Chapter 9: Health Promotion for the Adolescent My Nursing Test Banks

Chapter 9: Health Promotion for the Adolescent

Test Bank

MULTIPLE CHOICE

1. The nurse is explaining Tanner staging to an adolescent and her mother. Which statement best describes Tanner staging?

a.

Predictable stages of puberty that are based on chronologic age

b.

Staging of puberty based on the initiation of menarche and nocturnal emissions

c.

Predictable stages of puberty that are based on primary and secondary sexual characteristics

d.

Staging of puberty based on the initiation of primary sexual characteristics

ANS: C

Feedback

A

Tanner stages are not based on chronologic age. The age at which an adolescent enters puberty is variable.

B

The puberty stage in girls begins with breast development. Puberty stage in boys begins with genital enlargement.

C

Tanner sexual-maturing ratings are based on the development of stages of primary and secondary sexual characteristics.

D

Primary sexual characteristics are not the basis of Tanner staging.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 168

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

2. Which behavior suggests appropriate psychosocial development in the adolescent?

a.

The adolescent seeks validation for socially acceptable behavior from older adults.

b.

The adolescent is self-absorbed and self-centered and has sudden mood swings.

c.

Adolescents move from peers and enjoy spending time with family members.

d.

Conformity with the peer group increases in late adolescence.

ANS: B

Feedback

A

The peer group validates acceptable behavior during adolescence.

B

During adolescence, energy is focused within. Adolescents concentrate on themselves in an effort to determine who they are or who they will be. Adolescents are likely to be impulsive and impatient. Parents often describe their teenager as being self-centered or lazy.

C

Adolescents move from family and enjoy spending time with peers. Adolescents also spend time alone; they need this time to think and concentrate on themselves.

D

Conformity becomes less important in late adolescence.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 172

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

3. The parents of a 14-year-old girl are concerned that their adolescent spends too much time looking in the mirror. Which statement is the most appropriate for the nurse to make?

a.

Your teenager needs clearer and stricter limits about her behavior.

b.

Your teenager needs more responsibility at home.

c.

During adolescence this behavior is not unusual.

d.

The behavior is abnormal and needs further investigation.

ANS: C

Feedback

A

Stricter limits are not an appropriate response for a behavior that is part of normal development.

B

More responsibility at home is not an appropriate response for this situation.

C

Egocentric and narcissistic behavior is normal during this period of development. The teenager is seeking a personal identity.

D

The behavior is normal and needs no further investigation.

PTS: 1 DIF: Cognitive Level: Application REF: p. 173

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

4. Which statement is the most appropriate advice to give parents of a 16-year-old who is rebellious?

a.

You need to be stricter so that your teen stops trying to test the limits.

b.

You need to collaborate with your daughter and set limits that are perceived as being reasonable.

c.

Increasing your teens involvement with her peers will improve her self-esteem.

d.

Allow your teenager to choose the type of discipline that is used in your home.

ANS: B

Feedback

A

Setting stricter limits typically does not decrease rebelliousness or decrease testing of parental limits.

B

Allowing teenagers to choose between realistic options and offering consistent and structured discipline typically enhances cooperation and decreases rebelliousness. Structure helps adolescents to feel more secure and assists them in the decision-making process.

C

Increasing peer involvement does not typically increase self-esteem.

D

Allowing teenagers to choose the method of discipline is not realistic and typically does not reduce rebelliousness.

PTS: 1 DIF: Cognitive Level: Application REF: p. 174

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

5. Which statement by the nurse is most appropriate to a 15-year-old whose friend has mentioned suicide?

a.

Tell your friend to come to the clinic immediately.

b.

You need to gather details about your friends suicide plan.

c.

Your friends threat needs to be taken seriously, and immediate help for your friend is important.

d.

If your friend mentions suicide a second time, you will want to get your friend some help.

ANS: C

Feedback

A

Instructing a 15-year-old to tell a friend to come to the clinic immediately provides the teen with limited information and does not address the concern.

B

It is important to determine whether a person threatening suicide has a plan of action; however, the best information for the 15-year-old to have is that all threats of suicide should be taken seriously and immediate help is important.

C

Suicide is the third most common cause of death among American adolescents. A suicide threat from an adolescent serves as a dramatic message to others and should be taken seriously. Adolescents at risk should be targeted for supportive guidance and counseling before a crisis occurs.

D

It is imperative that help is provided immediately for a teenager who is talking about suicide. Waiting until the teen discusses it a second time may be too late.

PTS: 1 DIF: Cognitive Level: Application REF: p. 180

OBJ: Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity

6. When planning care for adolescents, the nurse should

a.

Teach parents first, and they, in turn, will teach the teenager.

b.

Provide information for their long-term health needs because teenagers respond best to long-range planning.

c.

Maintain the parents role by providing explanations for treatment and procedures to the parents only.

d.

Give information privately to adolescents about how they can manage the specific problems that they identify.

ANS: D

Feedback

A

Teenagers are socially and cognitively at the developmental stage where the health care provider can teach them.

B

Teenagers are more interested in immediate health care needs than in long-term needs.

C

Teenagers are at the developmental level that allows them to receive explanations about health care directly from the nurse.

D

Problems that teenagers identify and are interested in are typically the problems that they are the most willing to address. Confidentiality is important to adolescents. Adolescents prefer to confer privately (without parents) with the nurse and health care provider.

PTS: 1 DIF: Cognitive Level: Application REF: p. 171

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

7. A 17-year-old tells the nurse that he is not having sex because it would make his parents very angry. This response indicates that the adolescent has a developmental lag in which area?

a.

Cognitive development

b.

Moral development

c.

Psychosocial development

d.

Psychosexual development

ANS: B

Feedback

A

Cognitive development is related to moral development, but it is not the pivotal point in determining right and wrong behaviors.

B

The appropriate moral development for a 17-year-old would include evidence that the teenager has internalized a value system and does not depend on parents to determine right and wrong behaviors. Adolescents who remain concrete thinkers may never advance beyond conformity to please others and avoid punishment.

C

Identity formation is the psychosocial development task. Energy is focused within the adolescent, who exhibits behavior that is self-absorbed and egocentric.

D

Although a task during adolescence is the development of a sexual identity, the teenagers dependence on the parents sanctioning of right or wrong behavior is more appropriately related to moral development.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 175

OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance

8. What is the best response a nurse can make to a 15-year-old girl who has verbalized a desire to have a baby?

a.

Have you talked with your parents about this?

b.

Do you have plans to continue school?

c.

Will you be able to support the baby?

d.

Can you tell me how your life will be if you have an infant?

ANS: D

Feedback

A

Asking the teenager whether she has talked to her parents is not particularly helpful to the teen or the nurse and may terminate the communication.

B

A direct question about continuing school will not facilitate communication. Open-ended questions encourage communication.

C

Asking the teenager about how she will support the child will not facilitate communication. Open-ended questions encourage communication.

D

Having the teenager describe how the infant will affect her life will allow the teen to think more realistically. Her description will allow the nurse to assess the teens perception and reality orientation.

PTS: 1 DIF: Cognitive Level: Application REF: p. 183

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

9. Many adolescents decide to follow a vegetarian diet during their teen years. The nurse can advise the adolescent and his or her parents that

a.

This diet will not meet the nutritional requirements of growing teens.

b.

A vegetarian diet is healthy for this population.

c.

An adolescent on a vegetarian diet is less likely to eat high-fat or low-nutrient foods.

d.

A vegetarian diet requires little extra meal planning.

ANS: B

Feedback

A

Several dietary organizations have suggested that a vegetarian diet, if correctly followed, is healthy for this population.

B

A vegetarian diet is healthy for this population, and the low-fat aspect of the diet can prevent future cardiovascular problems.

C

As with any adolescent, nurses need to advise teens who follow a vegetarian eating plan to avoid low-nutrient, high-fat foods.

D

The nurse can assist with planning food choices that will provide sufficient calories and necessary nutrients. The focus is on obtaining enough calories for growth and energy from a variety of fruits and vegetables, whole grains, nuts, and soymilk.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 177

OBJ: Nursing Process: Planning and Implementation

MSC: Client Needs: Physiologic Integrity

10. Which is assessed with Tanner staging?

a.

Hormone levels

b.

Secondary sex characteristics

c.

Response to growth hormone secretion tests

d.

Hyperthyroidism

ANS: B

Feedback

A

Hormone levels are assessed by their concentration in the blood.

B

Tanner stages are used to assess staging of secondary sex characteristics at puberty.

C

Growth hormone secretion tests are not associated with Tanner staging.

D

Tanner stages are not associated with hyperthyroidism.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 169 | Table 9-1

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

11. A nurse is teaching adolescent boys about pubertal changes. The first sign of pubertal change seen with boys is

a.

Testicular enlargement

b.

Facial hair

c.

Scrotal enlargement

d.

Voice deepens

ANS: A

Feedback

A

The first sign of pubertal changes in boys is testicular enlargement in response to testosterone secretion, which usually occurs in Tanner stage 2. Slight pubic hair is present and the smooth skin texture of the scrotum is somewhat altered.

B

During Tanner stages 4 and 5, facial hair appears at the corners of the upper lip and chin.

C

As testosterone secretion increases, the penis, testes, and scrotum enlarge.

D

During Tanner stages 4 and 5, rising levels of testosterone cause the voice to deepen.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 167

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

12. According to Erikson, the psychosocial task of adolescence is to develop

a.

Intimacy

b.

Identity

c.

Initiative

d.

Independence

ANS: B

Feedback

A

Intimacy is the developmental stage for early adulthood.

B

Traditional psychosocial theory holds that the developmental crises of adolescence lead to the formation of a sense of identity.

C

Initiative is the developmental stage for early childhood.

D

Independence is not one of Eriksons developmental stages.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 166

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

13. According to Piaget, the adolescent is in the fourth stage of cognitive development, or period of what?

a.

Formal operations

b.

Concrete operations

c.

Conventional thought

d.

Postconventional thought

ANS: A

Feedback

A

Cognitive thinking culminates with capacity for abstract thinking. This stage, the period of formal operations, is Piagets fourth and last stage.

B

Concrete operations usually develops between ages 7 and 11 years.

C

Conventional and postconventional thought refer to Kohlbergs stages of moral development.

D

Conventional and postconventional thought refer to Kohlbergs stages of moral development.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 170

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

14. Why do peer relationships become more important during adolescence?

a.

Adolescents dislike their parents.

b.

Adolescents no longer need parental control.

c.

They provide adolescents with a feeling of belonging.

d.

They promote a sense of individuality in adolescents.

ANS: C

Feedback

A

During adolescence, the parent/child relationship changes from one of protection-dependency to one of mutual affection and quality.

B

Parents continue to play an important role in the personal and health-related decisions.

C

The peer group serves as a strong support to teenagers, providing them with a sense of belonging and a sense of strength and power.

D

The peer group forms the transitional world between dependence and autonomy.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 173

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

15. A 14-year-old male seems to be always eating, although his weight is appropriate for his height. The best explanation for this is that

a.

This is normal because of increase in body mass.

b.

This is abnormal and suggestive of future obesity.

c.

His caloric intake would have to be excessive.

d.

He is substituting food for unfilled needs.

ANS: A

Feedback

A

In adolescence, nutritional needs are closely related to the increase in body mass. The peak requirements occur in the years of maximal growth. The caloric and protein requirements are higher than at almost any other time of life.

B

This describes the expected eating pattern for young adolescents; as long as weight and height are appropriate, obesity is not a concern.

C

This describes the expected eating pattern for young adolescents; as long as weight and height are appropriate, obesity is not a concern.

D

This describes the expected eating pattern for young adolescents; as long as weight and height are appropriate, obesity is not a concern.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 176

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

16. What predisposes the adolescent to feel an increased need for sleep?

a.

An inadequate diet

b.

Rapid physical growth

c.

Decreased activity that contributes to a feeling of fatigue

d.

The lack of ambition typical of this age-group

ANS: B

Feedback

A

Rapid physical growth, the tendency toward overexertion, and the overall increased activity of this age contributes to fatigue.

B

During growth spurts, the need for sleep is increased.

C

Rapid physical growth, the tendency toward overexertion, and the overall increased activity of this age contributes to fatigue.

D

Rapid physical growth, the tendency toward overexertion, and the overall increased activity of this age contributes to fatigue.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 179

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

17. The most common cause of death in the adolescent age-group involves

a.

Drownings

b.

Firearms

c.

Drug overdoses

d.

Motor vehicles

ANS: D

Feedback

A

Drownings are major concerns in adolescence but do not cause the majority of deaths.

B

Firearms are major concerns in adolescence but do not cause the majority of deaths.

C

Drug overdoses are major concerns in adolescence but do not cause the majority of deaths.

D

Risk taking behaviors play a major role in the high incidence of motor vehicle injuries and death among teenagers i.e. alcohol use, failure to wear a seatbelt, and inexperience.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 180

OBJ: Nursing Process: Assessment

MSC: Client Needs: Safe and Effective Care Environment

18. In girls, the initial indication of puberty is

a.

Menarche

b.

Growth spurt

c.

Growth of pubic hair

d.

Breast development

ANS: D

Feedback

A

The usual sequence of secondary sexual characteristic development in girls is breast changes, rapid increase in height and weight, growth of pubic hair, appearance of axillary hair, menstruation, and abrupt deceleration of linear growth.

B

The usual sequence of secondary sexual characteristic development in girls is breast changes, rapid increase in height and weight, growth of pubic hair, appearance of axillary hair, menstruation, and abrupt deceleration of linear growth.

C

The usual sequence of secondary sexual characteristic development in girls is breast changes, rapid increase in height and weight, growth of pubic hair, appearance of axillary hair, menstruation, and abrupt deceleration of linear growth.

D

In most girls, the initial indication of puberty is the appearance of breast buds, an event known as thelarche.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 168

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

MULTIPLE RESPONSE

1. Injuries claim many lives during adolescence. Which factors contribute to early adolescents engaging in risk-taking behaviors? Select all that apply.

a.

Peer pressure

b.

A desire to master their environment

c.

Engagement in the process of separation from their parents

d.

A belief that they are invulnerable

e.

Impulsivity

ANS: A, D, E

Feedback

Correct

Peer pressure (including impressing peers) is a factor contributing to adolescent injuries. During early to middle adolescence, children feel that they are exempt from the consequences of risk-taking behaviors; they believe that negative consequences only happen to others. Feelings of invulnerability (It cant happen to me) are evident in adolescence. Impulsivity places adolescents in unsafe situations.

Incorrect

Mastering the environment is the task of young school-age children.Emancipation is a major issue for the older adolescent. The process is accomplished as the teenager gains an education or vocational training.

PTS: 1 DIF: Cognitive Level: Application REF: p. 180

OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance

2. You are working as the triage nurse in a pediatric emergency room. You receive a telephone call from the mother of an adolescent whose front tooth was completely knocked out of his mouth while he was playing soccer. The mother is seeking advice. Which is the appropriate response? Select all that apply.

a.

Rinse the tooth in lukewarm tap water.

b.

Place the tooth in saline, milk, or water.

c.

Scrub the tooth with a disinfectant, such as mouth wash.

d.

Bring the child to the emergency room within the next hour for the best prognosis.

ANS: A, B

Feedback

Correct

Rinse the tooth in lukewarm tap waterthis is a correct response. Place the tooth in saline, milk, or waterthis is a correct response.

Incorrect

The tooth should not be scrubbed, and cleaning agents and disinfectants should be avoided. The prognosis is best if the injury is treated within 30 minutes.

PTS: 1 DIF: Cognitive Level: Application REF: p. 177

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

3. Parents of a teenager ask the nurse what signs they should look for if their child is in a gang. The nurse should include which signs when answering? Select all that apply.

a.

Plans to try out for the debate team at school

b.

Skipping classes to go to the mall

c.

Hanging out with friends they have had since childhood

d.

Unexplained source of money

e.

Fear of the police

ANS: B, D, E

Feedback

Correct

Signs of gang involvement include skipping classes, unexplained sources of money, and fear of the police. Associating with new friends while ignoring old friends is also a sign. A change in attitude toward participating in activities is another sign of gang involvement.

Incorrect

Plans to try out for the debate team at school are not a sign of gang involvement. Hanging out with friends he or she has had since childhood is not a sign of gang involvement.

PTS: 1 DIF: Cognitive Level: Application REF: p. 174 | Box 9-3

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

4. Tattoos have become increasingly popular among mainstream adolescents. Like clothing and hairstyles, tattoos serve to define ones identity. It is important for nurses to caution adolescents on the health risks of obtaining a tattoo. These include (select all that apply)

a.

Amateur tattoos are difficult to remove.

b.

Tattoos pose a risk for bloodborne and skin infections.

c.

Health care professionals must be notified of the existence of a tattoo before a magnetic resonance imaging (MRI) scan.

d.

Tattoo dyes may cause allergic reactions.

e.

Tattoo parlors are well regulated.

ANS: B, C, D

Feedback

Correct

Tattoos carry the risk for contracting bloodborne diseases such as hepatitis B and HIV. Infection, allergic reaction to the dye, scarring, or keloid formation can occur. Should an MRI ever be required, it is important to notify the health care professionals, because the dyes can contain iron and other metals.

Incorrect

Amateur tattoos are easily removed; however, studio tattoos made with red and green dye are extremely difficult to remove. Very little regulation exists in the tattoo industry; therefore, the cleanliness of each tattoo parlor varies. Teens should be counseled to avoid making an impulsive decision to get a tattoo.

PTS: 1 DIF: Cognitive Level: Application REF: p. 181 | Box 9-3

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

COMPLETION

1. In assessing adolescents using Tanner staging, sexual maturity is rated using _________ distinct stages. (Your answer should appear as a number.)

ANS:

5

Tanner stages of adolescent sexual development describe five distinct stages of sexual maturity rating. There are separate rating scales for males and females, but both use five stages.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 169 | Table 9-1

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

2. Adolescents eyes and ears are fully developed and, with the exception of minor infections, the sensory system remains quite healthy during this period of development. The mother of a 12-year-old complains to the nurse that she is concerned that her daughter frequently needs changes to her corrective lenses. This is a condition known as ___________.

ANS:

myopia

Myopia (nearsightedness) occurs in early adolescence, between the ages of 11 and 13 and is a normal part of adolescent development.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 171

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

3. Adolescent sexuality refers to the thoughts, feelings, and behaviors related to the teens sexual identity. The most recent research (2009) indicates that 46% of all adolescents have been involved in some kind of sexual activity. The only complete protection from pregnancy and sexually transmitted diseases (STDs) is ____________.

ANS:

abstinence

Adolescents should be encouraged that there is nothing wrong with abstaining from sexual activity. Adolescents who engage in sexual activity at a young age are more likely to participate in other high-risk behaviors such as alcohol and drug use. Adolescents who demonstrate high self-esteem are more likely to delay sexual intercourse.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 183

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

TRUE/FALSE

1. The use of electronic or digital media for communication has had a negative effect on the language development of adolescents. Is this statement true or false?

ANS: T

Text messaging, instant messaging, blogs, and Twitter all contribute to abbreviated communication techniques, which eliminate not only grammar and sentence construction, but also word development (e.g., using ur, for you are).

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 171

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

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