Chapter 15: Health Promotion of the Adolescent and Family Flashcards
The most likely source of injury, whether intentional or unintentional in adolescents is associated with?
a. Motor vehicle accidents
b. Poisoning
c. Drowning
d. Homicide
a. Motor vehicle accidents
Motor vehicle accidents are the most common cause of injury and death in adolescents. Homicide is the second leading cause.
A 13-year old boy is concerned about bilateral breast enlargement. The most appropriate explanation by the nurse is based on knowing that this is
a. A sign of too much body fat
b. A sign of hormonal imbalance
c. A normal occurrence during puberty
d. An indication of precocious puberty
c. A normal occurrence during puberty
Gynecomastia, or enlargement of the breast tissue, is common during mid puberty in about one third of boys. For most boys, the breast enlargement disappears within 2 years. Although overweight boys may have excess body weight in the breast area, in boys of normal body weight, gynecomastia is a normal occurrence during puberty. If gynecomastia persists beyond 2 years, then a hormonal cause may need to be investigated. Precocious puberty is the early onset of puberty, before age 9 years in boys, and is not related to gynecomastia.
What is an important consideration for the school nurse planning a class on injury prevention for adolescents?
a. Adolescents generally are not risk takers
b. Adolescents can anticipate the long-term consequences of serious injuries
c. Adolescents need to discharge energy, often at the expense of logical thinking
d. During adolescence, participation in sports should be limited to prevent permanent injuries
c. Adolescents need to discharge energy, often at the expense of logical thinking
The physical, sensory, and psychomotor development of adolescents provides a sense of strength and confidence. There is also an increase in energy coupled with risk taking that puts them at risk, because they often ignore logical thinking. Adolescents tend to be risk takers because of their feelings of indestructibility. The feelings of indestructibility that accompany adolescence interfere with understanding the consequences of their behavior, thus increasing their potential for injuries. Sports can be a useful way to discharge energy and should not be limited. Care must be taken to avoid overuse injuries and to use appropriate protective equipment.
During the adolescence period, what role does the school environment take on?
a. It is the only site for their continuing education
b. It forms the basis for their social life
c. It provides a consistent structure based on peer group assignment
d. It allows for development of autonomy as a transition from only being in the home environment
b. It forms the basis for their social life
The school environment becomes the focus of the adolescent’s social life. While the school environment provides a site for education, the adolescent may also be receiving instruction at other areas or venues. The school environment is not based on peer group assignment and peer groups provide the transitional structure for adolescent’s emerging autonomy.
Which observation if noted by the school nurse would pose a priority concern?
a. Teenager is using her mobile phone while walking in the hallway to class
b. Student is using the computer in a classroom to post a picture of herself taken in class on facebook
c. Student is looking at a risque image of another student on her phone while seated at the cafeteria table
d. Student is texting her parents that she will be home later than expected
c. Student is looking at a risque image of another student on her phone while seated at the cafeteria table
This observation would be an example of sexting which is illegal and associated with risky sexual actions according to recent evidence-based practice. The use of social media within the school setting to post a picture of a student taken in class while not the best practice would not cause a concern unless the image was provocative or offensive. Texting information to advise parents that a student would be late would be considered to be appropriate. Use of mobile phones in the school setting may not pose a problem unless that activity is restricted by school policy.
The onset of puberty in boys is characterized by
a. Voice changes
b. Testicular enlargement
c. Growth of dark pubic hair
d. Increased size of penis
b. Testicular enlargement
This is the first change that signals puberty in boys during Tanner stage 2 of sexual development. Voice changes occur between Tanner stages 3 and 4 of sexual development. Fine pubic hair may occur at the base of the penis early in puberty, but darker hair occurs during Tanner stage 3 of sexual development. The penis enlarges during Tanner stage 3 of sexual development.
An adolescent teen has confided to the school nurse that he is bisexual and asks the school nurse for advice in “coming out” top his peers. What would be the best response to the student’s request?
a. Call the parents of the child directly and tell them before the child “comes out” to his peers
b. Suggest that the individual have formed a safety plan first before disclosing information
c. Suggest to the student that he tell his parents first before he tells everyone else
d. Let the student know that you are supportive but that he is the only person that knows when the time is right to “come out”
b. Suggest that the individual have formed a safety plan first before disclosing information
It is important to have a safety plan in place first before “coming out” as individuals may not be able to cope with the information and as such the adolescent teen may be exposed to potential rejection, violence or misunderstanding. The nurse has no legal authority to violate confidentiality by notifying the teen’s parents without his consent. And although it may be best to tell one’s parents first, the priority is to have a safety plan in place prior to disclosure of this type of information. Similarly, the teen is the best person to determine when the time is right but safety and support are a priority.
When conducting a class on sex and sexual activities with adolescents, the most appropriate approach by the nurse is to
a. Use dolls to teach the content
b. Present normal body functions in a straightforward manner
c. Refer the adolescents to their parents for sexual information
d. Delay giving information about pregnancy unless adolescents are sexually active
b. Present normal body functions in a straightforward manner
The nurse should provide accurate and complete information using correct terminology that is understandable to the adolescent. Dolls are appropriate for teaching a younger age-group of children. Using the correct terminology is more appropriate for a group of adolescents. Parents are important for conveying the morals and values surrounding sexual activities, but nurses may provide adolescents with accurate, complete information. Adolescents should have information before they become sexually active about the potential consequences of sex, including the practice of safe sex to prevent pregnancy and the transmission of sexually transmitted diseases.
Sexual orientation as a concept related to the adolescent period is
a. Not aligned with sexual identity
b. Refers to patterns of arousal of feelings only between heterosexual couples
c. Is different for each individual based on their own preferences
d. Can be measured by hormones levels
c. Is different for each individual based on their own preferences
Sexual orientation is the pattern of sexual arousal or romantic attraction between individuals regardless of whether it is based on heterosexual, same sex of transgender identification. It is not measured by hormone levels and is correlated with sexual identity.
An adolescent boy tells the school nurse that he is gay. The nurse’s response should be based on knowledge that
a. He is too young to have had enough sexual activity to determine his sexual orientation at this time
b. It is important to provide a non threatening environment for him to discuss his feelings
c. The nurse should feel open in discussing his or her own beliefs about homosexuality
d. Homosexual adolescents do not have concerns that differ from those of heterosexual adolescents
b. It is important to provide a non threatening environment for him to discuss his feelings
The nurse needs to be open and nonjudgmental in interactions with adolescents who have questions about their sexual orientation. This will allow a safe environment for the adolescents to speak and receive guidance from a health care professional as warranted. Adolescence is when sexual identity develops; therefore, questions about sexual orientation often surface at this time. The nurse’s own beliefs should not bias the interaction with this student and, therefore, are irrelevant. Homosexual adolescents have different challenges to growing up and their sexual identity than heterosexual adolescents, often related to societal, cultural, religious, and spiritual influences.
Evidence-based research shows that the most successful strategy for preventing smoking in teenagers is
a. Emphasis on immediate effects of smoking
b. Emphasis on long-term effects of smoking
c. Large-scale public information campaigns
d. Threatening the social norms of groups most likely to smoke
a. Emphasis on immediate effects of smoking
An emphasis on immediate effects of smoking has proven to be one of the most effective strategies for preventing smoking. Information focuses on tobacco smell and other aesthetic issues. Because this age-group is neither future oriented nor consequence oriented, emphasis on the long-term effects of smoking does not work as well as focusing on the immediate effects. Public campaigns can be effective when focused on the immediate effects of smoking, but they often focus on the more long-term effects of smoking. Threatening social norms in adolescents is not an effective strategy for the prevention of smoking.
While caring for hospitalized adolescents, the nurse observes that sometimes they are skeptical of their parents’ religious beliefs and practices. The nurse should recognize that this is
a. Normal in spiritual development
b. Abnormal in spiritual development
c. Related to illness and occurs only at times of crisis
d. Related to the parent’s inability to adequately explain their beliefs and practices
a. Normal in spiritual development
The behavior described occurs in stage 4 in spiritual development. Adolescents attempt to determine which of their parents’ standards and beliefs to incorporate into their own. The behavior described is not abnormal. The behavior described is not applicable only during times of crisis. The behavior described is not related to the parents’ inability to explain their beliefs and practices.
How does the onset of the pubertal growth spurt compare in girls and boys?
a. In girls, it occurs about 2 years before it appears in boys
b. In girls, it occurs about 3 years before it appears in boys
c. In boys, it occurs about 1 years before it appears in girls
It is about the same in both boys and girls
a. In girls, it occurs about 2 years before it appears in boys
The average age of onset for puberty is 12 years in girls and 14 years in boys. Although this may be true for an individual, the average difference is approximately 2 years. Usually, girls begin puberty and their growth spurt earlier than boys.
The school nurse is teaching a class on injury prevention. What should be included when discussing firearms?
a. Adolescents are too young to use a gun properly for hunting
b. Gun carrying among adolescents is on the rise, primarily among inner-city youth
c. Non Powder guns (air rifles, BB guns) are a relatively safe alternative to powder guns
d. Adolescence is the peak age for being either a victim or an offender in an injury involving a firearm
d. Adolescence is the peak age for being either a victim or an offender in an injury involving a firearm
Gun carrying among adolescents is on the rise. The increase in gun availability is linked to increased gun injuries and deaths among children. Adolescents can be taught to safely use and store guns for hunting. Gun carrying is on the rise in adolescents and is not limited to stereotypical inner-city youth. Non Powder guns, such as air rifles and BB guns, cause almost as many injuries as powder guns.
Girls experience an increase in weight and fat deposition during puberty. Nursing considerations related to this include
a. Giving reassurance that these changes are normal
b. Suggesting dietary measures to control weight gain
c. Recommending increased exercise to control weight gain
d. Encouraging a low-fat diet to prevent fat deposition
a. Giving reassurance that these changes are normal
A certain amount of fat is increased along with lean body mass to fill the characteristic contours of the child’s gender. A healthy balance must be achieved between expected healthy weight gain and obesity as related to these normal and expected physical changes. This should not be done unless weight gain is excessive. Eating disorders can develop in this group, and diet management should be considered only under a health care practitioner’s care. Exercise is an important component in weight management but should never be done or encouraged in increased amounts or in excess to control weight gain that occurs normally during puberty. Some fat deposition is essential for normal hormonal regulation. Menarche is delayed in girls with body fat contents that are too low; therefore, a low-fat diet is not a recommended intervention.
