Health promotion: The school-age child and the adolescent

Question 1

The nurse develops and implements a health promotion plan for an adolescent client. What
should the nurse include in the evaluation of the plan?
1. Methods to expand and sustain successful approaches
2. Instruction to the client on what is considered healthy behavior
3. Advice for promoting health behaviors that will maintain a healthy lifestyle
4. Information on the client’s attitude toward health

Answer 1

1. Methods to expand and sustain successful approaches.
   Explanation:
2. When establishing youth programs, whether with individual adolescents or with groups,
   the nurse includes methods to expand and sustain successful approaches.
3. Instruction on healthy behaviors would be included in the implementation phase of the
   plan.
4. Advising why promoting healthy behaviors is important is part of the implementation
   phase of the plan.
5. Including the adolescent’s attitude toward health has little to do with evaluating the
   success of the plan.

Question 2

The nurse is assessing an adolescent client to determine relationships with others. Which
nursing action is appropriate?
1. Telling the parents that information from the assessment will be shared with them after
the examination
2. Providing separate time to communicate with both the adolescent and the parents
3. Avoiding asking the parents their opinions of the adolescent’s friends
4. Telling the parents they are not allowed to come into the examination room

Answer 2

2. Providing separate time to communicate with both the adolescent and the parents
   Explanation:
3. The nurse cannot share the information about the examination, as this is a breach of
   client confidentiality.
4. Provide time alone with both the adolescent and the parents so that everyone has time to
   talk freely and ask questions.
5. The nurse should include the parents’ opinions of their child’s friends.
6. The nurse cannot keep the parents out of the examination room, especially if the
   adolescent wants the parents there.

Question 3

Which should the nurse keep in mind when providing care to an adolescent client during the
initial visit?
1. The importance of explaining procedures and introducing personnel to adolescents.
2. Adolescents usually are quiet and will offer no opinions.
3. The importance of attending to and discharging the adolescent quickly.
4. Adolescents are comfortable with their surroundings.

Answer 3

1. The importance of explaining procedures and introducing personnel to adolescents.

Question 4

Which nursing action is appropriate when providing care to an adolescent client who is
accompanied to an appointment by a parent?
1. Instructing the parent to stay in the waiting room with the explanation that the
adolescent will provide a report after the examination
2. Telling the parent it is against policy for a parent to accompany the adolescent to the
examination room
3. Reassuring the parent that the nurse will discuss any parental concerns or questions after
the examination
4. Allowing the parent to come into the examination room with the adolescent

Answer 4

3. Reassuring the parent that the nurse will discuss any parental concerns or questions after the examination
   Explanation:
4. The adolescent makes the decision about the parent’s presence and whether to report the
   examination to the parent.
5. The adolescent decides when the parent comes into the room.
6. If one or both parents come with the adolescent, be alert that you might need to provide
   some private time by asking the parents to wait outside for a moment. Reassure the
   parents that you will talk with them about any of their concerns and questions, and
   provide them with an opportunity to ask questions and get information as well.
7. The adolescent chooses when the parent comes into the room.

Question 5

A school nurse is performing annual height and weight screening. The nurse notes that three
adolescent girls who are close friends each lost 15 pounds over the past year. Which is the
priority nursing action?
1. Obtaining a nutritional history for each of these adolescents
2. Referring these adolescents to the school psychologist
3. Calling the respective parents to discuss the eating patterns of each adolescent
4. Speaking with the adolescents in a group to discuss the problems associated with
anorexia nervosa

Answer 5

1. Obtaining a nutritional history for each of these adolescents
   Explanation:
2. The school nurse must evaluate why these three friends have all lost 15 pounds in 1
   year. The best way to begin this assessment is to obtain a nutritional history for each
   client.
3. Referring the adolescents to a school psychologist without performing a complete
   nursing assessment is not appropriate.
4. Speaking with the parents would not be appropriate at this time.
5. Discussing anorexia nervosa at this point is too extreme.

Question 6

The following information is collected during the nursing assessment: the adolescent’s
menses began when she was 12 years old; a current body mass index (BMI) of 27.5;
inconsistent school performance over the last several years. Which is the priority area of
teaching for this adolescent?
1. Menstrual cycle
2. Nutritional intake
3. School performance
4. Mental health status

Answer 6

2. Nutritional intake

Question 7

The nurse is assessing an adolescent patient during a scheduled health maintenance visit.
The adolescent’s mother is currently in the examination room with the patient. Which topic
should the nurse avoid until the mother has left the examination room?
1. School performance
2. Cigarette smoking
3. School friends
4. Seat belt use

Answer 7

2. cigarette smoking 🚬

Question 8

The nurse is assessing an adolescent client during a scheduled health maintenance
appointment. Which issues should the nurse address when the parents are not present?
1. The adolescent’s role in the family
2. Teen job responsibilities
3. Possible domestic violence
4. Activities done as a family

Answer 8

3. Possible domestic violence 🤬

Question 9

An obese adolescent who adamantly denies sexual activity has a positive pregnancy test.
Which response by the nurse is most appropriate?
1. “When was your last menstrual period (LMP)?”
2. “Tell me how you feel about your body image.”
3. “Let’s discuss some activities that you have done within the past few months that could
possibly lead to pregnancy.”
4. “Why are you denying sexual intercourse?”

Answer 9

3. “Let’s discuss some activities that you have done within the past few months that could possibly lead to pregnancy.”

Question 10

A mother reports that her adolescent daughter is always late. The mother states, “She was
born late and has been late every day of her life.” Which response by the nurse is
appropriate?
1. “Setting specific alarms and then reinforce the value of being ‘on-time’ may be helpful
strategies to assist her to be more of an ‘on-time’ individual.”
2. “Just let it go for now. Teachers and, in the future, employers will be the best people to
help her be ‘on-time.’”
3. “You need to establish specific time frames for your adolescent and be certain she
adheres to them.”
4. “You have a major problem. There must be a lot of screaming in your home.”

Answer 10

1. “Setting specific alarms and then reinforce the value of being ‘on-time’ may be helpful.”

Question 11

Which screening is appropriate for the school nurse to perform on all adolescent students?
1. Respiratory rate
2. Hepatitis B profile
3. Chest x-ray
4. Scoliosis

Answer 11

4. Scoliosis

Question 12

During a health maintenance visit an adolescent states, “I have no friends in my new school,
and I no longer want to go to college. I know I will be lonely there, too.” Which is the
priority nursing action?
1. Stressing the importance of remaining in a close parent–child relationship during these
stressful times
2. Promoting healthy mental health outcomes
3. Acknowledging the fact that it takes several months to make new friends at a new
school due to adolescent exclusion behaviors
4. Helping the adolescent realize the value of postsecondary education

Answer 12

2. Promoting healthy mental health outcomes

Question 13

The nurse is planning to teach a group of adolescents about what can happen when having
unprotected sex. Which nursing action will allow effective communication with the group?
1. Offering personal opinions on the topic
2. Allowing for discussion among the participants
3. Lecturing on the topic for the allotted time without any discussion
4. Discussing sex education related to religious belief

Answer 13

2. Allowing discussion among the participants

Question 14

Which nursing action is best when teaching adolescent health promotion and health
maintenance topics?
1. Contacting the parents and asking what issues they have with their adolescents
2. Having the adolescents identify a personal health goal
3. Asking the advice of the counselors at school
4. Telling the adolescents information that will be included in the lecture

Answer 14

2. Having the adolescents identify a personal health goal.

Question 15

Which screenings are appropriate for an adolescent client who admits to being sexually
active during a scheduled health maintenance visit? Select all that apply.
1. Herpes simplex virus
2. Gonorrhea
3. Chlamydia
4. Impetigo
5. Mononucleosis

Answer 15

1. Herpes simplex virus
2. Gonorrhea
3. Chlamydia

Question 16

Which nursing action maintains confidentiality when performing height and weight
measurements during a co-ed physical education class?
1. Having a student worker record the screening findings on the appropriate adolescent’s
record
2. Having a volunteer weigh and measure the adolescents and verbally give the findings to
the nurse to calculate the body mass index and record
3. Providing a privacy screen and have the health aid record the findings directly on the
record. The nurse will then calculate body mass index
4. Using a buddy system with the students, having the students measure each other and
record the findings.

Answer 16

3. Providing a privacy screen and have the health aid record the findings directly on the record. The nurse will then calculate the BMI.

Question 17

17) The nurse is planning care for an overweight adolescent. Which topic may also be
appropriate for the nurse to include in the adolescent’s plan of care?
1. Substance abuse
2. School phobia
3. Spiritual distress
4. Negative self-esteem

Answer 17

4. Negative self-esteem

Question 18

The school nurse is assessing an adolescent who reports getting less than 6 hours of sleep at
night. Which consequences of inadequate sleep will the nurse include when responding to
the adolescent? Select all that apply.
1. Hyperactivity
2. Increased nocturnal emissions
3. Increased risk of automobile accidents when driving
4. Moodiness
5. An inability to perform well at school

Answer 18

3. Increased risk of automobile accidents when driving
4. moodiness
5. An inability to perform well at school

Question 19

Which teaching topics are appropriate for the nurse to include for an adolescent who admits
to the use of chewing tobacco? Select all that apply.
1. Lung cancer
2. Nicotine addiction
3. Mouth cancers
4. Emphysema
5. Mouth ulcers

Answer 19

2. Nicotine addiction
3. Mouth cancers
4. Mouth ulcers

Question 20

Which question is appropriate for the nurse to include in the assessment for an adolescent
client related to developmental tasks?
1. “How are you adapting to the high school setting?”
2. “What type of relationship do you have with your friends?
3. “Have you thought about your future career goals?”
4. “Do you play any team sports?”

Answer 20

2. “What type of relationship do you have with your friends?”

Question 21

The nurse notes dental issues during the assessment of an adolescent client. Which topics
will the nurse explore further to determine the cause of the issues? Select all that apply.
1. Use of fluoridated water
2. Use of a mouth guard when playing physical sports
3. Anorexia nervosa
4. Bulimia nervosa
5. Use of daily vitamins

Answer 21

2. Use of a mouth guard when playing physical sports.
3. Anorexia nervosa
4. Bulimia nervosa
5. Use of daily vitamins
   Explanation:
6. Fluoride is not needed in the adolescent once all teeth have emerged; this does not
   constitute a risk factor.
7. Sports injuries can be the cause of dental issues without proper safety equipment, such
   as a mouth guard.
8. Dental injuries can be related to eating disorders.
9. Repeated vomiting can destroy enamel due to contact with acidic stomach juices.
10. A lack of certain vitamins can cause dental issues.

Question 22

The nurse is planning care for an adolescent whose parents have both recently been laid off
from their jobs. Which is the priority diagnosis for the adolescent and family?
1. Disturbed Sleep Pattern
2. Imbalanced Nutrition: Less Than Body Requirements
3. Knowledge Deficit
4. Risk for Injury

Answer 22

2. Imbalanced nutrition: Less than body requirement’s

Question 23

Which is the most appropriate assessment question for the nurse to ask when collecting
nutritional data from an adolescent client?
1. “How do you feel about your weight and the way you look?”
2. “What did you have to eat so far today?”
3. “What is your favorite grocery store?”
4. “Do you eat school lunches or pack a lunch from home each day?”

Answer 23

1. “How do you feel about work weight and the way you look?”
   Explanation:
2. The best way to obtain information to include in the plan of care is to use a broad
   opening question. It also is important to ask information about the way the child feels
   about his or her body image.
3. Asking about eating habits contributes to the nutritional history but is not the most
   helpful individual aspect in establishing a comprehensive plan of care.
4. Asking about food selection at a grocery store contributes to the nutritional history but is
   not the most helpful individual aspect in establishing a comprehensive plan of care.
5. Asking about food selection at school contributes to the nutritional history but is not the
   most helpful individual aspect in establishing a comprehensive plan of care.

Question 24

A nurse obtains a nutritional health history from a 10-year-old child. Which food increases
the risk for dental caries necessitating education regarding oral hygiene?
1. Sorbet and yogurt
2. Fluoridated water
3. Gummy bears and licorice
4. Peanuts and crackers

Answer 24

3. Gummy bears and licorice

Question 25

The mother of a 12-year-old child informs the nurse that the child’s father died from sudden
cardiac death at 44 years old. Which laboratory tests does the nurse anticipate will be
prescribed by the healthcare provider?
1. Chest x-ray
2. Complete blood count (CBC) with differential
3. Electroencephalogram (EEG)
4. Lipid profile

Answer 25

4. Lipid profile
   Explanation:
5. A routine chest x-ray might be ordered by the healthcare provider, but will not provide
   relevant information at this time.
6. The CBC is routine, but will not give information related to cardiac disease.
7. An EEG reveals information about brain activity, not about cardiac status.
8. This child should have a lipid profile completed at 12 years old, and based on the
   results, further testing might be needed.

Question 26

Which will the nurse include in the assessment process for a school-age child who is
exhibiting poor school performance? Select all that apply.
1. Hearing screen
2. Muscle tone
3. Dental inspection
4. Vision screen
5. Throat culture

Answer 26

1. Hearing screening
2. Muscle tone
3. Vision screening
   Explanation:
4. Children with problems with vision, hearing, and muscle tone are at risk for poor school
   performance because most school activities involve listening, seeing, and kinetic
   activity. A hearing screen is appropriate for the nurse to include in the assessment
   process.
5. Children with problems with vision, hearing, and muscle tone are at risk for poor school
   performance because most school activities involve listening, seeing, and kinetic
   activity. A muscle tone assessment is appropriate for the nurse to include in the
   assessment process.
6. School performance would not likely be affected by dental caries.
7. Children with problems with vision, hearing, and muscle tone are at risk for poor school
   performance because most school activities involve listening, seeing, and kinetic
   activity. A vision screen is appropriate for the nurse to include in the assessment
   process.
8. School performance would not likely be affected by chronic tonsillitis.

Question 27

The school nurse is planning an education program for fourth-grade children regarding
prepubescent changes. What nursing action will make the educational program successful?
1. Discussing program content with the parents
2. Talking to all of the classes at one time
3. Planning the program for after school
4. Having the parents present during the program

Answer 27

1. Discussing program content with the parents
   Explanation:
2. At this age, the information might be new to the child. Involving the parents might
   entail a preprogram discussion by the parents with the child, or giving the parents a
   guide to discuss and reinforce later. If the parents and child are able to communicate
   about the changes, this will promote communication throughout the rest of the growth of
   the child.
3. Having boys and girls together for this information might be embarrassing or stressful
   for this aged child.
4. Some children would be unable to attend after school.
5. The children might not be comfortable having their parents present during the program.

Question 28

During the psychosocial portion of the nursing assessment a school-age child states, “I
know I am not as good as them, so I just play by myself at recess every day.” Which
conclusion by the nurse is accurate?
1. The child has a good sense of self-worth.
2. The child has a poor body image.
3. The child has decreased self-esteem.
4. The child has a self-determined concept.

Answer 28

3. The child has decreased self-esteem.

Question 29

An overweight school-age girl states, “I would like to be more active but my parents won’t
let me try out for the soccer team.” Which is an appropriate nursing action based on this
statement?
1. Referring the child to the school psychologist to discuss the weight issue
2. Telling the child to talk to the school nurse each day about the foods eaten
3. Encouraging the parents to investigate the option of ride sharing with a classmate’s
family
4. Suggesting that the family plan an activity night and play board games together

Answer 29

3. Encouraging the parents to investigate option of ride sharing with a classmate’s family