NURS 328-HEALTH PROBLEMS OF THE ADOLESCENT
QUESTIONS,ANSWERS WITH RATIONALE 2022
What is the usual presenting symptom for testicular cancer?
a. Solid, painful mass
b. Hard, painless mass
c. Scrotal swelling and pain
d. Epididymis easily palpated
ANS: B
The usual presenting symptom for testicular cancer is a heavy, hard, painless mass that is either smooth or
nodular and palpated on the testes. Pain is not usually associated with a testicular tumor. Scrotal swelling
needs to be evaluated. The epididymis is easily palpated in a normal scrotum.
DIF: Cognitive Level: Understanding REF: p. 691
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
A 13-year-old boy comes to the school nurse complaining of sudden and severe scrotal pain. He
denies any trauma to the scrotum. What is the most appropriate nursing action?
a. Refer him for immediate medical evaluation.
b. Administer analgesics and recommend scrotal support.
c. Apply an ice bag and observe for increasing pain.
d. Reassure the adolescent that occasional pain is common with the changes of puberty.
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,NURS 328-HEALTH PROBLEMS OF THE ADOLESCENT
QUESTIONS,ANSWERS WITH RATIONALE 2022
ANS: A
Any adolescent boy with redness, swelling, or pain in the scrotum is referred for immediate evaluation.
These are signs of testicular torsion, which is a medical emergency. If the possibility of testicular torsion is
eliminated, appropriate interventions include administering analgesics and recommending scrotal support.
applying an ice bag and observing for increasing pain. and reassuring the adolescent that occasional pain is
common with the changes of puberty.
DIF: Cognitive Level: Applying REF: p. 693
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
A 14-year-old boy is of normal weight, and his parents are concerned about bilateral breast enlargement.
The nurse’s discussion of this should be based on what?
a. The presence of too much body fat
b. Symptom that a hormonal imbalance is present
c. Most likely part of normal pubertal development
d. Indication that he is developing precocious puberty
ANS: C
Gynecomastia is common during midpuberty in about one third of boys. For most, the breast enlargement
disappears within 2 years. Although breast enlargement in overweight children can indicate too much body
fat, in children of normal body weight, it is a normal occurrence. If the gynecomastia persists beyond 2
years, then a hormonal cause may need to be investigated. Precocious puberty is the early onset of puberty,
before age 9 years in boys.
DIF: Cognitive Level: Applying REF: p. 693
TOP: Integrated Process: Teaching/Learning
2/43
,NURS 328-HEALTH PROBLEMS OF THE ADOLESCENT
QUESTIONS,ANSWERS WITH RATIONALE 2022
A 15-year-old girl tells the school nurse that she has not started to menstruate yet. Onset of
secondary sexual characteristics was about 2 1/2 years ago. The nurse should take which action?
a. Explain that this is not unusual.
b. Refer the adolescent for an evaluation.
c. Make an assumption that the adolescent is pregnant.
d. Suggest that the adolescent stop exercising until menarche occurs.
ANS: B
A referral is indicated. Menarche should follow the onset of secondary sexual development within 2 1/2
years. A careful examination is done to reveal any physical abnormalities, signs of androgen excess, and
congenital defects of the genital tract. The lack of the onset of menstruation at this age is a potential
indication of a physical problem. Assuming that the adolescent is pregnant is inappropriate. The nurse does
not have any indication that the adolescent is sexually active. The amount of exercise should be assessed
before suggesting that the adolescent stop exercising until menarche occurs.
DIF: Cognitive Level: Applying REF: p. 694
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
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 what?
a. Hormone therapy is necessary for the treatment of dysmenorrhea.
3/43
, NURS 328-HEALTH PROBLEMS OF THE ADOLESCENT
QUESTIONS,ANSWERS WITH RATIONALE 2022
b. Acetaminophen is the drug of choice for the treatment of dysmenorrhea.
c. Over-the-counter NSAIDs are rarely strong enough to provide adequate pain relief.
d. NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity.
ANS: D
First-line therapy for adolescents with dysmenorrhea is NSAIDs. NSAIDs are potent anti-inflammatory
agents that block the formation of prostaglandins, resulting in decreased uterine activity. Hormone
therapy may be indicated if there is no physical abnormality and NSAIDs are ineffective. Acetaminophen
does not have an antiprostaglandin action. It can help with pain control but will not be as effective as
NSAIDs.
DIF: Cognitive Level: Applying REF: p. 696
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
What is a major physical risk for young adolescents during pregnancy?
a. Osteoporosis frequently develops.
b. Fetopelvic disproportion is a common problem.
c. Delivery is usually precipitous in this age group.
d. Pregnancy will adversely affect the adolescent’s development.
ANS: B
Teenagers younger than 15 years of age have increased obstetric risks. Fetopelvic disproportion is one of
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QUESTIONS,ANSWERS WITH RATIONALE 2022
What is the usual presenting symptom for testicular cancer?
a. Solid, painful mass
b. Hard, painless mass
c. Scrotal swelling and pain
d. Epididymis easily palpated
ANS: B
The usual presenting symptom for testicular cancer is a heavy, hard, painless mass that is either smooth or
nodular and palpated on the testes. Pain is not usually associated with a testicular tumor. Scrotal swelling
needs to be evaluated. The epididymis is easily palpated in a normal scrotum.
DIF: Cognitive Level: Understanding REF: p. 691
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
A 13-year-old boy comes to the school nurse complaining of sudden and severe scrotal pain. He
denies any trauma to the scrotum. What is the most appropriate nursing action?
a. Refer him for immediate medical evaluation.
b. Administer analgesics and recommend scrotal support.
c. Apply an ice bag and observe for increasing pain.
d. Reassure the adolescent that occasional pain is common with the changes of puberty.
1/43
,NURS 328-HEALTH PROBLEMS OF THE ADOLESCENT
QUESTIONS,ANSWERS WITH RATIONALE 2022
ANS: A
Any adolescent boy with redness, swelling, or pain in the scrotum is referred for immediate evaluation.
These are signs of testicular torsion, which is a medical emergency. If the possibility of testicular torsion is
eliminated, appropriate interventions include administering analgesics and recommending scrotal support.
applying an ice bag and observing for increasing pain. and reassuring the adolescent that occasional pain is
common with the changes of puberty.
DIF: Cognitive Level: Applying REF: p. 693
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
A 14-year-old boy is of normal weight, and his parents are concerned about bilateral breast enlargement.
The nurse’s discussion of this should be based on what?
a. The presence of too much body fat
b. Symptom that a hormonal imbalance is present
c. Most likely part of normal pubertal development
d. Indication that he is developing precocious puberty
ANS: C
Gynecomastia is common during midpuberty in about one third of boys. For most, the breast enlargement
disappears within 2 years. Although breast enlargement in overweight children can indicate too much body
fat, in children of normal body weight, it is a normal occurrence. If the gynecomastia persists beyond 2
years, then a hormonal cause may need to be investigated. Precocious puberty is the early onset of puberty,
before age 9 years in boys.
DIF: Cognitive Level: Applying REF: p. 693
TOP: Integrated Process: Teaching/Learning
2/43
,NURS 328-HEALTH PROBLEMS OF THE ADOLESCENT
QUESTIONS,ANSWERS WITH RATIONALE 2022
A 15-year-old girl tells the school nurse that she has not started to menstruate yet. Onset of
secondary sexual characteristics was about 2 1/2 years ago. The nurse should take which action?
a. Explain that this is not unusual.
b. Refer the adolescent for an evaluation.
c. Make an assumption that the adolescent is pregnant.
d. Suggest that the adolescent stop exercising until menarche occurs.
ANS: B
A referral is indicated. Menarche should follow the onset of secondary sexual development within 2 1/2
years. A careful examination is done to reveal any physical abnormalities, signs of androgen excess, and
congenital defects of the genital tract. The lack of the onset of menstruation at this age is a potential
indication of a physical problem. Assuming that the adolescent is pregnant is inappropriate. The nurse does
not have any indication that the adolescent is sexually active. The amount of exercise should be assessed
before suggesting that the adolescent stop exercising until menarche occurs.
DIF: Cognitive Level: Applying REF: p. 694
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
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 what?
a. Hormone therapy is necessary for the treatment of dysmenorrhea.
3/43
, NURS 328-HEALTH PROBLEMS OF THE ADOLESCENT
QUESTIONS,ANSWERS WITH RATIONALE 2022
b. Acetaminophen is the drug of choice for the treatment of dysmenorrhea.
c. Over-the-counter NSAIDs are rarely strong enough to provide adequate pain relief.
d. NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity.
ANS: D
First-line therapy for adolescents with dysmenorrhea is NSAIDs. NSAIDs are potent anti-inflammatory
agents that block the formation of prostaglandins, resulting in decreased uterine activity. Hormone
therapy may be indicated if there is no physical abnormality and NSAIDs are ineffective. Acetaminophen
does not have an antiprostaglandin action. It can help with pain control but will not be as effective as
NSAIDs.
DIF: Cognitive Level: Applying REF: p. 696
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
What is a major physical risk for young adolescents during pregnancy?
a. Osteoporosis frequently develops.
b. Fetopelvic disproportion is a common problem.
c. Delivery is usually precipitous in this age group.
d. Pregnancy will adversely affect the adolescent’s development.
ANS: B
Teenagers younger than 15 years of age have increased obstetric risks. Fetopelvic disproportion is one of
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