TEST BANK Wong's Essentials of Pediatric Nursing 11th Edition by
Marilyn J. Hockenberry / Chapter 16-31
Chapter 16: Health Problems of School-Age
Children and Adolescents
MULTIPLE CHOICE
1. Which statement is true about smoking in adolescence?
a. Smoking is related to other high-risk behaviors.
b. Smoking will not continue unless peer pressure continues.
c. Smoking is less common when the adolescent’s parent(s) smokes.
d. Smoking among adolescents is becoming more prevalent.
ANS: A
, Cigarettes are considered a gateway drug. Teenagers who smoke are 11.4 times more likely to
use an illicit drug. Teenagers begin smoking for a variety of reasons, such as imitation of adult
behavior, peer pressure, imitation of behaviors portrayed in movies and advertisements, and a
desire to control weight. The absence of peer pressure alone will not stop smoking. Teenagers
who do not smoke usually have parents and friends who do not smoke or who oppose smoking.
The percentage of young people who report current cigarette use and frequent cigarette use has
declined significantly.
DIF: Cognitive Level: Understand TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance
2. An adolescent asks the nurse what causes primary dysmenorrhea. The nurse’s response would be
based on which statement?
a. It is an inherited problem.
b. Excessive estrogen production causes uterine pain.
c. There is no physiologic cause; it is a psychological reaction.
d. It arises from the release of prostaglandins.
ANS: D
The exact etiology of primary dysmenorrhea is debated. Overproduction of uterine
prostaglandins has been implicated, as has overproduction of vasopressin. Dysmenorrhea is not
known to be inherited. Excessive estrogen has not been implicated in the etiology. It has a
physiologic cause. Women with dysmenorrhea have higher prostaglandin levels.
DIF: Cognitive Level: Apply TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
3. An adolescent girl asks the school nurse if an over-the-counter nonsteroidal anti-inflammatory
drug (NSAID)is a good choice to treat her dysmenorrhea. The nurse’s response would be based
on which statement?
, a. Aspirin is the drug of choice for the treatment of dysmenorrhea.
b. Over-the-counter NSAIDs are rarely strong enough to provide adequate pain relief.
c. NSAIDs are effective because of their analgesic effect.
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. This group of drugs blocks the
formation of prostaglandins. NSAIDs, not aspirin, are the drugs of choice in dysmenorrhea.
NSAIDs are potent anti-inflammatory agents that inhibit prostaglandin. Although NSAIDs have
analgesic effects, the mechanism of action in dysmenorrhea is most likely the antiprostaglandin
effect.
DIF: Cognitive Level: Apply TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Pharmacologic and Parenteral Therapies
4. A 14-year-old boy and his parents are concerned about bilateral breast enlargement. The nurse’s
discussion of this would be based on which statement?
a. This occurs frequently during puberty.
b. This is usually caused by Klinefelter syndrome.
c. Administration of estrogen effectively reduces gynecomastia.
d. Administration of testosterone effectively reduces gynecomastia.
ANS: A
The male breast responds to hormonal changes. Some degree of bilateral or unilateral breast
enlargement occurs frequently in boys during puberty. Although individuals with Klinefelter
syndrome can have gynecomastia, it is not a common cause for male breast enlargement.
Estrogen is not a therapy for gynecomastia. Administration of testosterone has no benefit for
gynecomastia and may aggravate the condition.
, DIF: Cognitive Level: Understand TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
5. An adolescent tells the school nurse she has a confirmed pregnancy, her last menstrual cycle was
4 months ago, and she smokes cigarettes. Which is the priority nursing action?
a. Notify her parents
b. Refer for prenatal care
c. Explain the importance of not smoking
d. Discuss dietary needs for adequate fetal growth
ANS: B
Teenage girls and their unborn children are at greater risk for complications during pregnancy
and delivery. With improved therapies, the mortality for teenage pregnancy is decreasing, but the
morbidity is high. A pregnant teenager needs careful assessment by the nurse to determine the
level of social support available to her and possibly her partner. Guidance from the adults in her
life would be invaluable, but confidentiality should be maintained. Although it is important to
explain the importance of not smoking and to discuss dietary needs for adequate fetal growth,
because of her potential for having a high-risk pregnancy, she will need a comprehensive
prenatal program to minimize maternal-fetal complications.
DIF: Cognitive Level: Analyze
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
6. A sexually active female adolescent asks the nurse about the contraceptive Depo-Provera. Which
would the nurse explain regarding the contraceptive?
a. Requires injections every 3 months
b. Requires daily administration of medication by mouth
c. Provides long-term continuous protection, up to 5 years
Marilyn J. Hockenberry / Chapter 16-31
Chapter 16: Health Problems of School-Age
Children and Adolescents
MULTIPLE CHOICE
1. Which statement is true about smoking in adolescence?
a. Smoking is related to other high-risk behaviors.
b. Smoking will not continue unless peer pressure continues.
c. Smoking is less common when the adolescent’s parent(s) smokes.
d. Smoking among adolescents is becoming more prevalent.
ANS: A
, Cigarettes are considered a gateway drug. Teenagers who smoke are 11.4 times more likely to
use an illicit drug. Teenagers begin smoking for a variety of reasons, such as imitation of adult
behavior, peer pressure, imitation of behaviors portrayed in movies and advertisements, and a
desire to control weight. The absence of peer pressure alone will not stop smoking. Teenagers
who do not smoke usually have parents and friends who do not smoke or who oppose smoking.
The percentage of young people who report current cigarette use and frequent cigarette use has
declined significantly.
DIF: Cognitive Level: Understand TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance
2. An adolescent asks the nurse what causes primary dysmenorrhea. The nurse’s response would be
based on which statement?
a. It is an inherited problem.
b. Excessive estrogen production causes uterine pain.
c. There is no physiologic cause; it is a psychological reaction.
d. It arises from the release of prostaglandins.
ANS: D
The exact etiology of primary dysmenorrhea is debated. Overproduction of uterine
prostaglandins has been implicated, as has overproduction of vasopressin. Dysmenorrhea is not
known to be inherited. Excessive estrogen has not been implicated in the etiology. It has a
physiologic cause. Women with dysmenorrhea have higher prostaglandin levels.
DIF: Cognitive Level: Apply TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
3. An adolescent girl asks the school nurse if an over-the-counter nonsteroidal anti-inflammatory
drug (NSAID)is a good choice to treat her dysmenorrhea. The nurse’s response would be based
on which statement?
, a. Aspirin is the drug of choice for the treatment of dysmenorrhea.
b. Over-the-counter NSAIDs are rarely strong enough to provide adequate pain relief.
c. NSAIDs are effective because of their analgesic effect.
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. This group of drugs blocks the
formation of prostaglandins. NSAIDs, not aspirin, are the drugs of choice in dysmenorrhea.
NSAIDs are potent anti-inflammatory agents that inhibit prostaglandin. Although NSAIDs have
analgesic effects, the mechanism of action in dysmenorrhea is most likely the antiprostaglandin
effect.
DIF: Cognitive Level: Apply TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Pharmacologic and Parenteral Therapies
4. A 14-year-old boy and his parents are concerned about bilateral breast enlargement. The nurse’s
discussion of this would be based on which statement?
a. This occurs frequently during puberty.
b. This is usually caused by Klinefelter syndrome.
c. Administration of estrogen effectively reduces gynecomastia.
d. Administration of testosterone effectively reduces gynecomastia.
ANS: A
The male breast responds to hormonal changes. Some degree of bilateral or unilateral breast
enlargement occurs frequently in boys during puberty. Although individuals with Klinefelter
syndrome can have gynecomastia, it is not a common cause for male breast enlargement.
Estrogen is not a therapy for gynecomastia. Administration of testosterone has no benefit for
gynecomastia and may aggravate the condition.
, DIF: Cognitive Level: Understand TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
5. An adolescent tells the school nurse she has a confirmed pregnancy, her last menstrual cycle was
4 months ago, and she smokes cigarettes. Which is the priority nursing action?
a. Notify her parents
b. Refer for prenatal care
c. Explain the importance of not smoking
d. Discuss dietary needs for adequate fetal growth
ANS: B
Teenage girls and their unborn children are at greater risk for complications during pregnancy
and delivery. With improved therapies, the mortality for teenage pregnancy is decreasing, but the
morbidity is high. A pregnant teenager needs careful assessment by the nurse to determine the
level of social support available to her and possibly her partner. Guidance from the adults in her
life would be invaluable, but confidentiality should be maintained. Although it is important to
explain the importance of not smoking and to discuss dietary needs for adequate fetal growth,
because of her potential for having a high-risk pregnancy, she will need a comprehensive
prenatal program to minimize maternal-fetal complications.
DIF: Cognitive Level: Analyze
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
6. A sexually active female adolescent asks the nurse about the contraceptive Depo-Provera. Which
would the nurse explain regarding the contraceptive?
a. Requires injections every 3 months
b. Requires daily administration of medication by mouth
c. Provides long-term continuous protection, up to 5 years
