Deck 8: Developmental Management of Adolescents

Question 1

The parent of an adolescent reports noting cutting marks on the teen's arms
and asks the primary care pediatric nurse practitioner what it means. What will the nurse practitioner tell this parent?
A. Cutting is a way of dealing with emotional distress.
B. It is a method of fitting in with other adolescents.
C. The behavior is common and will usually stop.
D. This type of behavior is a type of suicide attempt.

Answer 1

Cutting is a way of dealing with emotional distress.

Question 2

During a well child assessment of a 13­year­old male, the primary care
pediatric nurse practitioner notes small testicles and pubic and axillary hair. To further evaluate these findings, the nurse practitioner will ask the patient about
A. alcohol and tobacco use.
B. changes in voice.
C. increase in height and weight.
D. participation in sports.

Answer 2

participation in sports.

Question 3

The primary care pediatric nurse practitioner is performing a well child
assessment on a 13­year­old female whose mother asks when her daughter's periods may start. Which information will the nurse practitioner use to help estimate the onset of periods?
A. The age of the mother's menarche
B. The patient's age at thelarche
C. When adrenarche occurred
D. Whether linear growth has stopped

Answer 3

The patient's age at thelarche

Question 4

The parent of a 14­year­old child tells the primary care pediatric nurse
practitioner that the adolescent has expressed a desire to be a vegetarian, is refusing all meat served at home, and wants the family to eat vegetarian meals. What will the nurse practitioner tell the parent?
A. Do not allow a vegetarian diet in order to maintain appropriate limits for the adolescent.
B. Provide vegetarian options for the adolescent that preserve adequate nutrition and protein intake.
C. Suggest that the adolescent prepare appropriate vegetarian dishes to complement family meals.
D. Tell the adolescent that a vegetarian diet may be considered in adulthood but not while living at home.

Question 5

The parent of a 14­year­old child tells the primary care pediatric nurse
practitioner that the child skips classes frequently in spite of various disciplinary measures, such as grounding and extra homework and is earning Cs and Ds in most classes. What will the nurse practitioner recommend?
A. Counseling for emotional problems
B. Development of an Individual Education Plan
C. Evaluation for possible learning disorders
D. Referral for a behavioral disorder

Question 6

The primary care pediatric nurse practitioner is performing a well child exam
on a 12­year­old female who has achieved early sexual maturation. The mother reports that she spends more time with her older sister's friends instead of her own classmates. What will the nurse practitioner tell this parent?
A. Early­maturing girls need to identify with older adolescents to feel a sense of belonging.
B. Girls who join an older group of peers may become sexually active at an earlier age.
C. Spending time with older adolescents indicates a healthy adjustment to her maturing body.
D. The association with older adolescents will help her daughter to gain social maturity.

Question 7

The primary care pediatric nurse practitioner is performing a well child exam
on a 17­year­old female whose mother is present during the history. The mother expresses concern that her daughter wishes to have an eyebrow piercing and states that she is opposed to the idea. What will the nurse practitioner do?
A. Provide information about piercings and encourage continued discussion.
B. Remind the adolescent that her mother is responsible for her health.
C. State that piercings are relatively harmless and are an expression of individuality.
D. Suggest that she wait until she is 18 years old and can make her own decisions.

Question 8

The parent of a 16­year­old tells the primary care pediatric nurse practitioner
that the teen was recently caught smoking an electronic cigarette (e­cigarette). What will the nurse practitioner tell this parent?
A. E­cigarette use may be a risk factor for later substance abuse.
B. Experimentation with e­cigarettes does not lead to future tobacco use.
C. Most teens who experiment with tobacco usually do not become addicted.
D. This form of nicotine ingestion is safer than regular cigarettes.

Question 9

The mother of a 16­year­old male was recently divorced after several years
of an abusive relationship and tells the primary care pediatric nurse practitioner that the adolescent has begun skipping school and hanging out with friends at the local shopping mall. When she confronts her child, he responds by saying that he hates her. What will the nurse practitioner tell this mother?
A. Adolescence is marked by an inability to comprehend complex situations.
B. Adolescence is typically marked by tempestuous and transient episodes.
C. Adolescents normally have extreme, disruptive conflicts with parents.
D. Adolescents often need counseling to help them cope with life events.

Question 10

The primary care pediatric nurse practitioner is performing an exam on an
adolescent male who asks about sexual identity because of concern that a friend is worried about being gay. Which response will the nurse practitioner make in this situation?
A. Provide the teen with a questionnaire to gain information about his sexuality.
B. Remind the adolescent that mandatory reporting requires disclosure to parents.
C. Suggest that the adolescent discuss sexual concerns with his parents.
D. Tell the adolescent that, unless he is at risk, what he says will be confidential.

Question 11

The mother of a 15­year­old adolescent female tells the primary care
pediatric nurse practitioner that her daughter has extreme mood swings prior to her periods, which the adolescent vehemently denies. When asked if she notices anything different just before her periods, the adolescent points to her mother and says, "She gets really hard to live with." This demonstrates which characteristic of adolescent thinking?
A. Apparent hypocrisy
B. Imaginary audience
C. Overthinking
D. Personal fable

Question 12

The primary care pediatric nurse practitioner is examining a 15­year­old
female who reports having her first period at age 13. She states that she has had five periods in the last year, with the last one 2 months prior. She participates in basketball at school.
Which action is correct?
A. Perform biometric screening to determine lean body mass.
B. Prescribe oral contraceptives pills to regulate her periods.
C. Reassure her that this is perfectly normal at her age.
D. Refer her to an endocrinologist for hormonal evaluation.