Question 1

A 16-year-old male tells the nurse that he is not in the mood to do anything with his friends.He states,"For weeks now I am just not interested in doing anything and I've stopped all my sports activities.I just feel sad all the time and I just don't want to go on." The nurse completes her assessment and begins her plan of care.What is the most appropriate nursing intervention at this time?

Accepted Answer

Depression affects up to 8.3% of adolescents in the United States and the percentage may even be higher.Adolescents who report feeling sad or hopeless almost every day for more than 2 weeks usually stop doing some activities they considered fun.Additionally,they may have difficulty identifying and describing their emotional or mood states.In this item,the male is expressing how he feels.He is also describing a severe depressive state by citing,"I do not want to go on." The nurse must be alerted to this and immediately intervene by making a mental health referral,as this male is at high risk for suicide.Confidentiality is important in this age group; however,if there is concern about suicide,explain to the adolescent that you are required to share this information with others including mental health specialists and parents.Contacting the parents is important but the first action is to make a mental health referral.

Question 2

A 12-year-old child diagnosed with cancer is hospitalized for the first time.Considering many children in this age group possess a fear of hospitals,what strategies will the nurse use to help the child during hospitalization? Select all that apply.

Accepted Answer

Hospitalized children may fear the unknown,the strange environment,and strange professionals.They report missing the comforts of home,their mother's cooking,their own room,and so on.They are bothered by separations from family and friends and by the loss of control over their personal needs.The nurse can help by maximizing their contact with outside friends and school.Offer children choices when possible to restore some sense of control.For example,allow them to choose meal preferences or time of bathing.Encourage parents to bring familiar items from home to personalize their space.Involve parents in their care as much as possible and provide the parents with accurate information so they can relieve the child's anxieties.

Question 3

A sexually active high school student is asking about contraceptive devices.The nurse knows that the student understands the information when she states which of the following? Select all that apply.

Accepted Answer

Sexual experimentation is common among teenagers.Sexually transmitted infections,including HIV/AIDS,and pregnancy are major health consequences associated with sexual activity,and especially with unprotected sexual activity.Use of condoms and safe sex practices are essential in preventing the unwanted consequences of sexual activity.Condoms are not 100% effective in preventing either STIs or pregnancy.

Question 4

The 17-year-old single mother of a 2-month-old infant comes to the clinic and tells the nurse,"Sometimes no matter what I do my baby won't stop crying.I hold him up in the air and shake him until he stops." Based on these statements by the mother,what is the first action by the nurse?

Accepted Answer

In this item,safety is the first concern.The mother needs education about the dangers of shaking the baby.Abusive head trauma (AHT),formerly known as shaken-baby syndrome,is a form of child abuse that causes severe brain injury.However,in this item it appears that the mother is open and honest with her concern and does not know the dangers of shaking the baby.Further assessment and questioning are indicated prior to reporting child abuse.Additionally,it is most important to first teach the mother the dangers of shaking the baby; then,the nurse can proceed with offering suggestions on managing a crying baby.

Question 5

The pediatric nurse is going to a preschooler class to do a presentation on teeth brushing.Prior to the start of class,she spends some time meeting and talking with the students.Which of the following statement(s)by the preschoolers indicates normal development for this group? Select all that apply.

Accepted Answer

Preschoolers aged 4 to 5 years become increasingly verbal and independent.Verbal skills expand dramatically and they are increasingly interested in books,reading,and counting.They do lack the ability to reason formally and are unable to understand that two objects that appear different may in fact be the same,for example,ice and water.Psychosocially,the child at this age develops a conscience and readily recognizes right from wrong.

Question 6

The parents of an adolescent client ask about strategies that can be used to aid in obesity prevention.Which strategies should the nurse present to them? Select all that apply.

Accepted Answer

Appropriate teaching topics to prevent obesity in adolescents include avoiding sedentary lifestyles by adhering to an exercise program,eating smaller portions,avoiding fast foods,and substituting balanced meals for high-calorie,nutrient-poor snacks.During a development stage in which adolescents strive for independence,avoid highly restrictive diets that forbid favorite foods (e.g.,fast foods,sodas).Following diet trends may be effective in short-term weight loss but does not lead to sustained weight maintenance.

Question 7

The nurse is teaching a parent group of adolescent children about body piercings and tattoos.What is most important for the nurse to include in her teaching? Select all that apply.

Accepted Answer

One of the strongest needs for teens is to feel accepted within a group of their own choosing.Acceptance on a sports team,in a club,or in a clique increases the teen's sense of self-esteem.Additionally,adolescents may engage in the trend of body art and piercings for a number of reasons,including a desire for social bonding,desire to look like their peers,and the wish to commemorate a friend or loved one.Tattoos and piercings can cause skin infections and blood-borne disease such as HIV and hepatitis and parents and teens should be educated about this.Some studies have reported a significant relationship between piercing and substance abuse,leading some to speculate that body piercing may serve as a marker of an at-risk teen.However,most teens who have tattoos and piercings do not have a substance abuse problem.

Question 8

The nurse is giving a health promotion class for middle-aged males.As part of her teaching plan,the nurse will provide information on which common health problems associated with this age group? Select all that apply.

Accepted Answer

In the middle adult years,chronic diseases emerge as a major health problem.The most common are cancer,primarily lung,breast,colon,and prostate,obesity,diabetes,hypertension,and cardiovascular disease.Health promotion and health screenings should be conducted in all these areas.Alcoholism is a health problem for many age groups but it is not classified as a major health problem for the middle-aged adult.

Question 9

The nurse is beginning her routine assessment on a 3-year-old child.To gain trust and support from the child,the most appropriate action by the nurse is to:

Accepted Answer

When performing an assessment on a toddler,the nurse must be sensitive to the fact that children of this age are generally fearful of strangers.Thus,before beginning an assessment you will need to establish a rapport with the child.To do so,the nurse might engage in play,for example,playing catch with a ball.Additionally,encourage parents to relieve their child's stress and anxiety by holding the child during the exam and speaking to the child in a calm and reassuring voice.

Question 10

A 30-year-old female comes to the emergency department with visible bruises to her face and arms.She tells the nurse: "My husband has been hitting me." The most appropriate response by the nurse is which of the following?

Accepted Answer

Suspected child and elder abuse must be reported to the appropriate agency,according to federal and state laws.Spousal abuse may be mandatory to report,depending on the state law.The Joint Commission requires that all cases of possible abuse or neglect be immediately reported in the hospital.If a patient discloses domestic violence,act immediately.Ask the patient whether she would like you to contact the agency's domestic violence advocate (if there is one).If not,provide contact information for community domestic violence programs.

Question 11

A 52-year-old female comes to the office for her routine yearly physical examination.As part of the nurse's assessment,which of the following principal physical changes in women of this age group is most expected?

Accepted Answer

One of the principal changes that middle-adult women experience is menopause,the cessation of menstrual periods for at least 12 months.Some symptoms include hot flashes,a decrease in breast size,nighttime awakenings,and mood swings.However,each patient is different and experiences different symptoms.Graying hair,decreasing muscle tone,decreasing bone mass,and decreasing elasticity of blood vessels are physiological changes in this age group; however,the principal change for a woman is menopause.Breast cancer is a common health problem but not an expected or principal change.

Question 12

The nurse from the local high school is giving a presentation to 16-year-olds on safety risks associated with driving.Which of the following will the nurse include in the presentation as being high-risk activities for motor vehicle crashes while driving? Select all that apply.

Accepted Answer

In the United States,77% of all deaths among young people aged 10 to 25 result from four causes; motor vehicle crashes are responsible for 30% of these.Many adolescents engage in behavior that increases their risk and likelihood of death or injury including texting while driving and drinking and driving.Talking to other people in the car and listening to the radio can be distractions while driving but not to the degree of high risk as texting and drinking.

Quiz 9: Life Span: Infancy Through Middle Adulthood