The school nurse recognizes that students who are targeted for repeated harassment and bullying may exhibit what? (Select all that apply.)
- A. Skip school
- B. Attempt suicide
- C. Bring weapons to school
- D. Attend extracurricular activities
- E. Report symptoms of depression
Correct Answer: A,B,C,E
Rationale: Students targeted for repeated teasing and harassment are more likely to skip school, to report symptoms of depression, and to attempt suicide. Equally troubling, teens who are regularly harassed or bullied are also more likely to bring weapons to school to feel safe. Students who are bullied do not want to attend extracurricular activities.
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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.
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.
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.
The nurse is assessing the Tanner stage in an adolescent female. The nurse recognizes that the stages are based on which?
- A. The stages of vaginal changes
- B. The progression of menstrual cycles to regularity
- C. Breast size and the shape and distribution of pubic hair
- D. The development of fat deposits around the hips and buttocks
Correct Answer: C
Rationale: In females, the Tanner stages describe pubertal development based on breast size and the shape and distribution of pubic hair. The stages of vaginal changes, progression of menstrual cycles to regularity, and the development of fat deposits occur during puberty but are not used for the Tanner stages.
The nurse is explaining to an adolescent the rationale for administering a Tdap (tetanus, diphtheria, acellular pertussis) vaccine 3 years after the last Td (tetanus) booster. What should the nurse tell the adolescent?
- A. It is time for a booster vaccine.
- B. It is past the time for a booster vaccine.
- C. This vaccine will provide pertussis immunity.
- D. This vaccine will be the last booster you will need.
Correct Answer: C
Rationale: When the Tdap is used as a booster dose, it may be administered earlier than the previous 5-year interval to provide adequate pertussis immunity (regardless of interval from the last Td dose). It is not time or past time for a booster because they are required every 5 years. Another booster will be needed in 5 years, so it is not the last dose.
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