Linda, a 14-year-old, and her mother are in the office.
As Linda goes to the bathroom, her mother stops the nurse and asks about the changes that Linda is going through.
She would like to talk to her about sex and the changes but she is unsure of how to do this.
As the nurse, which of the following would be appropriate for you to suggest?
Promote open lines of communication, encourage listening, do not lecture, and share family values.
Discuss with the adolescent the experiences that you had so that she can connect on a personal level.
Encourage her to talk to her peers and teachers in health class about any concerns that she has.
Do not initiate any conversation; let the teen come and seek you out for any advice and answers.
The Correct Answer is A
Choice A rationale
Promoting open, non-judgmental communication is crucial for building trust and encouraging the adolescent to share concerns regarding bodily changes and sexuality. Encouraging listening validates her feelings, while avoiding lectures prevents defensiveness. Sharing family values provides a moral and ethical framework for the complex information being processed, establishing a supportive and informative environment. The parent should be a primary source of accurate information.
Choice B rationale
While sharing personal experiences might be tempting to relate, the focus should remain on the adolescent's own feelings and experiences, not the parent's past. A parent's personal history may confuse or overwhelm the teen, or it may not be relevant to her current situation or feelings, potentially shifting the focus away from her needs and onto the parent's narrative, which is not the primary goal of the discussion.
Choice C rationale
While peer discussion and school health classes are supplemental resources, they should not replace the primary, personalized guidance from the parent. Peers may share misinformation, and health classes offer generalized facts. The parent-child conversation provides a safe, personalized space to discuss deeply personal issues, values, and specific family expectations, which is a vital part of sexual health education.
Choice D rationale
Given the complexity of pubertal changes and sexual development, a passive approach is inappropriate and potentially harmful. Adolescents often lack the language or comfort to initiate these difficult conversations and may feel abandoned if the parent does not take the lead. An active, initiated conversation ensures the adolescent receives accurate information and parental support, addressing concerns before they become problematic.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["36"]
Explanation
Step 1 is to convert the patient's weight from pounds to kilograms. 59 pounds ÷ 2.2 kg/pound = 26.8181. kg. We will use the unrounded number for the next step.
Step 2 is to calculate the daily fluid requirement based on the Holliday-Segar method. The patient weighs 26.8181. kg, which is more than 20 kg. Fluid for the first 10 kg: 10 kg × 100 mL/kg = 1000 mL. Fluid for the second 10 kg: 10 kg × 50 mL/kg = 500 mL. Remaining weight: 26.8181. kg - 20 kg = 6.8181. kg. Fluid for the remaining weight: 6.8181. kg × 20 mL/kg = 136.3636. mL.
Step 3 is to calculate the total daily fluid requirement. 1000 mL + 500 mL + 136.3636. mL = 1636.3636. mL.
Step 4 is to round the final answer to the nearest whole number. 1636.3636. mL rounded to the nearest whole number is 1636. The daily fluid requirement is 1636 mL.
Correct Answer is C
Explanation
Choice A rationale
Pain assessment and management are important components of comprehensive care for any child, including those with HIV, especially following invasive procedures. However, the immediate physiological priority in managing a child with a chronic, immunosuppressive disease like HIV is maintaining immune function and suppressing viral replication through scheduled medication administration to prevent opportunistic infections.
Choice B rationale
Reviewing the absolute CD4+ T-lymphocyte count daily provides information about the degree of immunosuppression, as a normal count for a child varies by age but indicates immune health. While monitoring this parameter is vital for guiding treatment and prophylaxis, the active administration of antiretroviral medications and prophylactic antibiotics is the priority intervention to directly protect the child's immune system.
Choice C rationale
Administering prescribed antiretroviral medications (ART) and prophylactic antibiotics is the priority nursing intervention for a child with Human Immunodeficiency Virus (HIV) infection. Adherence to the ART regimen is critical for maintaining viral suppression, preventing disease progression to AIDS, and preserving the function of the child's severely compromised immune system, thereby reducing the risk of life-threatening opportunistic infections.
Choice D rationale
Assisting the child with daily activities, such as bathing, feeding, and mobility, is part of supportive care. This promotes comfort and physical well-being, especially during periods of illness or fatigue. However, this is a supportive measure, whereas administering medications directly addresses the underlying pathological process of immune deficiency, making medication administration the higher-priority intervention.
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