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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.
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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.
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 are characteristics of dating relationships in early adolescence? (Select all that apply.)
- A. One-on-one dating
- B. Follow ritualized scripts
- C. Are psychosocially intimate
- D. Involve playing stereotypic roles
- E. Participating in mixed-gender group activities
Correct Answer: B,D,E
Rationale: Early dating relationships typically follow highly ritualized scripts in which adolescents are more likely to play stereotypic roles than to really be themselves. Participating in mixed-gender group activities, such as going to parties or other events, may have a positive impact on young teenagers well-being. One-on-one dating during early adolescence, however, with a lot of time spent alone, may lead to sexual intimacy before a teen is ready. Although teenagers may begin dating during early adolescence, these early dating relationships are not usually psychosocially intimate.
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 school nurse is teaching a class on injury prevention. What should be included when discussing firearms?
- A. Adolescents are too young to use guns properly for hunting.
- B. Gun carrying among adolescents is on the rise, primarily among inner-city youth.
- C. Nonpowder guns (air rifles, BB guns) are a relatively safe alternative to powder guns.
- D. Adolescence is the peak age for being a victim or offender in the case of injury involving a firearm.
Correct Answer: D
Rationale: The increase in gun availability in the general population is linked to increased gun deaths among children, especially adolescents. Gun carrying among adolescents is on the rise and not limited to the stereotypic inner-city youth. Adolescents can be taught to safely use guns for hunting, but they must be stored properly and used only with supervision. Nonpowder guns (air rifles, BB guns) cause almost as many injuries as powder guns.