ANSWERS
NR 602 Primary Care Of The A 14-year-old female presents to the clinic and is demonstrating some hesitancy in discussing an
important issue regarding her self-identity. What is the appropriate actions on behalf of the clinician?
Childbearing And Childrearing When a 14-year-old female patient presents with hesitancy in discussing an important issue regarding
her self-identity, the clinician should take several key steps to ensure a supportive, respectful, and
Family Practicum effective approach:
1. Create a Safe and Confidential Environment:
NR 602 Midterm Exam Week 4 – Real Exam Ensure privacy during the consultation, confirming that the patient feels comfortable and
understands that the conversation is confidential, within the limits of legal obligations.
I. Section I (17 questions with rationale answers)
Speak in a calm, non-judgmental tone and avoid any interruptions that could make her feel
II. Section II (51 questions with Correct answers) rushed or pressured.
2. Build Trust and Rapport:
Start by asking open-ended, non-threatening questions that allow the patient to share at her
1. A 14-year-old female presents to the clinic and is demonstrating some hesitancy in own pace.
discussing an important issue regarding her self-identity. What is the appropriate actions
Show empathy and understanding, making it clear that her feelings and experiences are valid
on behalf of the clinician?
and important.
2. When examining an adolescent between the ages of 10-13 years of age it is important to
remember what characteristic regarding socio-emotional development? 3. Use Age-Appropriate Communication:
3. What is the Ortolani Sign?
Use language that is appropriate for her age and developmental level. Avoid complex medical
4. Which activities are common in a 4-5 year-old child?
jargon, and instead, explain concepts in a way that she can easily understand.
5. When considering catch up vaccination in children for IPV vaccinations, it is important to
understand one of the following considerations is NOT a consideration when Validate her emotions and let her know that it’s okay to have questions or uncertainties.
administering the vaccine:
4. Be Patient and Give Her Time:
6. Primary dysmenorrhea is due to:
7. What are three findings using Jones criteria for Rheumatic Fever? Acknowledge her hesitancy and let her know that she can take her time to express what she’s
8. Which behavior would NOT be expected in a two-year old? feeling.
9. Primary dysmenorrhea is due to:
Reassure her that there’s no rush, and you’re there to support her whenever she’s ready to talk.
10. The most common congenital heart defect in children is:
11. Which malignancy is … with genitourinary anomalies? 5. Explore Concerns Gently:
12. Treatment for testicular torsion primarily?
If she hints at an issue but is reluctant to elaborate, gently encourage her by saying things like,
13. Which malignancy is … with genitourinary anomalies?
“It’s okay to talk about what’s on your mind,” or “I’m here to help with anything that’s worrying
14. A child with juvenile idiopathic arthritis (JIA) can present with which asymptomatic
you.”
condition that warrants close to follow up?
15. The appropriate management of Osgood-Schlatter disease includes: Avoid pushing too hard if she’s not ready, and instead offer to revisit the conversation later or
16. The most common rheumatoid disease of childhood is: provide resources she can explore on her own.
17. On exam, an 8 year old being seen at your clinic with complaints of persistent pain to left 6. Normalize the Conversation:
leg with limp. What is the most likely cause of this condition?
Normalize the discussion of identity and self-discovery as part of adolescent development,
helping her feel that it’s a common and acceptable topic to discuss.
, Mention that many teens go through similar experiences, which might help her feel less isolated 2. Developing Identity:
in her concerns.
This stage marks the beginning of identity exploration. Adolescents may start questioning who
7. Offer Resources and Support: they are and how they fit into various social groups. They often experiment with different roles,
behaviors, and values as they begin to form their own identity.
Provide resources such as educational materials, support groups, or counseling services if she
feels she needs additional support. 3. Increased Importance of Peer Relationships:
Ensure that she knows there are safe and supportive people available if she prefers to talk to Friendships and peer acceptance become increasingly important. Adolescents in this age group
someone else, such as a counselor or psychologist. may prioritize peer relationships over family ties and are highly influenced by their peers. Peer
approval can strongly impact their self-esteem and decision-making.
8. Respect Her Autonomy:
4. Emotional Variability:
Respect her autonomy and decisions, including the pace at which she wants to discuss her
concerns. This age group experiences a wide range of emotions and may fluctuate between moods rapidly.
Adolescents can feel strong emotions like joy, anger, sadness, and fear, sometimes without fully
If she decides not to talk at the moment, assure her that the door is always open for future
understanding why they feel that way.
conversations.
5. Desire for Independence:
9. Involve Parents or Guardians Appropriately:
Adolescents begin to seek more independence from their parents or caregivers. They may assert
If appropriate and with her consent, discuss involving her parents or guardians, particularly if
their autonomy by challenging authority or pushing boundaries as they navigate the balance
the issue might require their support.
between dependence and independence.
However, be mindful of her privacy and autonomy, especially if she is not comfortable involving
6. Sensitivity to Social Dynamics:
them at this stage.
They start to understand and navigate more complex social dynamics, such as popularity, social
10. Follow-Up:
hierarchies, and group affiliations. Social acceptance and fitting in can be a major concern.
Schedule a follow-up appointment to check in on her and provide an ongoing opportunity for
7. Developing Empathy and Perspective-Taking:
her to discuss her concerns.
Adolescents start to develop the ability to see things from others' perspectives and show more
Ensure she knows how to reach out if she has questions or needs to talk before the next
empathy. However, their ability to manage and express this empathy may still be maturing.
appointment.
8. Vulnerability to Peer Pressure:
These steps aim to provide a supportive and respectful environment that allows the patient to open up
about her concerns regarding self-identity, ultimately leading to a better understanding of her needs Due to their heightened need for peer acceptance, adolescents in this age group can be
and the provision of appropriate care. particularly vulnerable to peer pressure. They may engage in behaviors they wouldn’t otherwise
choose to fit in with a group.
Question:
9. Body Image Concerns:
When examining an adolescent between the ages of 10-13 years of age it is important to remember
what characteristic regarding socio-emotional development? With the onset of puberty, concerns about body image often emerge. Adolescents may compare
themselves to others and worry about whether they are developing "normally."
When examining an adolescent between the ages of 10-13 years of age, it's important to remember that
this is a period of significant socio-emotional development characterized by several key features: 10. Sensitivity to Privacy:
1. Heightened Self-Consciousness: They begin to value their privacy more and may be less willing to share their thoughts and
feelings with adults, including parents and clinicians. They may also be more guarded during
Adolescents in this age range often become more self-aware and self-conscious, particularly
medical examinations.
regarding their bodies, appearance, and how they are perceived by peers. They may be more
sensitive to criticism or perceived judgment.