Nokea
The school nurse recognizes that pubertal delay in boys is considered if no enlargement of the testes or scrotal changes have occurred by what age?
- A. 11 1/2 to 12 years
- B. 12 1/2 to 13 years
- C. 13 1/2 to 14 years
- D. 14 1/2 to 15 years
Correct Answer: C
Rationale: Concerns about pubertal delay should be considered for boys who exhibit no enlargement of the testes or scrotal changes by ages 13 1/2 to 14 years or if genital growth is not complete 4 years after the testicles begin to enlarge.
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The school nurse teaches adolescents that the detrimental long-term effects of tanning are what? (Select all that apply.)
- A. Vitamin D deficiency
- B. Premature aging of the skin
- C. Exacerbates acne outbreaks
- D. Increased risk for skin cancer
- E. Possible phototoxic reactions
Correct Answer: B,D,E
Rationale: Adolescents should be educated regarding the detrimental effects of sunlight on the skin. Long-term effects include premature aging of the skin; increased risk for skin cancer; and, in susceptible individuals, phototoxic reactions. Exposure to levels of sunlight cause an increase in vitamin D production. Tanning can often reduce outbreaks of acne.
A 12-year-old girl asks the nurse about an increase in clear white odorless vaginal discharge. What response should the nurse give?
- A. This may mean a yeast infection.
- B. This is normal before menstruation starts.
- C. This is caused by an increase in progesterone.
- D. This is possibly a sign of a sexually transmitted infection.
Correct Answer: B
Rationale: Early in puberty, there is often an increase in normal vaginal discharge (physiologic leukorrhea) associated with uterine development. Girls or their parents may be concerned that this vaginal discharge is a sign of infection. The nurse can reassure them that the discharge is normal and a sign that the uterus is preparing for menstruation. It is caused by an increase in estrogen, not progesterone.
The nurse is caring for children on an adolescent-only unit. What growth and development milestones should the nurse expect from 11- and 14-year-old adolescents? (Select all that apply.)
- A. Self-centered with increased narcissism
- B. No major conflicts with parents
- C. Established abstract thought process
- D. Have a rich, idealistic fantasy life
- E. Highly value conformity to group norms
- F. Secondary sexual characteristics appear
Correct Answer: B,E,F
Rationale: Growth and development milestones in the 11- to 14-year-old age group include minimal conflicts with parents (compared with the 15- to 17-year-old age group), a high value placed on conformity to the norm, and the appearance of secondary sexual characteristics. Selfcenteredness and narcissism are seen in the 15- to 17-year-old age group along with a rich and idealistic fantasy life. Abstract thought processes are not well established until the 18- to 20-year-old age group.
What aspects of cognition develop during adolescence?
- A. Ability to see things from the point of view of another
- B. Capability of using a future time perspective
- C. Capability of placing things in a sensible and logical order
- D. Progress from making judgments based on what they see to making judgments based on what they reason
Correct Answer: B
Rationale: Adolescents are no longer restricted to the real and actual. They also are concerned with the possible; they think beyond the present. During concrete operations (between ages 7 and 11 years), children exhibit thought processes that enable them to see things from the point of view of another, place things in a sensible and logical order, and progress from making judgments based on what they see to making judgments based on what they reason.
What are characteristics of middle adolescence (1517 years) with regard to relationships with peers? (Select all that apply.)
- A. Behavioral standards set by peer group
- B. Acceptance of peers extremely important
- C. Seeks peer affiliations to counter instability
- D. Exploration of ability to attract opposite sex
- E. Peer group recedes in importance in favor of individual friendship
Correct Answer: A,B,D
Rationale: Characteristics of middle adolescence relationships with peers include behavioral standards set by the peer group, acceptance of peers is extremely important, and exploration of the ability to attract opposite sex. Seeking peer affiliations to counter instability is a characteristic of early adolescence relationships with peers. Peer groups receding in importance in favor of individual friendships is characteristic of late adolescence relationships with peers.