Nursing school test bank questions

 

MULTIPLE CHOICE

 

  1. How does the onset of the pubertal growth spurt compare in girls and boys?
a. In girls it occurs about 1 year before it appears in boys.
b. In girls it occurs about 3 years before it appears in boys.
c. In boys it occurs about 1 year before it appears in girls.
d. It is about the same in both boys and girls.

 

 

ANS:  A

Average age of onset is 9 1/2 years for girls and 10 1/2 for boys. Although pubertal growth spurts may occur in girls 3 years before it appears in boys on an individual basis, the average difference is 1 year. Usually girls begin their pubertal growth spurt earlier than boys.

 

DIF:    Cognitive Level: Application           REF:   p. 744

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. In girls the initial indication of puberty is which of the following?
a. Menarche
b. Growth spurt
c. Breast development
d. Growth of pubic hair

 

 

ANS:  C

In most girls the initial indication of puberty is the appearance of breast buds, an event known as thelarche. The usual sequence of secondary sexual characteristic development in girls is breast changes, rapid increase in height and weight, growth of pubic hair, appearance of axillary hair, menstruation (menarche), and abrupt deceleration of linear growth.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 742

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. Girls experience an increase in weight and fat deposition during puberty. Nursing considerations related to this include which of the following?
a. Give reassurance that these changes are normal.
b. Suggest dietary measures to control weight gain.
c. Encourage low-fat diet to prevent fat deposition.
d. Recommend increased exercise to control weight gain.

 

 

ANS:  A

A certain amount of fat is increased along with lean body mass to fill the characteristic contours of the child’s gender. A healthy balance must be achieved between expected healthy weight gain and obesity. Suggesting dietary measures or increased exercise to control weight gain would not be recommended unless weight gain was excessive; eating disorders can develop in this group. Some fat deposition is essential for normal hormonal regulation. Menarche is delayed in girls with body fat contents that are too low.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 744

TOP:   Nursing Process: Implementation     MSC:  Client Needs: Health Promotion and Maintenance

 

  1. In boys the initial indication of puberty is which of the following?
a. Voice changes
b. Growth of pubic hair
c. Testicular enlargement
d. Increased size of penis

 

 

ANS:  C

Testicular enlargement is the first change that signals puberty in boys; it usually occurs between the ages of 9 1/2 and 14 years during Tanner stage 2. Voice change occurs between Tanner stages 3 and 4. Fine pubic hair may occur at the base of the penis; darker hair occurs during Tanner stage 3. Penis enlarges during Tanner stage 3.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 743

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. According to Piaget, adolescents tend to be in which stage of cognitive development?
a. Concrete operations
b. Conventional thought
c. Postconventional thought
d. Formal operational thought

 

 

ANS:  D

Cognitive thinking culminates in the capacity for abstract thinking. This stage, the period of formal operations, is Piaget’s fourth and last stage. Concrete operations usually occur between ages 7 and 11 years. Conventional and postconventional thought refers to Kohlberg’s stages of moral development.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 740

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. Which of the following aspects of cognition develops during adolescence?
a. Ability to see things from the point of view of another
b. Capability of using a future time perspective
c. Capability of placing things in a sensible and logical order
d. Progress from making judgments based on what they see to making judgments based on what they reason

 

 

ANS:  B

Adolescents are no longer restricted to the real and actual. They also are concerned with the possible; they think beyond the present. During concrete operations (between ages 7 and 11 years) children exhibit thought processes that enable them to see things from the point of view of another, place things in a sensible and logical order, and progress from making judgments based on what they see to making judgments based on what they reason.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 746

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. Adolescents often do not use reasoned decision making when issues such as substance abuse and sexual behavior are involved. This is because they:
a. tend to be immature.
b. do not need to use reasoned decision making.
c. lack cognitive skills to use reasoned decision making.
d. are dealing with issues that are stressful and emotionally laden.

 

 

ANS:  D

In the face of time pressures, personal stress, or overwhelming peer pressure, young people are more likely to abandon rational thought processes. Many of the health-related decisions adolescents confront are emotionally laden or new. Under such conditions, many people do not use their capacity for formal decision making. The majority of adolescents have cognitive skills and are capable of reasoned decision making. Stress affects their ability to process information. Reasoned decision making should be used in issues that are crucial such as substance abuse and sexual behavior.

 

DIF:    Cognitive Level: Analysis                REF:   p. 746

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Psychosocial Integrity

 

  1. Which of the following is most descriptive of the spiritual development of the older adolescent?
a. Beliefs become more abstract.
b. Rituals and practices become increasingly important.
c. Strict observance of religious customs is common.
d. Emphasis is placed on external manifestations, such as whether a person goes to church.

 

 

ANS:  A

Because of their abstract thinking abilities, adolescents are able to interpret analogies and symbols. Rituals, practices, and strict observance of religious customs become less important as the adolescent questions values and ideals of families. Adolescents question external manifestations when not supported by adherence to supportive behaviors.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 747

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Psychosocial Integrity

 

  1. According to Erikson, the psychosocial task of adolescence is developing which of the following?
a. Identity
b. Intimacy
c. Initiative
d. Independence

 

 

ANS:  A

Traditional psychosocial theory holds that the developmental crises of adolescence lead to the formation of a sense of identity. Intimacy is the developmental stage for early adulthood. Independence is not one of Erikson’s developmental stages.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 748

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. Which of the following is true concerning the development of autonomy during adolescence?
a. Development of autonomy typically involves rebellion.
b. Development of autonomy typically involves parent-child conflicts.
c. Parent and peer influences are opposing forces in the development of autonomy.
d. Conformity to both parents and peers gradually declines toward the end of adolescence.

 

 

ANS:  D

During middle and late adolescence the conformity to parents and peers declines. Subjective feelings of self-reliance increase steadily over the adolescent years. The adolescent has genuine behavioral autonomy. Rebellion is not typically part of adolescence. It can occur in response to excessively controlling circumstances or to growing up in the absence of clear standards. Parent and peer relationships can play complementary roles in the development of a healthy degree of individual independence.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 749

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. Which of the following is true concerning masturbation during adolescence?
a. Homosexuality is encouraged by the practice of masturbation.
b. Many girls do not begin masturbation until after they have intercourse.
c. Masturbation at an early age leads to sexual intercourse at an earlier age.
d. Development of intimate relationships is delayed when masturbation is regularly practiced.

 

 

ANS:  B

The age of first masturbation for girls is variable. Some begin masturbating in early adolescence; many do not begin until after they have had intercourse. Boys typically begin masturbation in early adolescence. Masturbation provides an opportunity for self-exploration. Both heterosexual and homosexual youth use masturbation. It does not affect the development of intimacy.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 772

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. A 16-year-old adolescent boy tells the school nurse that he is gay. The nurse’s response should be based on knowledge that:
a. he is too young to have had enough sexual activity to determine this.
b. the nurse should feel open to discussing his or her own beliefs about homosexuality.
c. homosexual adolescents do not have concerns that differ from those of heterosexual adolescents.
d. it is important to provide a nonthreatening environment in which he can discuss this.

 

 

ANS:  D

The nurse needs to be open and nonjudgmental in interactions with adolescents. This will provide a safe environment in which to provide appropriate health care. Adolescence is when sexual identity develops. The nurse’s own beliefs should not bias the interaction with this student. Homosexual adolescents face very different challenges as they grow up because of society’s response to homosexuality.

 

DIF:    Cognitive Level: Analysis                REF:   p. 750

TOP:   Nursing Process: Implementation     MSC:  Client Needs: Health Promotion and Maintenance

 

  1. The development of sexual orientation during adolescence:
a. is inflexible.
b. is a developmental process.
c. differs for boys and girls.
d. proceeds in a defined sequence.

 

 

ANS:  B

The development of sexual orientation as a part of sexual identity includes several developmental milestones during late childhood and throughout adolescence. The sequence and time spent in phases are different for each individual. Boys and girls pass through the same developmental milestones.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 751

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. Which of the following is an important consideration for the school nurse planning a class on injury prevention for adolescents?
a. Adolescents generally are not risk takers.
b. Adolescents can anticipate the long-term consequences of serious injuries.
c. Adolescents need to discharge energy, often at the expense of logical thinking.
d. During adolescence, participation in sports should be limited to prevent permanent injuries.

 

 

ANS:  C

The physical, sensory, and psychomotor development of adolescents provides a sense of strength and confidence. There is also an increase in energy coupled with risk taking that puts them at risk. Adolescents are risk takers because their feelings of indestructibility interfere with understanding of consequences. Sports can be a useful way for adolescents to discharge energy. Care must be taken to avoid overuse injuries.

 

DIF:    Cognitive Level: Application           REF:   p. 764

TOP:   Integrated Process: Teaching/Learning

MSC:  Client Needs: Health Promotion and Maintenance

 

  1. The school nurse is teaching a class on injury prevention. Which of the following should be included when discussing firearms?
a. Adolescents are too young to use a gun properly for hunting.
b. Gun carrying among adolescents is on the rise, primarily among inner-city youth.
c. Nonpowder guns (air rifles, BB guns) are a relatively safe alternative to powder guns.
d. Adolescence is the peak age for being a victim or offender in the case of injury involving a firearm.

 

 

ANS:  D

The increase in gun availability in the general population is linked to increased gun deaths among children, especially adolescents. Gun carrying among adolescents is on the rise and not limited to the stereotypic inner-city youth. Adolescents can be taught to safely use guns for hunting, but they must be stored properly and used only with supervision. Nonpowder guns (air rifles, BB guns) cause almost as many injuries as powder guns.

 

DIF:    Cognitive Level: Application           REF:   p. 762

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. A method for conducting a health-screening interview with adolescents is “SAFE TIMES.” The nurse working with adolescents should know that “SAFE” is an acronym for:
a. social roles, apathy/anger, frustration, emotional growth.
b. sexuality, affect/abuse, family, examination.
c. safety issues, appropriate/inappropriate behavior, firearms, employment.
d. security, acceptance/nonacceptance by peers, friends, education.

 

 

ANS:  B

SAFE TIMES is a method for conducting health-screening interviews with adolescents as a way to ensure that all topics are covered; it is best used in reverse order. SAFE is an acronym for Sexuality, Affect and Abuse, Family, and Examination; TIMES is the acronym for Timing of development, Immunization, Minerals, Education and Employment, and Safety.

 

DIF:    Cognitive Level: Analysis                REF:   p. 760

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance

 

  1. The nurse is preparing a pamphlet for parents of adolescents about guidance during the adolescent years. Which of the following suggestions should the nurse include in the pamphlet?
a. Provide criticism when mistakes are made or when views are different.
b. Use comparisons to older siblings or extended family to promote good outcomes.
c. Begin to disengage from school functions to allow the adolescent to gain independence.
d. Provide clear, reasonable limits and define consequences when rules are broken.

 

 

ANS:  D

An anticipatory guideline to include when teaching parents of adolescents is to provide clear, reasonable limits and have clear consequences when rules are broken. Parents should avoid criticism when mistakes are made and should allow opportunities for the teen to voice different views and opinions. Parents should try to avoid comparing the teen to a sibling or extended family member. Parents should try to be more engaged in the teen’s school functions to show support and unconditional love.

 

DIF:    Cognitive Level: Analysis                REF:   p. 772

TOP:   Integrated Process: Teaching/Learning

MSC:  Client Needs: Health Promotion and Maintenance

 

MULTIPLE RESPONSE

 

  1. The nurse is caring for children on an adolescent-only unit. Which of the following growth and development milestones would the nurse expect from 13- and 14-year-old children? Select all that apply.
a. Self-centered with increased narcissism
b. No major conflicts with parents
c. Established abstract thought process
d. Have a rich, idealistic fantasy life
e. Highly value conformity to group norms
f. Secondary sexual characteristics appear

 

 

ANS:  B, E, F

Growth and development milestones in the 11- to 14-year-old age-group include minimal conflicts with parents (compared with the 15- to 17-year-old age-group), a high value placed on conformity to the norm, and the appearance of secondary sexual characteristics. Self-centeredness and narcissism are seen in the 15- to 17-year-old age-group, along with a rich and idealistic fantasy life. Abstract thought processes are not well established until the 18- to 20-year-old age-group.

 

DIF:    Cognitive Level: Application           REF:   p. 740

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Health Promotion and Maintenance