Question 1

The weight loss of anorexia nervosa is usually triggered by

Accepted Answer

Weight loss may be triggered by a typical adolescent crisis such as the onset of menstruation or a traumatic interpersonal incident; situations of severe family stress,such as parental separation or divorce; or circumstances in which the young person lacks personal control,such as being teased,changing schools,or entering college."Sexual abuse," "school failure," and "independence from family" are not part of the behavioral characteristics of anorexia nervosa.

Question 2

The nurse is assisting the family of a child with a history of encopresis.Which should be included in the nurse's discussion with this family?

Accepted Answer

Children may be unaware of a prior sensation and unable to control the urge once it begins.They may be so accustomed to bowel accidents that they are unable to smell or feel it.Family counseling is directed toward reassurance that most problems resolve successfully,although relapses during periods of stress are possible.Sitting the child on the toilet is not recommended because it may intensify the parent-child conflict.Enemas may be needed for impactions,but long-term use prevents the child from assuming responsibility for defecation.Stimulant cathartics may cause cramping that can frighten child.

Question 3

A teen asks a nurse,"What is physical dependence in substance abuse?" Which is the correct response by the nurse?

Accepted Answer

Physical dependence is an involuntary response to the pharmacologic characteristics of drugs such as opioids or alcohol.A person can be physically dependent on a narcotic/drug without being addicted; for example,patients who use opioids to control pain need increasing doses to achieve the same effect.Dependence is a physiologic response; it is not culturally determined or subject to voluntary control.

Question 4

Young people with anorexia nervosa are often described as being:

Accepted Answer

Individuals with anorexia nervosa are described as perfectionist,academically high achievers,conforming,and conscientious."Independent," disruptive," and "low achieving" are not part of the behavioral characteristics of anorexia nervosa.

Question 5

A school nurse is conducting a class with adolescents on suicide.Which true statement about suicide should the nurse include in the teaching session?

Accepted Answer

A significant number of teenage suicides occur among homosexual youths.Gay and lesbian adolescents who live in families or communities that do not accept homosexuality are likely to suffer low self-esteem,self-loathing,depression,and hopelessness as a result of a lack of acceptance from their family or community.At-risk teenagers include those who are depressed,have poor problem-solving skills,or use drugs and alcohol.History of previous suicide attempt is a serious indicator for possible suicide completion in the future.

Question 6

Which symptoms should the nurse expect to observe during the physical assessment of an adolescent girl with severe weight loss and disrupted metabolism associated with anorexia nervosa?

Accepted Answer

Symptoms of anorexia nervosa include lower body temperature,severe weight loss,decreased blood pressure,dry skin,brittle nails,altered metabolic activity,and presence of lanugo hair.Amenorrhea,rather than dysmenorrhea,and cold intolerance are manifestations of anorexia nervosa.Bradycardia,rather than tachycardia,may be present.

Question 7

An adolescent girl tells the nurse that she is very suicidal.The nurse asks her whether she has a specific plan.Asking this should be considered:

Accepted Answer

Routine health assessments of adolescents should include questions that assess the presence of suicidal ideation or intent.Questions such as,"Have you ever developed a plan to hurt yourself or kill yourself?" should be part of that assessment.Adolescents who express suicidal feelings and have a specific plan are at particular risk and require further assessment and constant monitoring.The information about having a plan is an essential part of the assessment and greatly affects the treatment plan.

Question 8

The nurse is caring for an adolescent brought to the hospital with acute drug toxicity.Cocaine is believed to be the drug involved.Data collection should include what information?

Accepted Answer

When the drug is questionable or unknown,every effort must be made to determine the type,amount of drug taken,the mode and time of administration,and factors relating to the onset of presenting symptoms.The actual content of most street drugs is highly questionable.Pharmacologic agents should be administered with caution,except for the narcotic antagonists in case of suspected opioid use.The function the drug plays in the adolescent's life and the adolescent's level of interest in rehabilitation are important considerations in the long-term management during the nonacute stage.

Question 9

Which is descriptive of bulimia during adolescence?

Accepted Answer

Individuals with bulimia are of normal or more commonly slightly above normal weight.Those who also restrict their intake can become severely underweight.The adolescent has a lack of control over eating during the episode.Patients with bulimia commonly have self-deprecating thoughts and a depressed mood after binge-purge cycles; they are also aware that the eating pattern is abnormal but are unable to stop.

Question 10

Parents have a concern that their child is depressed.The nurse relates that which characteristic best describes children with depression?

Accepted Answer

Physiologic characteristics of children with depression include change in appetite resulting in weight loss or gain,nonspecific complaints of not feeling well,alterations in sleeping pattern,insomnia or hypersomnia,and constipation.Children who are depressed have sad facial expressions with absence or diminished range of affective response.These children withdraw from previously enjoyed activities and engage in solitary play or work with a lack of interest in play.A lack of interest is seen in doing homework or achieving in school,resulting in lower grades in children who are depressed.

Question 11

An adolescent teen has bulimia.Which assessment finding should the nurse expect to assess?

Accepted Answer

Some of the signs of bulimia include erosion of tooth enamel,increased dental caries from vomited gastric acid,throat complaints,fluid and electrolyte disturbances,and abdominal complaints from laxative abuse.Diarrhea is not a result of the vomiting.It may occur in patients with bulimia who also abuse laxatives.Amenorrhea and cold intolerance are characteristics of anorexia nervosa,which some bulimics have.These symptoms are related to the extreme low weight.

Question 12

The nurse is teaching the parents of a child recently diagnosed with ADHD who has been prescribed methylphenidate (Ritalin).Which should the nurse include in teaching about the side effects of methylphenidate?

Accepted Answer

Nervousness is one of the common side effects of Ritalin.Decreased appetite with subsequent weight loss,insomnia,and increased blood pressure are other common side effects.

Question 13

Which is descriptive of attention deficit hyperactivity disorder (ADHD)?

Accepted Answer

ADHD affects every aspect of the child's life,but the disruption is most obvious in the classroom.The behaviors exhibited by the child with ADHD are not unusual aspects of behavior.The difference lies in the quality of motor activity and developmentally inappropriate inattention,impulsivity,and hyperactivity that the child displays.Some children experience decreased symptoms during late adolescence and adulthood,but a significant number carry their symptoms into adulthood.Any given child will not have every symptom of the condition.The manifestations may be numerous or few,mild or severe,and will vary with the child's developmental level.

Question 14

An adolescent has been diagnosed with lactose maldigestion intolerance.The nurse teaches the adolescent about lactose maldigestion intolerance and notes the teen needs further teaching if which statement is made?

Accepted Answer

Most people are able to tolerate small amounts of lactose ( ≈1 cup of milk per day)even in the presence of deficient lactase activity.It is recommended that individuals with lactose maldigestion who do not experience lactose intolerance symptoms continue to consume small amounts of dairy products with meals to prevent reduced bone mass density and subsequent osteoporosis.Hard cheese,cottage cheese,and yogurt are sources of lactose that may be better tolerated.A calcium supplement should be taken daily.Milk taken at meals may be better tolerated than when taken alone.

Question 15

An adolescent has been diagnosed with Chlamydia infection.Which medication should the nurse expect to be prescribed for this condition?

Accepted Answer

Azithromycin is used to treat Chlamydia.The patient should be rescreened in 3 to 4 months.Ceftriaxone is used to treat gonorrhea,acyclovir is used to suppress genital herpes simplex virus,and penicillin G benzathine is used to treat syphilis.

Question 16

Which is the most commonly used method in completed suicides?

Accepted Answer

Firearms are the most commonly used instruments in completed suicides among both males and females.For adolescent boys,firearms are followed by hanging and overdose.For adolescent females,overdose and strangulation are the next most common means of completed suicide.The most common method of suicide attempt is overdose or ingestion of potentially toxic substances such as drugs.The second most common method of suicide attempt is self-inflicted laceration.Carbon monoxide poisoning is not one of the more frequent forms of suicide completion.

Question 17

A mother calls the school nurse saying that her daughter has developed a school phobia.She has been out of school 3 days.The nurse's recommendations should include which intervention?

Accepted Answer

The primary goal is to return the child to school.Parents must be convinced gently,but firmly,that immediate return is essential and that it is their responsibility to insist on school attendance.The longer the child is permitted to stay out of school,the more difficult it will be for the child to reenter.Trying to find the cause of phobia will only delay the return to school and inhibit the child's ability to cope.Professional counseling is recommended if the problem persists,but the child's return to school should not wait for the counseling.

Question 18

Which is descriptive of central nervous system stimulants?

Accepted Answer

Central nervous system stimulants such as amphetamines and cocaine produce a strong psychological dependence.This class of drugs does not produce strong physical dependence and can be withdrawn without much danger.Acute intoxication leads to violent,aggressive behavior or psychotic episodes characterized by paranoia,uncontrollable agitation,and restlessness.

Question 19

Which is an important consideration when the nurse is discussing enuresis with the parents of a young child?

Accepted Answer

Organic causes that may be related to enuresis should be ruled out before psychogenic factors are considered.Enuresis is more common in boys than in girls and has a strong familial tendency.Psychogenic factors may influence enuresis,but it is doubtful that they are causative.

Question 20

Which is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats?

Accepted Answer

Social isolation is a significant factor in distinguishing adolescents who will kill themselves from those who will not.It is also more characteristic of those who complete suicide than of those who make attempts or threats.Level of stress,degree of depression,and desire to punish others are contributing factors in suicide,but they are not the most significant factor in distinguishing those who complete suicide from those who attempt suicide.

Quiz 17: Health Problems of School-Age Children and Adolescents