Hockenberry & Wilson: Wongs Essentials of Pediatric Nursing, 8th Edition

Pub Review Chapter 16: Health Promotion of the Adolescent and Family MULTIPLE CHOICE 1. In girls, the initial indication of puberty is which of the following? a Menarche . b Growth spurt . c Growth of pubic hair . d Breast development . ANS: D In most girls, the initial indication of puberty is the appearance of breast buds, an event known as thelarche. DIF: Cognitive Level: Comprehension REF: Page 515 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development 2. The mean age of menarche in the United States is how many years? a 11-1/2 . b 12-3/4 . c 13-1/2 . d 14 . ANS: B The average age of menarche is 12 years 9.5 months in North American girls, with a normal range of 10-1/2 to 15 years. DIF: Cognitive Level: Comprehension REF: Page 515 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development
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3. By what age should concerns about pubertal delay be considered in boys? a 12 to 12-1/2 years . b 12-1/2 to 13 years . c 13 to 13-1/2 years . d 13-1/2 to 14 years . ANS: D Concerns about pubertal delay should be considered for boys who exhibit no enlargement of the testes or scrotal changes from 13-1/2 to 14 years. DIF: Cognitive Level: Comprehension REF: Page 515 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development 4. Steve, 14 years old, mentions that he now has to use deodorant but never had to before. The nurses response should be based on knowledge that: a eccrine sweat glands in the axillae become fully functional during puberty. . b sebaceous glands become extremely active during puberty. . c new deposits of fatty tissue insulate the body and cause increased sweat . production. d apocrine sweat glands reach secretory capacity during puberty. . ANS: D The apocrine sweat glands, nonfunctional in children, reach secretory capacity during puberty. They secrete a thick substance as a result of emotional stimulation that, when acted on by surface bacteria, becomes highly odoriferous. They are limited in distribution and grow in conjunction with hair follicles, in the axilla, genital, anal, and other areas. DIF: Cognitive Level: Comprehension REF: Page 518 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development 5. According to Erikson, the psychosocial task of adolescence is developing which of the following?

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Pub Review a . b . c . d . Intimacy Identity Initiative Independence

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ANS: B Traditional psychosocial theory holds that the developmental crises of adolescence lead to the formation of a sense of identity. DIF: Cognitive Level: Comprehension REF: Page 515 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance: Developmental Stages and Transitions 6. 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 Cognitive thinking culminates with capacity for abstract thinking. This stage, the period of formal operations, is Piaget's fourth and last stage. DIF: Cognitive Level: Comprehension REF: Page 519 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance: Developmental Stages and Transitions 7. Which of the following aspects of cognition develops during adolescence? a Capability to use a future time perspective . b Ability to place things in a sensible and logical order . c Ability to see things from the point of view of another

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Pub Review . d Progress from making judgments based on what they see to making judgments . based on what they reason

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ANS: A Adolescents are no longer restricted to the real and actual. They also are concerned with the possible; they think beyond the present. DIF: Cognitive Level: Comprehension REF: Page 519 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance: Developmental Stages and Transitions 8. 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 The peer group serves as a strong support to teenagers, providing them with a sense of belonging and a sense of strength and power. DIF: Cognitive Level: Comprehension REF: Page 520 TOP: Integrated Process: Nursing Process: Planning MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development 9. An adolescent boy tells the nurse that he has recently had homosexual feelings. The nurses response should be based on knowledge that: a this indicates the adolescent is homosexual. . b this indicates the adolescent will become homosexual as an adult. . c the adolescent should be referred for psychotherapy. . d the adolescent should be encouraged to share his feelings and experiences. .

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ANS: D These adolescents are at increased risk for health-damaging behaviors, not because of the sexual behavior itself, but because of societys reaction to the behavior. The nurses first priority is to give the young man permission to discuss his feelings about this topic, knowing that the nurse will maintain confidentially, appreciate his feelings, and remain sensitive to his need to talk about the topic. DIF: Cognitive Level: Application REF: Page 523 TOP: Integrated Process: Communication and Documentation MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development 10. The school nurse tells adolescents in the clinic that confidentiality and privacy will be maintained unless a life-threatening situation arises. This practice is: a not appropriate in a school setting. . b never appropriate because adolescents are minors. . c important in establishing trusting relationships. . d suggestive that nurse is meeting his or her own needs. . ANS: C Health professionals who work with adolescents should consider the adolescents' increasing independence and responsibility while maintaining privacy and ensuring confidentiality. However, in some circumstances, such as self-destructive behavior or maltreatment by others, they are not able to maintain confidentiality. DIF: Cognitive Level: Comprehension REF: Page 526 TOP: Integrated Process: Communication and Documentation MSC: Area of Client Needs: Safe and Effective Care Environment: Management of Care (Confidentiality) 11. Matt, age 14 years, seems to be always eating, although his weight is appropriate for his height. The best explanation for this is which of the following? 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. .

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ANS: 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. DIF: Cognitive Level: Comprehension REF: Page 526 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development 12. Which of the following 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 During growth spurts, the need for sleep increases. DIF: Cognitive Level: Comprehension REF: Page 526 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development 13. The most common cause of death in the adolescent age-group involves which of the following? a Drownings . b Firearms . c Drug overdoses . d Motor vehicles . ANS: D Forty percent of all adolescent deaths in the United States are the result of motor vehicle accidents.

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DIF: Cognitive Level: Comprehension REF: Page 532 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Safe and Effective Care Environment: Safety and Infection Control (Injury Prevention)

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