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The nurse is assessing the Tanner stage in an adolescent male. The nurse recognizes that the stages are based on what?
- A. Hair growth on the face and chest
- B. Changes in the voice to a deeper timbre
- C. Muscle growth in the arms, legs, and shoulders
- D. Size and shape of the penis and scrotum and distribution of pubic hair
Correct Answer: D
Rationale: In males, the Tanner stages describe pubertal development based on the size and shape of the penis and scrotum and the shape and distribution of pubic hair. During puberty, hair begins to grow on the face and chest; the voice becomes deeper; and muscles grow in the arms, legs, and shoulders, but these are not used for the Tanner stages.
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What guidelines should the nurse use when interviewing adolescents? (Select all that apply.)
- A. Ensure privacy.
- B. Use open-ended questions.
- C. Share your thoughts and assumptions.
- D. Explain that all interactions will be confidential.
- E. Begin with less sensitive issues and proceed to more sensitive ones.
Correct Answer: A,B,E
Rationale: Guidelines for interviewing adolescents include ensuring privacy, using open-ended questions, and beginning with less sensitive issues and proceeding to more sensitive ones. The nurse should not share thoughts but maintain objectivity and should avoid assumptions, judgments, and lectures. It may not be possible for all interactions to be confidential. Limits of confidentiality include a legal duty to report physical or sexual abuse and to get others involved if an adolescent is suicidal.
The school nurse recognizes that adolescents should get how many hours of sleep each night?
- A. 6 hours
- B. 7 hours
- C. 8 hours
- D. 9 hours
Correct Answer: D
Rationale: Adolescents should generally get around 9 hours of sleep each night.
Girls experience an increase in weight and fat deposition during puberty. What do nursing considerations related to this include?
- A. Give reassurance that these changes are normal.
- B. Suggest dietary measures to control weight gain.
- C. Encourage a low-fat diet to prevent fat deposition.
- D. Recommend increased exercise to control weight gain.
Correct Answer: A
Rationale: A certain amount of fat is increased along with lean body mass to fill the characteristic contours of the adolescents gender. A healthy balance must be achieved between expected healthy weight gain and obesity. Suggesting dietary measures or increased exercise to control weight gain would not be recommended unless weight gain was excessive because eating disorders can develop in this group. Some fat deposition is essential for normal hormonal regulation. Menarche is delayed in girls with body fat contents that are too low.
What is most descriptive of the spiritual development of older adolescents?
- A. Beliefs become more abstract.
- B. Rituals and practices become increasingly important.
- C. Strict observance of religious customs is common.
- D. Emphasis is placed on external manifestations, such as whether a person goes to church.
Correct Answer: A
Rationale: Because of their abstract thinking abilities, adolescents are able to interpret analogies and symbols. Rituals, practices, and strict observance of religious customs become less important as adolescents question values and ideals of families. Adolescents question external manifestations when not supported by adherence to supportive behaviors.
A 16-year-old adolescent boy tells the school nurse that he is gay. The nurses response should be based on what?
- A. He is too young to have had enough sexual activity to determine this.
- B. The nurse should feel open to discussing his or her own beliefs about homosexuality.
- C. Homosexual adolescents do not have concerns that differ from those of heterosexual adolescents.
- D. It is important to provide a nonthreatening environment in which he can discuss this.
Correct Answer: D
Rationale: The nurse needs to be open and nonjudgmental in interactions with adolescents. This will provide a safe environment in which to provide appropriate health care. Adolescence is when sexual identity develops. The nurses own beliefs should not bias the interaction with this student. Homosexual adolescents face very different challenges as they grow up because of societys response to homosexuality.