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Chapter 19: Care of the Adolescent
1. A 15-year-old male complains of persistent scrotal pain, edema, and nausea since being hit in
the groin by a baseball 3 hours ago. Which is the priority action by the nurse?
A. Applying an ice pack to alleviate the pain
B. Documenting the swelling and discoloration
C. Administering pain medications as ordered
D. Ensuring that the teen is assessed by the physician immediately
ANS: D
Rationale: The nurse should suspect testicular torsion, which requires emergent interventions
to prevent testicular death. Ice should never be applied because of the decreased circulation.
Documentation of signs and administration of pain medications are both correct but are not
the highest priority tasks.
PTS: 1
REF: p. 270
OBJ: 8
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
2. A nurse is preparing an in-service presentation about adolescent reproductive health for nurses
who work in an adolescent health center. Which topics would the nurse plan to include in this
presentation? Select all that apply.
A. Safe sex
B. Menstrual health
C. Testicular self-examination
D. Sexually transmitted infections
E. Breast health
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ANS: A, B, C, D, E
Rationale: It is important to address information related to reproductive functioning and
measures for maintaining reproductive and sexual health. Topics that need to be addressed
related to adolescent reproductive health include information about safe sex practices,
menstrual health, testicular self-examination, sexually transmitted infections, and breast
health.
PTS: 1
REF: p. 277
OBJ: 8
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
3. A school health nurse is supporting a 15-year-old young woman with acne. What is a common
myth related to acne in adolescent populations?
A. Diet plays a significant role in acne production.
B. Do not pick or squeeze acne lesions because it will just increase symptoms.
C. Excessive face washing is not necessary to prevent lesions from forming.
D. Makeup may increase lesion formation.
ANS: A
Rationale: Diet does not actually influence the development of acne lesions; rather, acne is
caused by the changes in puberty, specifically the rapid increase in androgen secretion, which
causes the sebaceous glands to become active.
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PTS: 1
REF: p. 284
OBJ: 5
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
4. A 13-year-old girl has grown rapidly in height over the past 2 years and is taller than most of
the boys in her class. She wonders when she will stop growing. What should the nurse tell her
as a general guideline for the ages at which most girls stop growing?
A. 16 to 17 years old
B. 14 to 15 years old
C. 18 to 19 years old
D. 20 to 21 years old
ANS: A
Rationale: Growth stops with closure of the epiphyseal lines of long bones which occurs at
about 16 or 17 years of age in females and about 18 to 20 years of age in males.
PTS: 1
REF: p. 271
OBJ: 1
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
5. A 13-year-old girl tells the nurse during a gynecological visit that a friend of hers developed
toxic shock syndrome from tampon use. The client says that tampons work well for her, but
she wonders whether they are safe. Which of the following recommendations should the nurse
give this client to help prevent toxic shock syndrome?
A. Alternate use of tampons with sanitary pads
B. Use the highest absorbency tampon possible
C. Insert two tampons at a time
URSIin
NGconjunction
-TESTBAwith
NK.tampons
COM
D. Use feminine hygieneNsprays
ANS: A
Rationale: To help prevent toxics shock syndrome, the nurse should recommend that the client
alternate use of tampons with use of sanitary pads; change tampons at least every 4 hours; use
the lowest absorbency tampon possible that is still adequate for her individual flow; avoid
handling the portion of the tampon that will be inserted vaginally; not use tampons near the
end of a menstrual flow, when excessive vaginal dryness can result from scant flow; not insert
more than one tampon at a time, to avoid abrasions and to keep the vaginal walls from
becoming too dry; and avoid deodorant tampons, deodorant sanitary pads, and feminine
hygiene sprays as these products can irritate the vulvar–vaginal lining.
PTS: 1
REF: p. 279
OBJ: 8
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
6. Linda, a 14-year-old, and her mother are in the office. As Linda goes to the bathroom, her
mother stops the nurse and asks about the changes that Linda is going through. She would like
to talk to her about sex and the changes but she is unsure of how to do this. As the nurse,
which of the following would be appropriate for you to suggest?
A. Promote open lines of communication, encourage listening, don't lecture, and share
family values.
B. Discuss with the adolescent the experiences that you had so that she can connect
on a personal level.
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C. Encourage her to talk to her peers and teachers in health class about any concerns
that she has.
D. Do not initiate any conversation; let the teen come and seek you out for any advice
and answers.
ANS: A
Rationale: Due to the influence of television and movies, many teenagers have an idealized
body image or misinformation about sex. In many case the teenager receives excellent
information in health education classes. There still may be many unanswered questions it is
important for the parents to share family values regarding sexual behavior. By promoting
open lines of communication between parents and teens, the teenager can go to the parents
with problems or questions. Encourage parents to listen to their teens than lecture them.
PTS: 1
REF: p. 267
OBJ: 7
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
7. Jerry and his mother have come to the office for a routine visit. In the hall away from Jerry,
his mother relates to the nurse that she is concerned because Jerry is playing games that girls
play, and has noticed that when he plays any role-playing games his character is very
feminine. She tells the nurse that she is worried about Jerry's sexual orientation. What is the
best response to her concerns?
A. "This behavior may be exploratory or reflect peer pressure, so avoid making
assumptions about his sexual orientation."
B. "Make sure that you do not allow him to play any of these games and be sure to get
him some manly games."
C. "Pay close attention to the activities that he is participating in because this has been
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shown to decrease these behaviors."
D. "This is a concern. Examine what you are exposing him to because this could
affect his behavior."
ANS: A
Rationale: Many adolescent sexual behaviors may be exploratory or reflect peer pressure;
therefore, it is important to avoid making assumptions regarding the sexual orientation of any
adolescent. Assist the adolescent to understand both the physical and psychosocial dimensions
of their sexual development. Avoid labeling, use open communication, use gender-neutral
language, provide accurate information, and be accepting while communicating with
adolescents about sexuality. Adolescents might question their social-sexual role identity.
Homosexual orientation may develop as the adolescent's definition of his or her sexual
attractions, thoughts, fantasies, behaviors, and lifestyles emerge more solidified toward same
sex attractions. Again, no assumptions should be made regarding sexual orientation of any
adolescent.
PTS: 1
REF: p. 275
OBJ: 6
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
8. The nurse is describing the nutritional requirements of an adolescent to a local parent group.
Which of the following would the nurse include as needing to be increased in the adolescent's
diet? Select all that apply.
A. Iron
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B.
C.
D.
E.
Folate
Calcium
Potassium
Magnesium
ANS: A, B, C
Rationale: Several nutrients may need to be added to the adolescent's diet including folate,
iron, and calcium. Folate is recommended for all female adolescents who are capable of
becoming pregnant to reduce the risk of giving birth to a child with a neural tube defect.
Rapid growth during the adolescent years leads to an increase need for iron. Calcium intake
also needs to be increased as a result of the bone mass development that occurs during
adolescence. Neither potassium or magnesium need to be increased.
PTS: 1
REF: p. 280
OBJ: 5
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
9. An adolescent comes into the emergency department with a foot wound. Upon assessment, the
nurse learns that the patient is a runaway and has been living on the streets. Which is the most
appropriate care for the nurse to provide to the client at this time?
A. Recommend returning to live with parents.
B. Treat the wound and provide wound care supplies.
C. Discuss the importance of a diet high in protein and vitamin C.
D. Explain how the wound needs to be flushed with water every 4 hours.
ANS: B
Rationale: The nurse is not aware of the adolescent runaway's family situation so suggesting
NURmay
SINorGmay
-TEnot
STbe
BAappropriate.
NK.COM Because the adolescent runaway
returning home with parents
has no money for any kind of food, giving instructions to eat foods high in protein and
vitamin C makes no sense. If the adolescent runaway does not have a source of running water,
telling them to flush the wound with water every 4 hours will be impossible. The best care at
this time would be for the nurse to treat the adolescent runaway's wound and provide him or
her with wound care supplies.
PTS: 1
REF: p. 275
OBJ: 3
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
10. The nurse is caring for a chronically ill adolescent client. What can the nurse do to maintain
stimulation and support the client's sense of identity while hospitalized?
A. Plan activities around scheduled rest periods.
B. Explain food choices appropriate to the prescribed diet.
C. Teach the name and indications for use of all medications.
D. Encourage communicating with friends through social media.
ANS: D
Rationale: To encourage stimulation while supporting the adolescent patient's sense of identity
while hospitalized, the nurse should encourage the patient to communicate with friends
through social media. Planning activities around rest periods does not promote stimulation.
Explaining food choices does not promote stimulation. Learning about medications does not
promote stimulation.
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PTS: 1
REF: p. 283
OBJ: 5
NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
11. A nurse is assessing, Maria, an 11-year-old female. During the assessment, the nurse notices
that the girl's breasts have begun to develop. Based on an understanding of adolescent growth
and development, the nurse would anticipate that Maria would most likely begin to
menstruate within which time period?
A. 1 year
B. 2 years
C. 3 years
D. 4 years
ANS: B
Rationale: The onset of menstruation occurs approximately 2 years after the breasts start
growing, or an average age of 12.8 years.
PTS: 1
REF: p. 269
OBJ: 1
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
12. A nurse working at a pediatric clinic includes an adolescent history for every child aged 11 to
18 years when the child is new to the office. Which issues should the nurse address when the
parents are not in the room? Select all that apply.
A. Job responsibilities
B. Abuse/domestic violence
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C. Self-image
D. Sexual activities
E. Adolescent's fit in the family
ANS: B, D
Rationale: A primary reason for addressing abuse and sexual activities while the parent is not
in the room is that the child may not want the parent/family member to know about sexual
activity; the provider may be able to help the child develop ways of telling the parent about
the issue or the child may divulge the "real" reason for coming to the health care agency. The
child's self-image, job responsibilities, and his or her fit in the family could all be assessed
while the parent/family member is in the room.
PTS: 1
REF: p. 282
OBJ: 6
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
13. The parent of a teenager diagnosed with iron deficient anemia asks the nurse for help with
incorporating more iron into the teens diet when packing lunches and snacks for school.
Which foods would be good sources of iron that could be easily incorporated into the diet
when taking lunches and snacks to school? Select all that apply.
A. Peanut butter
B. Eggs
C. Oranges
D. Strawberries
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E. Nuts
ANS: A, B, D, E
Rationale: Good sources of iron that may work well in a teen's diet include peanut butter,
eggs, strawberries, and nuts. Oranges are a good source of vitamin C but not iron.
PTS: 1
REF: p. 281
OBJ: 5
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
14. During a complete physical assessment of a preteen boy, the nurse correctly recognizes which
finding as being the first change of puberty?
A. Increase in height
B. Deepening voice
C. Development of axillary hair
D. Testicular enlargement
ANS: D
Rationale: The first sign of pubertal changes in boys is testicular enlargement in response to
testosterone secretion, usually occurring in Tanner stage 2. As testosterone levels increase, the
penis and scrotum enlarge, hair distribution increases, and scrotal skin texture changes.
PTS: 1
REF: p. 269
OBJ: 2
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
15. When interviewed by the school nurse, a 13-year-old adolescent female states she has a
boyfriend and that her parents
NURSdoINnot
G-talk
TEabout
STBAsex
NKwith
.COher.
M She says is confused about the
facts and wants to know the truth. Which approach would best address this adolescent's
concerns?
A. Explain that a discussion about sex is best handled by her parents and she should
go home and ask them.
B. Offer to provide her some brochures to help her better understand how her body
works.
C. Sit down with her and openly discuss her concerns and questions in an honest,
straightforward manner.
D. Refer the adolescent to a local health department for sexual counseling and
pregnancy prevention.
ANS: C
Rationale: Discussions about human sexuality need to be open, honest and straightforward
with adolescents. Parents and health care providers must remain nonjudgmental if they want
adolescents to come to them with questions. Sitting down with the student and addressing her
questions is the best way to establish a trusting relationship with her. Recommending that she
talk with her parents will not help her since they are apparently not open to discussing the
topic. Brochures cannot answer her specific questions and may result in more confusion on
her part. Referring her to the health department is passing the nurse's responsibility to
someone else, and there is no indication that any pregnancy prevention is needed.
PTS: 1
REF: p. 274
OBJ: 6
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
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16. A nurse is admitting a 16-year-old male to the floor for an appendectomy. How can the nurse
prepare this client for hospitalization? Select all that apply.
A. Encourage him to keep his cell phone nearby to communicate with his friends.
B. Interview the adolescent separately from the parent to allow expression of
information that he may not be comfortable sharing in front of the parent.
C. Remind him that there are strict rules regarding meal times and when lights are
turned out on the floor.
D. Encourage parents to do as much as possible for the client, including ADLs and
meal selection.
E. Provide privacy when client is changing into the hospital gown or going to the
bathroom.
ANS: A, B, E
Rationale: In order for an adolescent to adapt well to hospitalization, the nurse needs to
provide him privacy and allow him control over his surroundings and care when possible.
Keeping in contact with peers is very important to an adolescent, as is being discreet in regard
to sharing personal information that typically is elicited in an admission interview.
PTS: 1
REF: p. 273
OBJ: 4
NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Analyze
17. The adolescent comes to the clinic seeking information about sexuality concerns. The clinic
nurse assures the adolescent that confidentiality and privacy will be maintained unless a
life-threatening situation occurs. Maintaining confidentiality demonstrates which nursing
goal? Select all that apply.
NURS
ING-TESTBANK.COM
A. development of a trusting
relationship
B. compliance with existing laws
C. inappropriate response because adolescents are minors
D. an environment where adolescents can be truthful
E. concern from parents who pay the office visit bill
ANS: A, B, D
Rationale: Adolescents may seek a health care appointment for an unrelated health concern as
a reason to discuss a sexual health question with a health care professional. Reassurance
should be given to the adolescent that all questions and concerns will be addressed and will be
kept confidential. This is the basis for the nurse–client relationship. All questions and
concerns do not involve treatment and therefore do not involve parental consent. Parents may
voice concerns because they are responsible for the insurance and billing. The nurse should
act as a client advocate and work with the parents to develop a mutual understanding of the
situation.
PTS: 1
REF: p. 269
OBJ: 4
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Understand
18. An adolescent who is depressed states, "Nothing ever seems to be right in my life." Which
would be the most appropriate response by the nurse?
A. "Things will be better when you go off to college."
B. "You are feeling sad right now. It's a hard time."
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C. "Try to look at the bright side of things."
D. "Being a teenager is hard work."
ANS: B
Rationale: Some degree of depression is present in most adolescents because they are not only
losing their parents while they grow apart from them but also their carefree childhood. When
using therapeutic communication, it is important for the nurse to accept the client's
verbalization as real. Support should be real. Telling the adolescent that things will be better
in college provides false reassurance. Telling the adolescent to "look on the bright side of
things" or that "being a teen is hard work" offer platitudes and interrupt the client's
interactions.
PTS: 1
REF: p. 283
OBJ: 2
NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Analyze
19. An male adolescent comes to the clinic for a routine health care followup accompanied by the
parents. During the visit, the parents tell the nurse, "Our son just doesn't seem to listen to us
anymore. It's like he's tuning us out. Is there anything we can do to get him to hear what we're
saying to him?" Which suggestions would be appropriate for the nurse to offer? Select all that
apply.
A. "When you talk to him, speak to him face to face and be careful of your body
language."
B. "Don't be afraid to ask him questions about why he feels a certain way."
C. "Choose words carefully to make sure that he understands you."
D. "Tell him firmly that you have the answers because you are his parents."
E. "Talk to you son as an equal and don't talk down to him."
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ANS: A, B, C, E
Rationale: To improve communication with an adolescent, it is important to talk face to face
with the adolescent and be aware of body language that could influence what is being said. In
addition, parents should not be afraid to ask the adolescent why he or she feels a certain way,
Parents need to speak to their teenager as an equal and not talk down to the adolescent,
making sure to choose words that the adolescent will understand. Parents also need to be open
to not knowing all the answers and be able to admit that they do make mistakes.
PTS: 1
REF: p. 273
OBJ: 3
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Apply
20. A nurse is reading a journal article about adolescents and major causes of injuries in this age
group. The nurse demonstrates understanding of this information by identifying which
situation as the major cause of adolescent injuries?
A. Drowning
B. Motor vehicle crashes
C. Violence
D. Suicide
ANS: B
Rationale: Although drowning, violence, and suicide are causes of adolescent injury, the
largest number of adolescent injuries are due to motor vehicle crashes.
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PTS: 1
REF: p. 275
OBJ: 7
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 19: Care of the Adolescent
BLM: Cognitive Level: Remember
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