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Instructors Manual
Chapter 12
Growth and Development of the Adolescent
Answers to Study Questions
1.

Which of the following statements about physiological development of adolescents is

true?
a.

The physiological changes that occur during adolescence occur in

isolation and therefore are not related to psychosexual, cognitive, or
psychological development.

b.

The age of onset, intensity, and duration of the adolescent growth spurt
does not vary across gender or individually.

c.

Although fully developed in size, the right and left hemispheres of the
brain continue to thicken and process information more efficiently during
adolescence.

d.

For females the first sign of sexual maturation is growth of pubic hair; for
males, the first sign of sexual maturation is darkening of the scrotum.

Answer: c. The physiological changes that occur during adolescence do not occur in
isolation and therefore are related to psychosexual, cognitive, or psychological
development. The age of onset, intensity, and duration of the adolescent growth spurt
varies individually and across genders. For females the first sign of sexual maturation
is breast bud development; for males, the first sign of sexual maturation is sparse
growth of dark straight pubic hair and reddening of the scrotum.

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2.

Which of the following statements is true about psychosexual or psychosocial

development?
a.

An adolescents body image is often influenced by present/past

experiences, level of cognitive development, identity formation, as well as
ones degree of attractiveness, size, and physique appropriate to gender.

b.

Two major tasks of adolescence (figuring out who they are and what their
unique place is in the world) occur in isolation.

c.

An adolescent with a foreclosed identity has not experienced any active

exploration of what the possibilities are, nor made any commitment
toward an occupation.

d.

In order to facilitate adolescent psychosocial development it would be

important to allow adolescents to take little part in family decision making
and discourage exploration of career options.

Answer: a. Two major tasks of adolescence (figuring out who they are and what their
unique place is in the world) cannot be separated; they are strongly connected. An
adolescent with a diffused identity has not experienced any active exploration of what
the possibilities are, nor made any commitment toward an occupation. In order to
facilitate adolescent psychosocial development it would be important to allow
adolescents to take part in family decision making and encourage exploration of
career options.
3.

The following statements relate to adolescent cognitive development. Which

statement is true?

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a.

Piaget suggests adolescent cognitive development involves being aware of

what is real rather than the possibilities of what may be real.

b.

The zone of proximal development suggests students are capable of

understanding difficult concepts if they are coached by a teacher who
pushes them to think at a higher level and is sensitive to their potential.

c.

The imaginary audience and personal fable rarely affect adolescent

behaviors because they are aware of their own uniqueness and are proud
of their skills and abilities.

d.

Social perspective-taking allows an adolescent to ignore relationships with

others and therefore think and dress as one wants rather than as peers may
think and dress.

Answer: b. Piaget suggests adolescent cognitive development involves being aware

of what is real as well as what may be possible. The imaginary audience and personal
fable affect adolescent behaviors because they believe they are always on stage and
have an exaggerated belief of their own uniqueness. Social perspective-taking
suggests an adolescent thinks about what is best for a relationship rather than what is
best for individual members.
4.

The statements below discuss parent-adolescent conflict. If parents come to you for
advice about conflicts they are having with their adolescent, which of the following
statements can you use in discussing the issue?
a.

Conflict between adolescents and their parents is highest during late

adolescence.

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b.

Topics of conflicts adolescents have with their mothers are different than
topics of conflicts they have with their fathers.

c.

If parents use psychological control (controlling a persons behavior by

guilt induction), the adolescent is at risk for failing, having low selfesteem, and becoming depressed.

d.

Conflict between parents and adolescents is rare and should not be a

concern to parents.

Answer: c. Conflict between adolescents and their parents is highest during early and
middle adolescence. Topics of conflicts adolescents have with their mothers and
fathers are often the same: homework, sibling relationships, and household tasks.
Conflict between parents and adolescents is common and needs to be handled
appropriately.
5.

The following statements relate to adolescent-peer relationships. Which is correct?

a.

Peer relationships are not important to adolescents, especially if they have

a positive self-esteem.

b.

Adolescent crowds provide an alternate family structure for adolescents

and are usually made up of both gender adolescents.

c.

Adolescents who are secure in their relationships with others are more
likely to engage in behavior they would otherwise avoid.

d.

Adolescents who are in the periphery of their peer group are most
vulnerable to peer influences because of their position within the group.

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Answer: d. Peer relationships are very important to adolescents, especially if they

have a poor self-esteem. Adolescent cliques provide an alternate family structure for
adolescents and are usually made up of same-sexed adolescents. Adolescents who are
insecure in their relationships with others are more likely to engage in behavior they
would otherwise avoid.
6.

School is important for adolescents. Which of the following statements is true?

a.

Those adolescents who do not feel connected to school report lower levels
of well-being and have more psychological problems than those who feel
connected to their school.

b.

An adolescents feelings of connection to school depend mainly on

parents views of the school.

c.

Skipping school is common during adolescence and is an issue that should

be ignored by parents.

d.

The transition from middle school to high school rarely affects adolescents
because relationships with teachers are similar to those of middle school.

Answer: a. An adolescents feelings of connection to school depend on parent and

family context, peer group, the size of the school, extracurricular activities available,
and the students academic track. Skipping classes or school, chronic absenteeism,
and other kinds of school avoidance need in-depth assessment because they may
indicate an underlying mental health problem. The transition from middle school to
high school may cause stress because of shifts from the personal to the impersonal;
from smaller to larger classes and buildings; from the same class with the same peers

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and teachers to different classes, different peers, and different teachers; and from
simple to complex classrooms.
7.

Adolescents are faced with several issues and nurses need to be aware of not only
how to interact with adolescents but also how best to help them through these issues.
Consequently which of the following statements is not true?
a.

To work effectively with adolescents, nurses should demonstrate poise,

tolerance, warmth, and empathy.

b.

Nurses do not need to be aware of their own biases, since they rarely have
an impact on interactions or care delivered.

c.

Nursing care should be provided in settings, sometimes away from

caregivers, where the self-conscious adolescent feels welcome and
comfortable.

d.

Allowing sufficient time and privacy for all interactions is essential, so

sensitive topics can be discussed in an unhurried and nonjudgmental
atmosphere.

Answer: b. Nurses need to be aware of their own biases, since they often have an
impact on interactions or care delivered.
8.

Below are several statements related to adolescents; only one is correct.

a.

Caregivers need to realize that adolescents need for freedom,

independence, and peer acceptance is rarely reflected in their eating habits.

b.

Obesity in adolescence may also be connected to not wanting or being

able to master the psychosocial and psychosexual tasks of adolescence.

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c.

It is difficult to provide helpful suggestions to adolescents struggling with

their weight because suggestions rarely work.

d.

Adolescents should not be concerned about their activity levels since they
often are more active than they need to be.

Answer: b. Suggestions to help adolescents manage their weight should be part of

every visit to a health care provider, are proven to be helpful, and should include
eating slowly by cutting food into small mouthfuls and putting eating utensils down
between bites, and keeping a food diary to discover if ones diet contains food from
the traditional food groups. Adolescents should be involved in moderate to vigorous
physical activity three or more times a week for at least 30 minutes per session, and
be active daily or nearly every day in order to maintain their health.
9.

The statements below relate to suggestions to help adolescents remain healthy. Which
one is incorrect?
a.

Nurses need to inquire about an adolescents activity program, including

frequency, vigor, and preferences, before making any recommendations.

b.

Nurses need to educate adolescents and their caregivers about safety issues
and accident prevention, and remind them they are not immortal or
immune from being injured (personal fable) if they take unnecessary
chances.

c.

When working with youths who are victims of violence, ask about the
victims relationship to the perpetrator, circumstances surrounding the
event, use of alcohol or drugs, and predisposing risk factors.

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d.

Since smoking is not common in adolescents, nurses do not need to talk to

them about prevention strategies or risks to their health if they choose to
smoke.

Answer: d. Smoking is an issue for many adolescents. Therefore, it is important to

talk to teens about the health issues related to smoking as well as prevention strategies
that include antismoking campaigns directed at teens, increasing the cost of tobacco
products, implementing school-based programs, and supporting parenting practices
discouraging smoking.
10.

Adolescent pregnancy is a concern to parents and teens. Which of the following

statements would be the best response to parents who ask you to talk to them about
adolescent pregnancy?
a.

Adolescents reasons for becoming sexually active include feeling grownup; to enhance self-esteem; to experiment; to be accepted by friends; to
have someone to care about, love, and be close to; for pleasure; to gain
control over ones life; to seek revenge; and to prove they are normal.

b.

Sexually active young people rarely are exposed to sexually transmitted

disease because they usually have one partner and use condoms or other
forms of contraception.

c.

There are few risks associated with adolescent pregnancies since those
teens that become pregnant are usually healthy and the rate of neonatal
death is low for these mothers.

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d.

Improved methods of contraception and the increased number of sex

education courses in the schools reach most adolescents who then
integrate this information into their behavior.

Answer: a. Sexually active young people often participate in behaviors that put them
at risk for sexually transmitted diseases and pregnancy because they frequently have
multiple partners or do not use condoms or other forms of contraception. There are
many risks for adolescents who become pregnant, including low birth weight (more
than double the rate for adults) and neonatal death (almost three times as high as in
adults). The mortality rate for the teenaged pregnant woman is twice as high as for
adult pregnant women. Improved methods of contraception and the increased number
of sex education courses in the schools reach only a small percentage of adolescents.
Not all those students who are sexually active attend such courses or have them
readily available, and those adolescents who do participate in the courses may not
integrate this information into their behavior because they do not see pregnancy as a
concern for themselves or their partners.

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