San Jacinto College - RNSG 2201

Chapter 16: Health Problems of School-Age Children and Adolescents Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition

MULTIPLE CHOICE

1)Which statement is true about smoking in adolescence?

1. 1. Smoking is related to other high-risk behaviors.
   2. Smoking will not continue unless peer pressure continues.
   3. Smoking is less common when the adolescent’s parent(s) smokes.
   4. Smoking among adolescents is becoming more prevalent.

2. What is smokeless tobacco?

1. 1. Not addicting
   2. Proven to be carcinogenic
   3. Easy to stop using

1. 4. A safe alternative to cigarette smoking

3. A child has been diagnosed with enuresis. TCA imipramine (Tofranil) has been prescribed for the child. The nurse understands that this medication is in which category?
   1. Antidepressant
   2. Antidiuretic
   3. Antispasmodic
   4. Analgesic

4. A 12-year-old male has short stature because of a constitutional growth delay. What should the nurse be the most concerned about?
   1. Proper administration of thyroid hormone
   2. Proper administration of human growth hormones
   3. Child’s self-esteem and sense of competence
   4. Helping child understand that his height is most likely caused by chronic illness and is not his fault

5. An adolescent asks the nurse what causes primary dysmenorrhea. The nurse’s response should be based on which statement?
   1. It is an inherited problem.
   2. Excessive estrogen production causes uterine pain.
   3. There is no physiologic cause; it is a psychological reaction.
   4. There is a relation between prostaglandins and uterine contractility.

6. An adolescent girl asks the school nurse for advice because she has dysmenorrhea. She says that a friend recommended she try an over-the-counter nonsteroidal anti-inflammatory drug (NSAID). The nurse’s response should be based on which statement?

1. 1. Aspirin is the drug of choice for the treatment of dysmenorrhea.
   2. Over-the-counter NSAIDs are rarely strong enough to provide adequate pain relief.
   3. NSAIDs are effective because of their analgesic effect.
   4. NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity.

7. A 14-year-old boy and his parents are concerned about bilateral breast enlargement. The nurse’s discussion of this should be based on which statement?
   1. This is usually benign and temporary.
   2. This is usually caused by Klinefelter syndrome.
   3. Administration of estrogen effectively reduces gynecomastia.
   4. Administration of testosterone effectively reduces gynecomastia.

8. An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago. She has not received any medical care. She smokes but denies any other substance use. What is the priority nursing action?
   1. Notify her parents
   2. Refer for prenatal care
   3. Explain the importance of not smoking
   4. Discuss dietary needs for adequate fetal growth

9. An adolescent girl calls the nurse at the clinic because she had unprotected sex the night before and does not want to be pregnant. What should the nurse explain to the girl?
   1. It is too late to prevent an unwanted pregnancy
   2. An abortion may be the best option if she is pregnant
   3. Norplant can be administered to prevent pregnancy for up to 5 years
   4. Postcoital contraception is available to prevent implantation

10. A sexually active female adolescent asks the nurse about the contraceptive Depo-Provera. What should the nurse explain regarding the contraceptive?
    1. Requires injections every 3 months
    2. Requires daily administration of medication by mouth
    3. Provides long-term continuous protection, up to 5 years
    4. Prevents pregnancy if given within 72 hours of unprotected sex

11. Which statement is true about gonorrhea?
    1. It is caused by Treponema pallidum.
    2. Treatment is by multidose administration of penicillin.
    3. Treatment is by topical applications to lesions.

1. 4. Treatment of all sexual contacts is an essential part of treatment.

12. Which statement regarding chlamydia infection is correct?
    1. Treatment of choice is oral penicillin.
    2. Treatment of choice is nystatin or miconazole.
    3. Clinical manifestations include dysuria and urethral itching in males.
    4. Clinical manifestations include small, painful vesicles on genital areas.

13. A nurse is conducting a class for adolescent girls about pelvic inflammatory disease (PID). Why should the nurse emphasize the importance of preventing pelvic inflammatory disease (PID)?
    1. PID can be sexually transmitted.
    2. PID cannot be treated.
    3. PID can have devastating effects on the reproductive tract.
    4. PID can cause serious defects in future children of affected adolescents.

14. Which statement is correct about childhood obesity?
    1. Heredity is an important factor in the development of obesity.
    2. Childhood obesity in the United States is decreasing.

1. 3. Childhood obesity is the result of inactivity.
   4. Childhood obesity can be attributed to an underlying disease in most cases.

15. What is a psychological effect of being obese during adolescence?
    1. Sexual promiscuity
    2. Poor body image
    3. Feelings of contempt for thin peers
    4. Accurate body image but self-deprecating attitude

16. What is the best description of anorexia nervosa?
    1. Occurs most frequently in adolescent males
    2. Occurs most frequently in adolescents from lower socioeconomic groups
    3. Results from a posterior pituitary disorder
    4. Results in severe weight loss in the absence of obvious physical causes

17. How are young people with anorexia nervosa often described?
    1. Independent
    2. Disruptive
    3. Conforming
    4. Low achieving

18. What usually triggers the weight loss of anorexia nervosa?
    1. Sexual abuse
    2. School failure
    3. Independence from family
    4. Traumatic interpersonal conflict

19. 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?

1. 1. Dysmenorrhea and oliguria
   2. Tachycardia and tachypnea
   3. Heat intolerance and increased blood pressure
   4. Lowered body temperature and brittle nails

20. Which is descriptive of bulimia during adolescence?
    1. Strong sense of control over eating behavior
    2. Feelings of elation after the binge-purge cycle
    3. Profound lack of awareness that the eating pattern is abnormal
    4. Weight that can be normal, slightly above normal, or below normal

21. An adolescent teen has bulimia. Which assessment finding should the nurse expect to assess?
    1. Diarrhea
    2. Amenorrhea
    3. Cold intolerance
    4. Erosion of tooth enamel

22. Which is descriptive of attention deficit hyperactivity disorder (ADHD)?
    1. Manifestations exhibited are so bizarre that the diagnosis is fairly easy.
    2. Manifestations affect every aspect of the child’s life but are most obvious in the classroom.
    3. Learning disabilities associated with ADHD eventually disappear when adulthood is reached.
    4. Diagnosis of ADHD requires that all manifestations of the disorder be present.

23. 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?
    1. “Your child may experience a sense of nervousness.”
    2. “You may see an increase in your child’s appetite.”
    3. “Your child may experience daytime sleepiness.”
    4. “You may see a decrease in your child’s blood pressure.”

24. Which is an important consideration when the nurse is discussing enuresis with the parents of a young child?
    1. Enuresis is more common in girls than in boys.
    2. Enuresis is neither inherited nor has a familial tendency.
    3. Organic causes that may be related to enuresis should be considered first.
    4. Psychogenic factors that cause enuresis persist into adulthood.

25. 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?
    1. Instruct the parents to sit the child on the toilet at twice-daily routine intervals.
    2. Instruct the parents that the child will probably need to have daily enemas.
    3. Suggest the use of stimulant cathartics weekly.
    4. Reassure the family that most problems are resolved successfully, with some relapses during periods of stress.

26. 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?
    1. Immediately return the child to school.
    2. Explain to the child that this is the last day she can stay home.
    3. Determine the cause of phobia before returning the child to school.
    4. Seek professional counseling before forcing the child to return to school.

27. Parents have a concern that their child is depressed. The nurse relates that which characteristic best describes children with depression?
    1. Increased range of affective response
    2. Preoccupation with need to perform well in school
    3. Change in appetite, resulting in weight loss or gain
    4. Tendency to prefer play instead of school work.

28. A teen asks a nurse, “What is physical dependence in substance abuse?” Which is the correct response by the nurse?
    1. Problem that occurs in conjunction with addiction
    2. Involuntary physiologic response to drug
    3. Culturally defined use of drugs for purposes other than accepted medical purposes
    4. Voluntary behavior based on psychosocial needs

29. Which is descriptive of central nervous system stimulants?
    1. They produce strong physical dependence.
    2. They can result in strong psychological dependence.
    3. Withdrawal symptoms are life threatening.
    4. Acute intoxication can lead to coma.

30. 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?
    1. Mode of administration
    2. Drug’s actual content
    3. Function the drug plays in the adolescent’s life
    4. Adolescent’s level of interest in rehabilitation

31. A school nurse is conducting a class with adolescents on suicide. Which true statement about suicide should the nurse include in the teaching session?
    1. A sense of hopelessness and despair are a normal part of adolescence.
    2. Gay and lesbian adolescents are at a particularly high risk for suicide.

1. 3. Problem-solving skills are of limited value to the suicidal adolescent.
   4. Previous suicide attempts are not an indication of risk for completed suicides.

32. Which is the most commonly used method in completed suicides?
    1. Firearms
    2. Drug overdose
    3. Self-inflected laceration
    4. Carbon monoxide poisoning

33. Which is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats?
    1. Social isolation
    2. Level of stress
    3. Degree of depression
    4. Desire to punish others

34. 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:
    1. an appropriate part of the assessment.
    2. not a critical part of the assessment.
    3. suggesting that the adolescent needs a plan.
    4. encouraging the adolescent to devise a plan.

35. 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?
    1. “I will limit my milk consumption to one to two glasses a day.”
    2. “I should drink the milk alone and not with other foods.”
    3. “Hard cheese, cottage cheese, or yogurt can be substituted for milk.”
    4. “I will take a calcium supplement daily.”

36. An adolescent has been diagnosed with Chlamydia infection. Which medication should the nurse expect to be prescribed for this condition?
    1. Ceftriaxone (Rocephin) IM
    2. Azithromycin (Zithromax) PO
    3. Acyclovir (Zovirax) PO
    4. Penicillin G benzathine (Bicillin) IV

37. Tretinoin (Retin-A) is a topical agent commonly used to treat acne. Nursing considerations with this drug should include:
    1. teaching to avoid use of sunscreen agents.
    2. applying generously to the skin.
    3. explaining that medication should not be applied until at least 20 to 30 minutes after washing.
    4. explaining that erythema and peeling are indications of toxicity.

38. When is isotretinoin (Accutane) indicated for the treatment of acne during adolescence?
    1. The acne has not responded to other treatments.
    2. The adolescent is or may become pregnant.
    3. The adolescent is unable to give up foods causing acne.
    4. Frequent washing with antibacterial soap hasbeen unsuccessful.

MULTIPLE RESPONSE

1. A nurse is recommending strategies to a group of school-age children for prevention of obesity. Which should the nurse include? (Select all that apply.)
   1. Eat breakfast daily.
   2. Limit fruits and vegetables.
   3. Have frequent family meals with parents present.
   4. Eat frequently at restaurants.
   5. Limit television viewing to 2 hours a day.

2. Which strategies should the school nurse recommend implementing in the classroom for a child with attention deficit hyperactive disorder (ADHD)? (Select all that apply.)
   1. Schedule heavier subjects to be taught in the afternoon.
   2. Accompany verbal instructions by written format.
   3. Limit number of breaks taken during instructional periods.
   4. Allow more time for testing.
   5. Reduce homework and classroom assignments.