Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse in a pediatric clinic is assessing a female adolescent who is 15 years of age.
When the nurse performs a sexuality assessment, the patient states, “I have never had
anything but safe sex.” Which approach does the nurse take next?
a. Provide birth-control options.
b. Ascertain the number of sex partners.
c. Ask the patient to define “safe sex.”
d. Inquire about treatment of a sexually transmitted infection (STI).
ANS: C
Chapter: Chapter 11 Adolescents
Chapter Learning Objective: 5. Describe strategies for assessing health promotion
practices among adolescents.
Page: 208
Heading: Health Promotion and Education > Sexuality Assessment
Integrated Processes: Nursing Process
Client Need: Health Promotion and Maintenance
Cognitive Level: Analysis [Analyzing]
Concept: Health Promotion
Difficulty: Moderate
Feedback
A. This is incorrect. The nurse may decide to present birth-control options, but first
the nurse needs to determine in which type of sexual activity the patient is
involved.
B. This is incorrect. The nurse may decide to ascertain the number of the patient’s
sexual partners, especially if she has been treated for an STI.
C. This is correct. Given the patient’s comment about having only safe sex, the
nurse needs to determine the patient’s definition of the term. Engagement in
oral/anal sex is often considered “safe” by adolescents. If this defines the
patient’s sexual practice, the nurse needs to educate the patient about risks such
as acquiring STIs via oral and anal routes.
D. This is incorrect. It is appropriate for the nurse to ask a sexually active adolescent
about treatment for STIs; however, the definition of “safe sex” is more important.
PTS: 1 CON: Health Promotion
2. The nurse working in the emergency department of a pediatric care facility is receiving an
, adolescent patient with a gunshot wound to the head. The patient is unconscious but
exhibiting signs of life-threatening deterioration. Which action does the nurse take?
a. Keep attempting to reach the parents.
b. Determine whether the patient is emancipated.
c. Prepare the patient for surgery.
d. Call the facility’s legal advisor.
ANS: C
Chapter: Chapter 11 Adolescents
Chapter Learning Objective: 6. Describe emergency care considerations for
adolescent patients. Page: 209
Heading: Emergency Care > Primary Assessment
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Difficult
Feedback
A. This is incorrect. If reasonable attempts have been made to reach the patient’s
parents, the medical team will make a decision about treatment.
B. This is incorrect. In this situation, it does not matter if the patient is emancipated
or not.
C. This is correct. Under the Emergency Medical Treatment and Active Labor Act
of 1986, adolescents who require emergency care may be treated regardless of
whether caregiver consent has been obtained. The nurse will prepare the patient
for surgery.
D. This is incorrect. There is no need to contact the facility’s legal advisor; the law
is clear and defendable.
PTS: 1 CON: Professionalism
3. The nurse in an acute pediatric care setting is providing care for a 15-year-old patient.
The patient is recovering from abdominal surgery. Which nursing intervention is
appropriate for this patient?
a. Offer to play a video game with the patient.
b. Ask if the patient wants to learn how to care for the incision.
c. Tell the patient that intramuscular (IM) injections will feel like a small pinch.
d. Discourage long visits by peers by reinforcing the need for rest.
ANS: B
Chapter: Chapter 11 Adolescents
Chapter Learning Objective: 7. Identify strategies to support hospitalized adolescents.
Page: 209
, Heading: Acute-Care Hospitalization > Environment of Care
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Synthesis [Creating]
Concept: Comfort
Difficulty: Difficult
Feedback
A. This is incorrect. Playing a video game is not considered a nursing intervention.
The nurse is not expected to entertain the patient.
B. This is correct. It is appropriate for the nurse to encourage the adolescent’s active
participation in meeting health-care needs. Because the patient may be involved
in wound care after discharge, this is a prime time for the nurse to provide
appropriate patient education.
C. This is incorrect. The nurse is always to be honest about pain and side effects
associated with patient care.
D. This is incorrect. The nurse needs to cluster activities to leave periods of free
time for relaxation, homework, or visiting with family and friends. Interaction
with family and peers is important to adolescents.
PTS: 1 CON: Comfort
4. The nurse is aware that the prefrontal cortex of the adolescent brain is still developing.
The processes of critical thinking and decision making are in a stage of development.
Which example best identifies these changes?
a. Some awareness of personal limitations
b. Disinterested in politics and social issues
c. Capable of identifying and setting short-term goals
d. Exhibits confidence by not comparing self to peers
ANS: A
Chapter: Chapter 11 Adolescents
Chapter Learning Objective: 1. Describe the growth and development that occur
during adolescence.
Page: 200
Heading: Growth and Development > Cognitive
Integrated Process: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Growth and Development
Difficulty: Moderate
Feedback
A. This is correct. During adolescence, the nurse is aware there is beginning to be
Identify the choice that best completes the statement or answers the question.
1. The nurse in a pediatric clinic is assessing a female adolescent who is 15 years of age.
When the nurse performs a sexuality assessment, the patient states, “I have never had
anything but safe sex.” Which approach does the nurse take next?
a. Provide birth-control options.
b. Ascertain the number of sex partners.
c. Ask the patient to define “safe sex.”
d. Inquire about treatment of a sexually transmitted infection (STI).
ANS: C
Chapter: Chapter 11 Adolescents
Chapter Learning Objective: 5. Describe strategies for assessing health promotion
practices among adolescents.
Page: 208
Heading: Health Promotion and Education > Sexuality Assessment
Integrated Processes: Nursing Process
Client Need: Health Promotion and Maintenance
Cognitive Level: Analysis [Analyzing]
Concept: Health Promotion
Difficulty: Moderate
Feedback
A. This is incorrect. The nurse may decide to present birth-control options, but first
the nurse needs to determine in which type of sexual activity the patient is
involved.
B. This is incorrect. The nurse may decide to ascertain the number of the patient’s
sexual partners, especially if she has been treated for an STI.
C. This is correct. Given the patient’s comment about having only safe sex, the
nurse needs to determine the patient’s definition of the term. Engagement in
oral/anal sex is often considered “safe” by adolescents. If this defines the
patient’s sexual practice, the nurse needs to educate the patient about risks such
as acquiring STIs via oral and anal routes.
D. This is incorrect. It is appropriate for the nurse to ask a sexually active adolescent
about treatment for STIs; however, the definition of “safe sex” is more important.
PTS: 1 CON: Health Promotion
2. The nurse working in the emergency department of a pediatric care facility is receiving an
, adolescent patient with a gunshot wound to the head. The patient is unconscious but
exhibiting signs of life-threatening deterioration. Which action does the nurse take?
a. Keep attempting to reach the parents.
b. Determine whether the patient is emancipated.
c. Prepare the patient for surgery.
d. Call the facility’s legal advisor.
ANS: C
Chapter: Chapter 11 Adolescents
Chapter Learning Objective: 6. Describe emergency care considerations for
adolescent patients. Page: 209
Heading: Emergency Care > Primary Assessment
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Difficult
Feedback
A. This is incorrect. If reasonable attempts have been made to reach the patient’s
parents, the medical team will make a decision about treatment.
B. This is incorrect. In this situation, it does not matter if the patient is emancipated
or not.
C. This is correct. Under the Emergency Medical Treatment and Active Labor Act
of 1986, adolescents who require emergency care may be treated regardless of
whether caregiver consent has been obtained. The nurse will prepare the patient
for surgery.
D. This is incorrect. There is no need to contact the facility’s legal advisor; the law
is clear and defendable.
PTS: 1 CON: Professionalism
3. The nurse in an acute pediatric care setting is providing care for a 15-year-old patient.
The patient is recovering from abdominal surgery. Which nursing intervention is
appropriate for this patient?
a. Offer to play a video game with the patient.
b. Ask if the patient wants to learn how to care for the incision.
c. Tell the patient that intramuscular (IM) injections will feel like a small pinch.
d. Discourage long visits by peers by reinforcing the need for rest.
ANS: B
Chapter: Chapter 11 Adolescents
Chapter Learning Objective: 7. Identify strategies to support hospitalized adolescents.
Page: 209
, Heading: Acute-Care Hospitalization > Environment of Care
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Synthesis [Creating]
Concept: Comfort
Difficulty: Difficult
Feedback
A. This is incorrect. Playing a video game is not considered a nursing intervention.
The nurse is not expected to entertain the patient.
B. This is correct. It is appropriate for the nurse to encourage the adolescent’s active
participation in meeting health-care needs. Because the patient may be involved
in wound care after discharge, this is a prime time for the nurse to provide
appropriate patient education.
C. This is incorrect. The nurse is always to be honest about pain and side effects
associated with patient care.
D. This is incorrect. The nurse needs to cluster activities to leave periods of free
time for relaxation, homework, or visiting with family and friends. Interaction
with family and peers is important to adolescents.
PTS: 1 CON: Comfort
4. The nurse is aware that the prefrontal cortex of the adolescent brain is still developing.
The processes of critical thinking and decision making are in a stage of development.
Which example best identifies these changes?
a. Some awareness of personal limitations
b. Disinterested in politics and social issues
c. Capable of identifying and setting short-term goals
d. Exhibits confidence by not comparing self to peers
ANS: A
Chapter: Chapter 11 Adolescents
Chapter Learning Objective: 1. Describe the growth and development that occur
during adolescence.
Page: 200
Heading: Growth and Development > Cognitive
Integrated Process: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Growth and Development
Difficulty: Moderate
Feedback
A. This is correct. During adolescence, the nurse is aware there is beginning to be
