

An association to blur personal identity

c.

A platform for group think

d.

An initial separation from family

ANS: D

Being a member of a peer group and communicating with and seeking approval from this group are the first separation from the family.

DIF: Cognitive Level: Analysis REF: Text Reference: 461

OBJ: Objective: 10 TOP: Topic: Peer Groups

KEY: Nursing Process Step: N/A

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

17. The nurse understands that the adolescents avid sexual orientation to be based on Freuds theory, which describes adolescence as the _____ stage.

a.

Conceptual

b.

Genital

c.

Glandular

d.

Pubertal

ANS: B

Freud describes the adolescent period as genital.

DIF: Cognitive Level: Knowledge REF: Text Reference: 445, Box 20-1

OBJ: Objective: 3 TOP: Topic: Freud

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

18. The nurse using the PACE interview guide for persons at risk for substance abuse arrives at a score of 2 for an adolescent patient. The nurse should assess this score as:

a.

Nonindicative of potential substance abuse

b.

Normal experimentation of the adolescent

c.

Need to schedule another PACE interview in 3 months

d.

Indication for referral for counseling

ANS: D

The PACE guide recommends that a score of 2 or higher would suggest the need for a referral for counseling about substance abuse.

DIF: Cognitive Level: Knowledge REF: Text Reference: 445

OBJ: Objective: 4 TOP: Topic: PACE Interview

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

MULTIPLE RESPONSE

1. The nurse explains that the restlessness seen in the adolescent is, in part, attributable to:

Select all that apply.

a.

Drive to be accepted by society as an individual

b.

Surge for independence

c.

Establishment of a personal identity

d.

Intense libido

e.

Rapid body changes

ANS: A, B, C, D, E

All the options listed are sources of stress to the adolescent and are stimulants to restlessness.

DIF: Cognitive Level: Comprehension REF: Text Reference: 444

OBJ: Objective: 2 TOP: Topic: Sources of Stress for the Adolescent

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

2. The nurse teaching a seminar on teen pregnancy tells the parents that they should be alert for indications of a child concealing a pregnancy with such behaviors as:

Select all that apply.

a.

Wearing baggy clothes

b.

Wearing excessive makeup

c.

Dieting to lose weight

d.

Seeking privacy

e.

Ostentatiously purchasing tampons

ANS: A, C, E

Wearing of concealing clothing, dieting to lose weight, and conspicuous advertising of a menstrual period are indicators of a hidden pregnancy. Wearing of excessive makeup and seeking privacy are normal adolescent behaviors.

DIF: Cognitive Level: Analysis REF: Text Reference: 460, Box 20-5

OBJ: Objective: 12 TOP: Topic: Signals of Concealed Pregnancy

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

3. The nurse considers the rites of passage that are valued by the adolescent in American society, which are:

Select all that apply.

a.

Attaining legal drinking age

b.

Selection of a career

c.

Religious affiliation

d.

Obtaining a drivers license

e.

High school graduation

ANS: A, D, E

Rites of passage are socially recognized milestones that signify adulthood. Legal drinking age, drivers license, and matriculation through high school are such signals. Religious affiliation and selection of a career path do not necessarily signal adulthood.

DIF: Cognitive Level: Analysis REF: Text Reference: 459

OBJ: Objective: 2 TOP: Topic: Rites of Passage

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

COMPLETION

1. The nurse is amused, but understands that as adolescents strive for individuality, the strongest need of any adolescent in society is that of ____________________.

ANS: conformity

DIF: Cognitive Level: Analysis REF: Text Reference: 445

OBJ: Objective: 10 TOP: Topic: Conformity

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

NOT: Rationale: For all of the stress from coming of age as an individual in his own right, the adolescent also has an equal drive for conformity.

2. The nurse knows that an adolescent may find making a career choice difficult because there is less clarity in ____________________ roles.

ANS: gender

DIF: Cognitive Level: Analysis REF: Text Reference: 445

OBJ: Objective: 4 TOP: Topic: Blurred Gender Roles

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

NOT: Rationale: The blurring of gender roles in the United States-women holding jobs as engineers, lawyers, and physicians; and men entering nursing and culinary pursuits- has caused confusion with the selection of a career path.

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