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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.
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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 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.
The school nurse is teaching an adolescent about social networking and texting on phones. What statement by the adolescent indicates a need for further teaching?
- A. Social networking can help me develop interpersonal skills.
- B. I will have an opportunity to interact with people like myself.
- C. My text messaging during class time in school will not cause any disruption.
- D. I should be cautious, as the online environment can create opportunities for cyberbullying.
Correct Answer: C
Rationale: Internet chatrooms and social networking sites have created a more public arena for trying out identities and developing interpersonal skills with a wider network of people, occasionally with anonymity. This can create opportunities for young people who have a limited access to friends (because of rural location, shyness, or rare chronic conditions) to interact with people like themselves. Both the online and text environment can create opportunities for cyberbullying, in which teens engage in insults, harassment, and publicly humiliating statements online or on cell phones. Text messaging and instant messaging via cell phones has become a common activity and can sometimes be disruptive during school. If the adolescent indicates it will not be disruptive, further teaching is needed.
What are characteristics of early adolescence (1114 years) with regard to identity? (Select all that apply.)
- A. Mature sexual identity
- B. Increase in self-esteem
- C. Trying out of various roles
- D. Conformity to group norms
- E. Preoccupied with rapid body changes
Correct Answer: C,D,E
Rationale: Characteristics of early adolescence identity include trying out of various roles, conformity to group norms, and preoccupation with rapid body changes. Mature sexual identity and increase in self-esteem are characteristics of late adolescent identity.
The school nurse recognizes that pubertal delay in girls is considered if breast development has not occurred by which age?
- A. 10 years
- B. 11 years
- C. 12 years
- D. 13 years
Correct Answer: D
Rationale: Girls may be considered to have pubertal delay if breast development has not occurred by age 13 years or if menarche has not occurred within 2 to 2 1/2 years of the onset of breast development.