The nurse is conducting a physical assessment on a 14-year-old male.
Which of the following physical changes should the nurse expect to find during this stage of development? Select all that apply.

Choice A rationale

Adolescence is characterized by the onset of puberty and significant hormonal shifts that drive an increased interest in romantic and sexual relationships. This reflects the transition into the genital stage of psychosexual development and the exploration of intimacy. It is a normal finding for a fifteen year old to seek peer validation and explore their sexual identity as they move away from the family unit and toward more complex social interactions.

Choice B rationale

While adolescents begin to consider their future, solidifying specific long term occupational plans is generally not expected by age fifteen. According to Erikson, this age group is primarily focused on identity versus role confusion. Most fifteen year olds are still exploring various interests and lack the cognitive maturity or life experience to lock in a definitive career path. Pressuring for a solid decision at this stage would be developmentally premature and potentially stressful.

Choice C rationale

Developing a sense of industry is the primary developmental task of the school age child, typically between ages six and twelve. This stage involves mastering skills and feeling competent in one's abilities. By age fifteen, the individual has moved past industry and into the identity formation phase. Expecting a teenager to be focused on industry rather than identity indicates a misunderstanding of the chronological progression of psychosocial stages defined by developmental theorists.

Choice D rationale

A hallmark of middle adolescence is the drive for autonomy and independence from parental figures. Fifteen year olds often exhibit a push for self governance and may challenge established rules to define their own boundaries. This process is essential for healthy emotional growth and the eventual transition into adulthood. Nurses should recognize this behavior as a sign of progress in establishing a unique personal identity separate from the family structure.

Choice A rationale

Contractions that diminish or disappear with ambulation or a change in position are a hallmark of Braxton Hicks contractions, which are false labor. True preterm labor contractions continue and typically intensify regardless of the client's activity level. If walking causes the sensations to stop, it indicates that the uterus is simply irritable rather than undergoing the coordinated, rhythmic contractions required to cause cervical effacement and dilation, which defines the start of actual physiological labor.

Choice B rationale

True labor contractions, including those in preterm labor, often begin in the lower back and radiate toward the front of the abdomen. This pattern reflects the neurological pathways involved in uterine contractions and the engagement of the fetus in the pelvis. Intermittent contractions that follow this specific radiation pattern and increase in frequency are highly suspicious for preterm labor. Braxton Hicks are generally felt only in the front of the abdomen or the groin area.

Choice C rationale

Irregular contractions that vary in intensity and lack a predictable rhythm are characteristic of Braxton Hicks. These are often described as a tightening or squeezing sensation that does not become stronger or closer together over time. True labor involves a progressive increase in the strength, duration, and frequency of the contractions. When the intensity remains variable and does not follow a crescendo pattern, it is less likely to be causing the cervical changes of labor.

Choice D rationale

The timing of contractions in the evening is not a definitive diagnostic feature of preterm labor. Braxton Hicks contractions often occur more frequently at the end of a long day when the client is tired or dehydrated. While preterm labor can occur at any time, the mere presence of evening contractions without other signs like back pain or cervical change is common in late pregnancy. The diagnostic focus is on the quality and regularity rather than the clock. .