Deck 7: The Adolescent and Young Adult 12-21 Years of Age Interval Visit

Question 1

A 15-year-old girl presents for an annual primary care visit accompanied by her mother. In order to provide adequate and appropriate care, the clinician should:

A) Inform the parent that her daughter has the right to confidential services and the parent needs to remain in the waiting room during the visit
B) Inform the parent that her daughter has the right to confidential services, but include the parent in all aspects of the visit because it is an annual exam, not a confidential visit
C) Inform the parent that her daughter has the right to confidential services and advise the parent that if there are any confidential concerns she will be asked to leave the exam room
D) Inform the parent that her daughter has the right to confidential services and include the parent in some, but not all, aspects of the visit

Answer 1

D

Question 2

The psychosocial assessment:

A) Should be completed with both the youth and caregiver to obtain both of their perspectives
B) Helps to identify risk and protective factors in the youth and their environment
C) Should be completed once in adolescence and once in young adulthood
D) Is a specific set of questions that should be asked of all adolescents regardless of the reason for visit

Answer 2

B

Question 3

The clinical breast exam is indicated for:

A) Adolescent females with Sexual Maturity Rating (SMR) 4
B) Adolescent females with SMR 5
C) Females beginning at 20 years of age
D) All adolescent females regardless of age

Answer 3

C

Question 4

A pelvic exam is indicated for:

A) Sexually active adolescent females after the age of 16
B) Sexually active adolescent females regardless of age
C) Females at 21 years of age regardless of reported sexual activity
D) Sexually active adolescents who report multiple sexual partners

Question 5

Diane is a well-nourished, well-developed 17-year-old female who reports regular menses every 30 days, moderate flow for 3-5 days, who presents for a well adolescent visit. Routine adolescent primary care visits should include:

A) Hemoglobin/hematocrit every 5-10 years starting in adolescence
B) Annual hemoglobin/hematocrit due to potential menstrual blood loss starting with menarche
C) Biannual complete blood count (CBC) to evaluate for anemia starting at age 12
D) Iron supplementation to compensate for menstrual blood loss

Question 6

Dyslipidemia screening is recommended:

A) Universally using a fasting lipid profile for all 12-16 year olds
B) Universally using a nonfasting non-HDL-C for all 17-21 year olds
C) Selectively based on risk using a nonfasting non-HDL-C for all 12-16 year olds
D) Selectively only in adolescents, based on personal and family risk regardless of age using a fasting lipid profile

Question 7

Adam is at his pediatric clinic visit, is a 16-year-old male, reports one lifetime sexual partner who is female, denies any symptoms, and requests "to be tested for everything." He has never been screened for any sexually transmitted infection (STI). Following STI screening recommendations by the CDC and/or the U.S. Preventive Services Task Force (USPSTF), Adam should be offered which of the following:

A) HIV screening
B) Gonorrhea screening
C) Chlamydia screening
D) Syphilis screening

Question 8

Anita is at her pediatric clinic visit, is a 17-year-old female, reports one lifetime sexual partner who is male, denies any symptoms, and requests "to be tested for everything." She has never been screened for any STI and is not pregnant. Following STI screening recommendations by the CDC and the USPSTF, Anita should be offered which of the following:

A) Gonorrhea, chlamydia, and syphilis screening
B) No STI screening because she is low risk and asymptomatic
C) Gonorrhea and chlamydia screening
D) Gonorrhea, chlamydia, and HIV screening

Question 9

James is 13 years old, SMR 3/2, and his BMI is at the 85th percentile. The most appropriate follow-up plan for him would be:

A) Advice to not be concerned about his weight, as he will gain height and grow into his weight
B) Recommendation for a calorie-restricted diet with limited carbohydrates
C) Referral to a program that includes dietary, physical activity, and behavioral counseling components
D) Motivational interviewing with the goal of increasing physical activity

Question 10

When asked if she has ever used any alcohol or drugs, Alicia, an 18-year-old college freshman, responds "Just drinking at parties and smoking weed…nothing heavy or serious." The clinician's next step should be:

A) Administering the CAGE questionnaire because it is adolescent specific to quantify and qualify substance use
B) Advising Alicia not to drink and drive
C) Commending Alicia for not using dangerous drugs
D) Administering the CRAFFT questionnaire because it is adolescent specific to quantify and qualify substance use