Chapter 14: Problems of Adolescence Nursing School Test Banks

Chapter 14: Problems of Adolescence
Test Bank

MULTIPLE CHOICE

1. The child in early adolescence experiences developmental issues with his or her identity as evidenced by:
a. Feeling stable with his or her self-esteem
b. Conforming to group norms
c. Being very self-centered
d. Being idealistic
ANS: B
Acceptance and rejection of peers are very important to this age group, so conforming to norms is frequently seen. Feeling stable with ones self-esteem refers to late adolescence (17 to 20 years old), and being self-centered and idealistic applies to middle adolescence (14 to 17 years old).

DIF: Cognitive Level: Comprehension REF: p. 156 OBJ: 1
TOP: Psychosocial Development KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

2. Internal developmental problems are seen as a causative factor for some behavioral and family problems during adolescence. Psychological developmental issues that can lead to problems during late adolescence (17 to 20 years old) include:
a. Wide mood swings
b. Tendency to withdraw when upset
c. Intense daydreaming
d. Concealing of anger
ANS: D
Even though adolescents in this age group experience few mood swings, they tend to conceal their anger to a greater extent than do adolescents from other developmental periods. Wide mood swings are typical of the early adolescent period (11 to 14 years old), and the tendency to withdraw when upset and intense daydreaming refer to middle adolescence (14 to 17 years old).

DIF: Cognitive Level: Comprehension REF: p. 158 OBJ: 1
TOP: Psychosocial Development KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

3. A male adolescent client tells the nurse that he is almost positive that he is homosexual. This realization most likely has occurred during the developmental period of:
a. Late childhood
b. Early adolescence
c. Middle adolescence
d. Late adolescence
ANS: C
Usually by the age of 14 to 17 years, most adolescents have discovered their sexual preference.

DIF: Cognitive Level: Comprehension REF: p. 158 OBJ: 1
TOP: Psychosocial Development KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

4. Environmental problems often lead to mental health problems among adolescents. Approximately _____ million children and adolescents must cope with the issue of having a parent in jail or on parole.
a. 3
b. 7
c. 11
d. 14
ANS: B
These adolescents have to deal with the many issues associated with having a parent in this circumstance while maintaining the energy necessary to focus on the typical growth and development issues that adolescents experience.

DIF: Cognitive Level: Knowledge REF: p. 157 OBJ: 1
TOP: External (Environmental) Problems
KEY: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

5. The nurse is working with a 15-year-old girl and her parents on a treatment plan for her diagnosis of attention-deficit/hyperactivity disorder (ADHD). The nurse should be sure to:
a. Encourage the parents to seek teachers for their daughter who are going to be lenient with assignment schedules because of her diagnosis.
b. Remind the parents to determine ahead of time consequences/punishment that they will give their daughter when she is not listening to them and/or teachers.
c. Teach the parents how to structure and enforce limits on their daughters behavior that are appropriate to her condition.
d. Inform the client and her parents that medications typically used for ADHD are very safe and have few side effects.
ANS: C
Consistent limit setting is helpful to teens with ADHD because it is difficult for them to set limits for themselves. Encouraging lenient teachers violates this principle. The parents should seek teachers who are understanding of their daughters condition but remain consistent in setting limits in their course. Positive reinforcement for appropriate behavior is more effective than punishment, and many medications for ADHD react with other medications and sometimes have serious side effects.

DIF: Cognitive Level: Application REF: p. 160 OBJ: 3
TOP: Behavioral Disorders KEY: Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity

6. The nurse is working with a teen in whom conduct disorder was diagnosed and his family on developing a plan of care for treatment. What is the nurses first intervention?
a. Assessing and/or stabilizing the home environment
b. Teaching effective communication skills to the client and family members
c. Advocating behavior modification for the client to gain self-control
d. Teaching effective discipline techniques
ANS: A
After the home environment has been assessed and stabilized, the other interventions can be implemented in the order necessary according to priority of need.

DIF: Cognitive Level: Application REF: p. 161 OBJ: 3
TOP: Behavioral Disorders KEY: Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity

7. Adolescents and young adult women account for ______% of Americans affected by eating disorders.
a. 25 to 30
b. 55 to 60
c. 70 to 75
d. 85 to 90
ANS: D
This high percentage is thought to be due to societys influence on what constitutes being attractive.

DIF: Cognitive Level: Knowledge REF: p. 162 OBJ: 5
TOP: Eating Disorders KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

8. In a research study of eating disorders, it was found that the most frequent weight loss method used by female high school students was:
a. Exercising
b. Skipping meals
c. Using diet pills
d. Vomiting
ANS: B
Forty-nine percent of high school females in this study used skipping meals as a weight loss method, followed by exercising, using diet pills, and vomiting.

DIF: Cognitive Level: Knowledge REF: p. 162 OBJ: 5
TOP: Eating Disorders KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

9. A 15-year-old girl is being admitted to an inpatient mental health clinic with the diagnosis of anorexia nervosa. The nurse knows that the most common personality characteristic of teens affected with this disorder is:
a. Excessive cooperation
b. Underachievement
c. Normal body weight
d. Positive self-esteem
ANS: A
Characteristics of the personality of female teens with anorexia nervosa include being excessively cooperative and achievement oriented and having a body image of being overweight. Underachievement and positive self-esteem are opposite traits to those seen in a teen with anorexia nervosa, and normal body weight may characterize a teen with a healthy self-concept, or it may be a characteristic of bulimia.

DIF: Cognitive Level: Knowledge REF: p. 162 OBJ: 5
TOP: Eating Disorders KEY: Nursing Process Step: Planning
MSC: Client Needs: Psychosocial Integrity

10. When one is developing the care plan for a female adolescent with an eating disorder, the primary issue to consider as the underlying cause is:
a. Control
b. Body image
c. Self-esteem
d. Coping skills
ANS: A
Although any of the issues listed in these options can be an underlying cause, control is the primary issue with an eating disorder. The client often feels that this is the only thing in her life over which she has complete control.

DIF: Cognitive Level: Comprehension REF: p. 162 OBJ: 5
TOP: Eating Disorders KEY: Nursing Process Step: Nursing Diagnosis
MSC: Client Needs: Psychosocial Integrity

11. One of the major goals of therapy for adolescents with chemical dependency is:
a. Replacing the use of the chemical with effective coping skills
b. Placing the chemically dependent adolescent in a residential treatment program
c. Finding a group home setting to which the adolescent will be able to adjust
d. Isolating the adolescent from family and friends during withdrawal from the chemical
ANS: A
This is the overall goal of therapy, so the adolescent will not feel the need to depend on the chemical for coping with stressors. A residential treatment program or a group home setting may be a necessary intervention in some cases, but it is not a goal of therapy. Isolation during withdrawal is not necessary.

DIF: Cognitive Level: Comprehension REF: p. 164 OBJ: 6
TOP: Chemical Dependency KEY: Nursing Process Step: Planning
MSC: Client Needs: Psychosocial Integrity

12. Personality disorders in the adolescent are characterized by:
a. Onset usually in middle childhood
b. Impulsivity
c. Flexibility
d. High self-esteem
ANS: B
Behavior is typically impulsive, leading to poor decision-making skills. Onset of personality disorder usually occurs in adolescence or early adulthood. These individuals tend to be inflexible when dealing with others, and their self-esteem is generally low.

DIF: Cognitive Level: Knowledge REF: p. 164 OBJ: 1
TOP: Personality Disorders KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

13. The parents of a 13-year-old girl are concerned that their daughter has a gender identity disorder. Which sign or symptom most indicates that their concern is correct?
a. Their daughter is playing sports typically considered boys sports.
b. Their daughter has more male friends than female friends.
c. Their daughter does not like to change her clothes in front of anyone.
d. Their daughter frequently wears clothes designed for males.
ANS: D
This behavior is more indicative of a gender identity disorder than the other options. This behavior fulfills the need for this girl to identify with the male gender. Playing sports typically considered boys sports and having more male friends are not considered behaviors of gender identity disorders unless other characteristic behaviors of the disorder occur. Not wanting to change clothes in front of anyone is a common behavior that reflects a 13-year-olds need for privacy.

DIF: Cognitive Level: Application REF: p. 164 OBJ: 1
TOP: Sexual Disorders KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

14. Signs and symptoms of schizophrenia often are first seen in:
a. Early childhood
b. Adolescence
c. Early adulthood
d. Middle adulthood
ANS: B
The onset of schizophrenia usually occurs during adolescence. The individual usually has had a normal childhood but then begins to display behaviors associated with loss of contact with reality, such as hallucinations, delusions, and paranoid feelings.

DIF: Cognitive Level: Knowledge REF: p. 165 OBJ: 1
TOP: Psychosis KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

15. The rate of attempted suicide in adolescents is _____ times higher with females than with males.
a. 3
b. 6
c. 9
d. 12
ANS: A
Although the rate of attempted suicide is three times higher among females, males are more successful in committing suicide because of the more lethal methods that they choose to use. The suicide rate in teens doubled between 1960 and 2000, and the rate increased by 18% in 2004.

DIF: Cognitive Level: Knowledge REF: p. 165 OBJ: 7
TOP: Suicide KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Psychosocial Integrity

16. A teenage girls boyfriend of 1 year ended their relationship and began to date someone else, resulting in the girls attempting suicide by taking an overdose of her mothers sleeping medication. What is the most likely cause of this girls suicide attempt?
a. Depression
b. Serious mental illness
c. The need to influence others
d. An anxiety disorder
ANS: C
This is an example of her need to influence others by getting back at the boyfriend. Depression and serious mental illness are other reasons frequently noted as causative factors when adolescents attempt suicide. An anxiety disorder is not typically a causative factor.

DIF: Cognitive Level: Analysis REF: p. 166 OBJ: 7
TOP: Suicide KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Psychosocial Integrity

17. A 16-year-old teenage boy who is bullied at school has recently started staying in his room and not associating with his friends. His grades are dropping and he refuses to eat dinner with his family. What actions should his parents be advised to take?
a. Accept this as a normal part of adolescent behavior and do not interfere.
b. Take the door off his room and scold him for his behavior.
c. Realize that his peer group will handle this as he needs to break away from family.
d. Set limits with him in a respectful manner and assist him to problem solve.
ANS: D
Adolescents who are bullied are at high risk for suicide. Health care providers who work with adolescents must assess every teen for his or her suicidal risk. The goals of treatment for suicidal adolescents are to protect them from harm, build trusting therapeutic relationships, and assist them in developing self- awareness and alternate coping skills.

DIF: Cognitive Level: Analysis REF: p. 166 OBJ: 7
TOP: Suicide KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Psychosocial Integrity

18. One of the developmental tasks of adolescence is to establish intimacy and relationships. By the age of 14, what percentage of teens have experienced sexual intercourse?
a. 10%
b. 25%
c. 50%
d. 85%
ANS: C
During adolescence interest in people of the opposite gender begins to increase. By age 14 years, teens explore the concepts of sex appeal and being in love. More than 50% of them have experienced sexual intercourse by this age.

DIF: Cognitive Level: Analysis REF: p. 159 OBJ: 1
TOP: External (Environmental) Problems
KEY: Nursing Process Step: Evaluation MSC: Client Needs: Psychosocial Integrity

19. By the ages of 14 to 17, teens are able to demonstrate problem solving skills using concepts, generalizations, and being flexible in planning actions and goals. What is this an example of?
a. Concrete operations
b. Pre-operational thinking
c. Operational thinking
d. Abstract thinking
ANS: D
By the middle teens (14 to 17), abstract thinking (adaptable, flexible thinking that uses concepts, generalizations, and problem solving) is well entrenched, along with a feeling of power and self- centeredness. Many believe that they can change the world by just thinking about it. At about 17, teens abstract thinking becomes more realistic and they become able to plan reachable actions, goals, and careers.

DIF: Cognitive Level: Analysis REF: p. 156 OBJ: 1
TOP: Psychosocial Development KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Psychosocial Integrity

20. A 15-year-old female started going to parties earlier in the year where drinking and drug use occurred. Her friends now notice that she actively looks for a party every weekend and attends even when her friends are not invited. If they suggest an alternate activity, she refuses to go with them, and is avoiding them at school. What stage of chemical dependency is she exhibiting?
a. Burnout
b. Actively seeking
c. Experimentation
d. Preoccupation
ANS: B
In the actively seeking stage the teen looks forward to and actively seeks out the mood changes brought about by the chemicals; becomes expert in the use of chemicals to regulate moods; schoolwork and relationships with family erode; friends become limited to other teens who use.

DIF: Cognitive Level: Analysis REF: p. 164 OBJ: 6
TOP: Stages of Chemical Dependency KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Psychosocial Integrity

MULTIPLE RESPONSE

21. Which of the following are common signs and symptoms of the eating disorder bulimia? (Select all that apply.)
a. Intake of less than 1000 calories per day
b. Purging after meals
c. Body weight greater than 20% under normal
d. Consumption of 5000 to 20,000 calories per day
e. Erosion of tooth enamel
ANS: B, D, E
Purging commonly occurs after bingeing, and this causes erosion of tooth enamel. Intake of less than 1000 calories per day and body weight at least 20% less than normal are typical of anorexia nervosa. Body weight is often kept normal or within 20% of normal with bulimia.

DIF: Cognitive Level: Knowledge REF: p. 163 OBJ: 5
TOP: Eating Disorders KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

22. Social development and forming an identity are important tasks for the adolescent. Which of the following is true regarding the function of a peer group? (Select all that apply.)
a. Provides stability during change
b. Helps loosen ties to family
c. Serves as standard for dress and behavior
d. Helps to define future roles
e. Learn to doubt self-made choices
ANS: A, B, C, D
Peer groups help to loosen family ties, provide stability during times of change, help adolescents define present and future social roles, learn to trust their own choices, as well as establish behavioral and dress standards.

DIF: Cognitive Level: Knowledge REF: p. 159 OBJ: 1
TOP: Functions of Peer Groups KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

COMPLETION

23. Adolescence is defined as beginning at age _____ years and ending at age _____ years.

ANS:
11, 21
These are the ranges of the beginning and end of adolescence. Physical, sexual, and psychological growth are greatest during these years.

DIF: Cognitive Level: Knowledge REF: p. 155 OBJ: 1
TOP: Problems of Adolescence KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

24. Obesity is defined as body weight that is _____ above average, based on the individuals height and build.

ANS:
20%
Obesity is a growing problem in the United States.

DIF: Cognitive Level: Knowledge REF: p. 162 OBJ: 5
TOP: Eating Disorders KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Psychosocial Integrity

OTHER

25. Adolescents who become chemically dependent progress through four stages. Place these stages in order of occurrence. (Separate letters by a comma and space as follows: A, B, C, D.)
A. Burnout
B. Active seeking
C. Preoccupation
D. Experimentation

ANS:
D, B, C, A
Experimentation involves using the drug for the first time with peers and enjoying the effects of the drug. Active seeking refers to looking forward to using the drug and wanting the feeling that one experiences when using the drug; relationships then begin to become affected, and the teens only friends are the ones who also take the drugs. During the preoccupation stage, the adolescent believes that he or she has to use the drug to cope with life, and relationships fall apart. The last stage, burnout, is characterized by drug use as the primary focus of the teens life, along with addiction and withdrawal symptoms when the drug is not used.

DIF: Cognitive Level: Application REF: p. 164 OBJ: 6
TOP: Chemical Dependency KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

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