Adolescence: 13 to 18 Years Practice Questions

62 multiple-choice questions on Adolescence: 13 to 18 years for paramedic and EMT students, from Chapter 10 (Life Span Development). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

62 practice questions

1. Vital signs in adolescence:

   1. A. Match toddler values
   2. B. Reach adult ranges
   3. C. Remain pediatric
   4. D. Are highly variable
   Show answer

   Answer: B. Reach adult ranges

   A heart rate of 60 to 100 and respirations of 12 to 20 are typical.

2. Puberty in females typically begins:

   1. A. Around age 6, before school entry
   2. B. About 10 to 14, earlier than males
   3. C. After age 18, in early adulthood
   4. D. Around age 16, later than males
   Show answer

   Answer: B. About 10 to 14, earlier than males

   Timing varies widely among individuals.

3. A defining feature of adolescent brain development is that:

   1. A. Emotion regulation is fully developed
   2. B. The brain is fully mature by age 13
   3. C. Learning capacity declines after puberty
   4. D. Impulse control matures into the twenties
   Show answer

   Answer: D. Impulse control matures into the twenties

   This helps explain injury patterns in this age group. Risk-taking and impulse-control areas are still developing.

4. Leading causes of death in adolescence include:

   1. A. Infectious diseases such as pneumonia
   2. B. Congenital and genetic conditions
   3. C. Cancer and heart disease
   4. D. Unintentional injury, homicide, suicide
   Show answer

   Answer: D. Unintentional injury, homicide, suicide

   Prevention focuses on driving, substance use, and mental health. Motor vehicle crashes are the leading unintentional injury.

5. When assessing an adolescent, the paramedic should:

   1. A. Always interview with the parents present
   2. B. Offer privacy and explain its limits
   3. C. Direct all questions to the parent
   4. D. Refuse to speak with them alone
   Show answer

   Answer: B. Offer privacy and explain its limits

   Honest answers about substances, pregnancy, or mental health often depend on privacy. Offer to speak privately when appropriate and explain confidentiality and its limits.

6. Adolescents are often especially concerned about:

   1. A. Long-term cardiovascular disease risk
   2. B. Separation from parents and caregivers
   3. C. Body image, privacy, and peer perception
   4. D. Whether illness is punishment for misbehavior
   Show answer

   Answer: C. Body image, privacy, and peer perception

   Preserving modesty during assessment matters greatly. Adolescents focus on body image, privacy, and how peers see them. Separation anxiety belongs to infants and toddlers, viewing illness as punishment is typical of preschoolers, and teens rarely focus on long-term disease risk.

7. Consent for treatment of an adolescent generally requires:

   1. A. A parent, with legal exceptions
   2. B. No consent, since minors cannot refuse
   3. C. The adolescent's own consent only
   4. D. A court order for any treatment
   Show answer

   Answer: A. A parent, with legal exceptions

   Many states allow minors to consent for pregnancy, substance, or mental health care. Exceptions include emancipated minors and care state law lets minors consent to.

8. Mental health conditions such as depression and anxiety in adolescence:

   1. A. Are common and often begin then
   2. B. Are rare before adulthood
   3. C. Usually resolve without support
   4. D. Affect only certain social groups
   Show answer

   Answer: A. Are common and often begin then

   Asking directly about mood and safety is appropriate and important.

9. Eating and body image concerns in adolescence should be handled by:

   1. A. Reassuring them that their weight looks fine
   2. B. Recommending a diet plan
   3. C. Confronting them about the eating behavior
   4. D. Objective, nonjudgmental assessment
   Show answer

   Answer: D. Objective, nonjudgmental assessment

   Keep the focus on the medical complaint and connect them with care. Involve appropriate professional resources. Comments on weight, even reassuring ones, reinforce the focus on body size, and confrontation or diet advice tends to increase shame and secrecy.

10. Adolescents with chronic illness may:

    1. A. Have no concerns about treatment
    2. B. Adhere more closely than adults
    3. C. Struggle with adherence
    4. D. Prefer full parental management
    Show answer

    Answer: C. Struggle with adherence

    Ask about their routine without lecturing. They seek independence and want to be like peers.

11. Erikson described adolescence as:

    1. A. Intimacy versus isolation
    2. B. Autonomy versus shame and doubt
    3. C. Identity versus role confusion
    4. D. Industry versus inferiority
    Show answer

    Answer: C. Identity versus role confusion

    Identity formation drives much of the behavior of this stage.

12. Communication with an adolescent patient works best when the paramedic:

    1. A. Directs most of the questions to the parents
    2. B. Speaks to them as a young child
    3. C. Uses teen slang to build rapport
    4. D. Treats them as a near-adult with respect
    Show answer

    Answer: D. Treats them as a near-adult with respect

    Respect earns cooperation quickly in this age group. Explain clearly, avoid condescension, and speak directly to the teen rather than mainly to the parents. Forced slang usually seems insincere and can undermine trust.

13. Adolescent heart rate is approximately:

    1. A. 40 to 60
    2. B. 60 to 100
    3. C. 80 to 120
    4. D. 100 to 140
    Show answer

    Answer: B. 60 to 100

    Adult range.

14. Adolescent respiratory rate is approximately:

    1. A. 8 to 10
    2. B. 30 to 40
    3. C. 20 to 30
    4. D. 12 to 20
    Show answer

    Answer: D. 12 to 20

    Adult range.

15. A 16-year-old has a resting heart rate of 120 and a respiratory rate of 28. How should you interpret this?

    1. A. Both are normal for a teenager
    2. B. Both are abnormal; teens have adult vital signs
    3. C. Normal, since teens have faster rates than younger children
    4. D. Abnormal only if the BP is also low
    Show answer

    Answer: B. Both are abnormal; teens have adult vital signs

    By adolescence, normal vital signs are adult values: heart rate about 60 to 100 and respiratory rate about 12 to 20. Tachycardia with tachypnea at rest is abnormal and needs a cause (for example, pain, fever, hypovolemia, or PE). Teen rates are not faster than children's, and hypotension is not required for concern.

16. The adolescent growth spurt occurs:

    1. A. During puberty, earlier in girls
    2. B. Before puberty begins
    3. C. After puberty is complete
    4. D. During puberty, earlier in boys
    Show answer

    Answer: A. During puberty, earlier in girls

    Girls around 11 to 12, boys around 13 to 14.

17. Puberty in males typically begins:

    1. A. Age 6 to 7
    2. B. Age 4 to 5
    3. C. Age 17 to 19
    4. D. Age 12 to 16
    Show answer

    Answer: D. Age 12 to 16

    Later than females.

18. Secondary sexual characteristics develop from:

    1. A. Estrogen and testosterone
    2. B. Thyroid hormone surges
    3. C. Growth hormone from the pituitary
    4. D. Insulin and cortisol
    Show answer

    Answer: A. Estrogen and testosterone

    Tanner staging. These sex hormones drive the changes.

19. A 17-year-old crashes after driving 90 mph with friends. Which brain development explains this risk-taking?

    1. A. The adult brain is already fully formed at 13
    2. B. The limbic system is underactive in teenagers
    3. C. Teens cannot understand speed limits or rules
    4. D. Reward circuits mature before impulse control
    Show answer

    Answer: D. Reward circuits mature before impulse control

    In adolescence, limbic reward-seeking is very active while the prefrontal cortex, which controls impulses and weighs consequences, matures into the mid-twenties. Peers amplify the gap. The brain is not mature at 13, the limbic system is overactive rather than underactive, and teens do understand rules.

20. The limbic system in adolescents:

    1. A. Is highly active, driving reward-seeking
    2. B. Functions at adult levels of regulation
    3. C. Is still undeveloped
    4. D. Is suppressed by rising hormones
    Show answer

    Answer: A. Is highly active, driving reward-seeking

    Reward sensitivity peaks.

21. Risk-taking in adolescence results from:

    1. A. Mature reward drive, immature control
    2. B. Peer pressure alone
    3. C. Ignorance of the risks involved
    4. D. Lack of formal safety education
    Show answer

    Answer: A. Mature reward drive, immature control

    They know the risks and do it anyway. It is a mismatch between a mature reward system and an immature control system.

22. Peer influence in adolescence:

    1. A. Replaces family influence entirely
    2. B. Is at its strongest
    3. C. Is absent in most teens
    4. D. Is minimal compared with childhood
    Show answer

    Answer: B. Is at its strongest

    Risk-taking rises with peers present. It shapes behavior and risk.

23. Identity formation in adolescence involves:

    1. A. Rejecting all adult values
    2. B. Copying parents' values and roles
    3. C. Little change from childhood
    4. D. Exploring values and roles
    Show answer

    Answer: D. Exploring values and roles

    Erikson's identity versus role confusion. This exploration forms a sense of self.

24. Role confusion results when:

    1. A. No clear sense of self forms
    2. B. Peers are absent from daily life
    3. C. Parents set strict rules
    4. D. Identity is firmly established early
    Show answer

    Answer: A. No clear sense of self forms

    May contribute to mental health problems.

25. Adolescents' abstract thinking:

    1. A. Declines as concrete thinking grows
    2. B. Develops, allowing hypothetical reasoning
    3. C. Is absent until adulthood
    4. D. Is fully adult-level at age 13
    Show answer

    Answer: B. Develops, allowing hypothetical reasoning

    Piaget's formal operations. Idealism also emerges.

26. The personal fable in adolescence refers to:

    1. A. Imaginary friends persisting from childhood
    2. B. A habit of lying to adults
    3. C. Belief in being unique and invulnerable
    4. D. Belief that everyone is watching them
    Show answer

    Answer: C. Belief in being unique and invulnerable

    It won't happen to me. The personal fable is the belief in being unique and invulnerable, which feeds risk-taking. The belief that everyone is watching is the imaginary audience, a related but separate idea.

27. The imaginary audience in adolescence refers to:

    1. A. Fear of family members' judgment
    2. B. Belief in being unique and invulnerable
    3. C. Imagined friends who offer support
    4. D. Belief that everyone is watching them
    Show answer

    Answer: D. Belief that everyone is watching them

    Self-consciousness. The imaginary audience is the belief that everyone is watching and judging them. Feeling unique and invulnerable is the personal fable, a related but separate concept.

28. Which statement about mortality among U.S. adolescents is most accurate?

    1. A. Cancer is the leading cause of death
    2. B. Injuries, including firearms, cause most deaths
    3. C. Congenital anomalies cause most of the deaths at this age
    4. D. Infections cause most deaths in this group
    Show answer

    Answer: B. Injuries, including firearms, cause most deaths

    Most adolescent deaths are from injury: unintentional injuries such as crashes and overdoses, suicide, and homicide. Since 2020 firearm injuries have been the leading single mechanism. Cancer, congenital anomalies, and infections cause far fewer deaths in this age group.

29. Motor vehicle crash risk in teens is increased by:

    1. A. Years of driving experience
    2. B. Inexperience, distraction, and passengers
    3. C. Daytime driving on weekdays
    4. D. Driving alone without passengers
    Show answer

    Answer: B. Inexperience, distraction, and passengers

    Graduated licensing addresses these. Night driving and alcohol also raise risk.

30. Substance use in adolescence:

    1. A. Is nearly universal among teens
    2. B. Often begins then
    3. C. Is harmless to the developing brain
    4. D. Is rare before age 18
    Show answer

    Answer: B. Often begins then

    Earlier use predicts later problems. Use commonly begins in adolescence and affects brain development.

31. Vaping and e-cigarettes in adolescents:

    1. A. Are harmless water vapor
    2. B. Are rare among high school students
    3. C. Are a safe way to quit smoking
    4. D. Deliver nicotine and can injure lungs
    Show answer

    Answer: D. Deliver nicotine and can injure lungs

    Ask specifically. They may also deliver THC and other substances.

32. Alcohol in adolescence:

    1. A. Is rare among high school students
    2. B. Is harmless in moderation at this age
    3. C. Mainly causes long-term liver disease
    4. D. Contributes to crashes and violence
    Show answer

    Answer: D. Contributes to crashes and violence

    Binge drinking is common. It also drives injuries and risky behavior.

33. Depression in adolescence:

    1. A. May present as irritability
    2. B. Usually resolves on its own
    3. C. Is rare before adulthood
    4. D. Presents the same as in adults
    Show answer

    Answer: A. May present as irritability

    Screen for it. It is common, and irritability may replace sadness.

34. Suicide risk assessment in adolescents should include:

    1. A. Direct questions about thoughts and plan
    2. B. Indirect questions to avoid planting ideas
    3. C. Parental report only
    4. D. Observation of behavior only
    Show answer

    Answer: A. Direct questions about thoughts and plan

    Asking does not plant the idea. Also ask about means and prior attempts.

35. Self-harm in adolescents:

    1. A. Is only attention-seeking
    2. B. Is always a suicide attempt
    3. C. May occur without suicidal intent
    4. D. Is rare in adolescents
    Show answer

    Answer: C. May occur without suicidal intent

    Take it seriously. It still signals distress.

36. Eating disorders typically begin in:

    1. A. Adolescence
    2. B. Middle adulthood
    3. C. Early childhood
    4. D. Late adulthood
    Show answer

    Answer: A. Adolescence

    Anorexia, bulimia, and binge eating.

37. Anorexia nervosa physiologic effects include:

    1. A. Bradycardia and hypothermia
    2. B. Tachycardia and hyperthermia
    3. C. Fever and elevated metabolic rate
    4. D. Hypertension and fluid overload
    Show answer

    Answer: A. Bradycardia and hypothermia

    Cardiac arrest risk. Hypotension and electrolyte imbalance also occur.

38. Bulimia physiologic effects include:

    1. A. Hypokalemia from purging
    2. B. Fever from recurrent aspiration
    3. C. Bradycardia as the only finding
    4. D. Hypertension from fluid retention
    Show answer

    Answer: A. Hypokalemia from purging

    Dysrhythmia risk.

39. Adolescent sexual activity:

    1. A. Is rare before age 18
    2. B. Is common and raises care issues
    3. C. Is irrelevant to emergency care
    4. D. Is nearly universal by age 14
    Show answer

    Answer: B. Is common and raises care issues

    Ask privately. Issues include pregnancy, infection, and consent.

40. Pregnancy should be considered in:

    1. A. Teens who appear visibly pregnant
    2. B. Only those who disclose sexual activity
    3. C. Teens older than about 16
    4. D. Any female teen with abdominal pain
    Show answer

    Answer: D. Any female teen with abdominal pain

    Ask directly. Also consider it with other relevant complaints. Early pregnancy is not visible, teens may not disclose sexual activity, and pregnancy occurs in younger teens too, so consider it in any female adolescent with abdominal pain.

41. Sexually transmitted infections in adolescents:

    1. A. Are mostly seen in adults over 30
    2. B. Are always obvious on exam
    3. C. Are rare in this age group
    4. D. Are common and often asymptomatic
    Show answer

    Answer: D. Are common and often asymptomatic

    Half of new infections occur in young people.

42. Adolescent confidentiality:

    1. A. Is absolute in all circumstances
    2. B. Is protected for certain services
    3. C. Is identical to adult confidentiality
    4. D. Does not exist for minors
    Show answer

    Answer: B. Is protected for certain services

    Explain the limits. Many states legally protect it for specific services.

43. When privately interviewing a 17-year-old about drug use, what should you tell her about confidentiality?

    1. A. Everything she says will be reported to her parents
    2. B. Nothing she says will ever be shared with anyone
    3. C. It stays private unless she or others are in danger
    4. D. Any drug use she mentions will be reported to police
    Show answer

    Answer: C. It stays private unless she or others are in danger

    Offer privacy and explain its limits honestly: information is shared with the care team but not her parents, except when there is risk of serious harm, such as suicidality or abuse. Promising total secrecy is dishonest. Threatening to report to parents or police shuts down disclosure.

44. The HEADSS assessment covers:

    1. A. Health, exercise, alcohol, diet, sleep, safety
    2. B. Home, education, activities, drugs, sex, suicide
    3. C. History, exam, allergies, diet, symptoms, stress
    4. D. Hearing, eyes, airway, dental, skin, spine
    Show answer

    Answer: B. Home, education, activities, drugs, sex, suicide

    A psychosocial screening framework.

45. A 16-year-old with abdominal pain gives short answers while his parents are present. Which approach is best?

    1. A. Ask the parents to step out and talk to him privately
    2. B. Direct all of the questions to his parents instead
    3. C. Ask the sensitive questions in front of his parents
    4. D. Skip the history and perform only the physical exam on him
    Show answer

    Answer: A. Ask the parents to step out and talk to him privately

    Adolescents respond to being treated as near-adults, with respect, privacy, and honesty. A private conversation, with its limits explained, often brings out sensitive history such as substance use or sexual activity that changes care. Talking only to the parents, asking sensitive questions with them in the room, or skipping the history loses information and trust.

46. Adolescent body image concerns:

    1. A. Are a sign of mental illness
    2. B. Are trivial and can be ignored
    3. C. Are rare in this age group
    4. D. Can affect cooperation and need respect
    Show answer

    Answer: D. Can affect cooperation and need respect

    Explain before exposing.

47. A 15-year-old with an ankle injury asks you not to call her parents. In most states, for routine care you should:

    1. A. Treat and release her, since teens can always consent to care
    2. B. Refuse to touch her at all until a parent arrives
    3. C. Have her sign a refusal so you can leave
    4. D. Explain that a parent generally must consent, then call
    Show answer

    Answer: D. Explain that a parent generally must consent, then call

    Minors usually need a parent's consent for routine care, with exceptions such as emancipation, certain confidential services, or emergencies (implied consent). Explain this respectfully. Teens cannot always consent, a minor generally cannot sign a valid refusal, and refusing to assess is inappropriate when urgent care may be needed.

48. Mature minor doctrine allows:

    1. A. No minor to consent under any law
    2. B. Parents to refuse emergency care
    3. C. All minors to consent to any care
    4. D. Some mature minors to consent to care
    Show answer

    Answer: D. Some mature minors to consent to care

    Varies by jurisdiction. It covers certain care in some states only.

49. A 16-year-old with type 1 diabetes has DKA after skipping insulin at a sleepover. What best explains this?

    1. A. Pubertal hormones lower insulin needs, so doses can drop
    2. B. Adolescents metabolize insulin too slowly
    3. C. Exercise at the sleepover raised his insulin needs
    4. D. Wanting to fit in with peers and not look different
    Show answer

    Answer: D. Wanting to fit in with peers and not look different

    Adolescents with chronic illness often struggle with adherence because of peer pressure, wanting to be normal, and growing independence. Pubertal hormones raise insulin needs rather than lowering them, teens do not metabolize insulin too slowly, and exercise lowers insulin needs rather than raising them.

50. Sports participation in adolescence requires:

    1. A. Proper equipment only
    2. B. Pre-participation screening
    3. C. Coach and parent approval only
    4. D. No medical evaluation
    Show answer

    Answer: B. Pre-participation screening

    Sudden cardiac death screening. It screens for cardiac and other risks.

51. Adolescent sleep needs are approximately:

    1. A. About 6 hours
    2. B. About 7 hours
    3. C. About 12 hours
    4. D. 8 to 10 hours
    Show answer

    Answer: D. 8 to 10 hours

    Most get less, partly because the adolescent body clock shifts later. The American Academy of Sleep Medicine recommends 8 to 10 hours a night for teens 13 to 18. Six or seven hours is too little, and 12 hours is more than a healthy teen typically needs.

52. Adolescent sleep phase delay means:

    1. A. They need less total sleep
    2. B. Their body clock shifts later
    3. C. They need far more sleep than children
    4. D. They fall asleep earlier each night
    Show answer

    Answer: B. Their body clock shifts later

    Later school start times help. Early mornings become difficult.

53. Adolescent nutrition needs:

    1. A. Decrease as growth slows
    2. B. Increase to support growth
    3. C. Are mainly met by protein alone
    4. D. Stay the same as in childhood
    Show answer

    Answer: B. Increase to support growth

    Eating disorders and obesity both occur. Iron and calcium are especially important.

54. Acne in adolescence results from:

    1. A. Poor hygiene and dirty skin
    2. B. Bacterial infection alone
    3. C. Hormonal effects on oil glands
    4. D. Diet, especially chocolate
    Show answer

    Answer: C. Hormonal effects on oil glands

    Can affect self-esteem significantly.

55. Scoliosis screening occurs in:

    1. A. Infancy, at well-baby visits
    2. B. Old age, with osteoporosis
    3. C. Early adolescence
    4. D. Adulthood, after growth ends
    Show answer

    Answer: C. Early adolescence

    Progression during growth. Screening targets the growth spurt.

56. Adolescent violence exposure:

    1. A. Is rare except among gang-involved teens
    2. B. Includes dating and community violence
    3. C. Has no lasting physical or mental effects
    4. D. Occurs mostly in large urban centers only
    Show answer

    Answer: B. Includes dating and community violence

    Ask about safety. Fights are also common.

57. Which statement about the exploitation of adolescents is most accurate?

    1. A. It is mostly limited to low-income neighborhoods
    2. B. Trafficking and online predators are risks
    3. C. It is uncommon in this age group
    4. D. It is mostly committed by strangers
    Show answer

    Answer: B. Trafficking and online predators are risks

    Adolescents are vulnerable to trafficking, sexual exploitation, and online predators, and warning signs such as an older controlling partner or unexplained money matter. Exploitation crosses all income levels, is not uncommon in teens, and is often committed by someone the teen knows, with coercion common.

58. Adolescent independence should be:

    1. A. Suppressed until adulthood
    2. B. Ignored by caregivers
    3. C. Unlimited to build maturity
    4. D. Supported with limits
    Show answer

    Answer: D. Supported with limits

    Autonomy with safety.

59. Adolescents facing a parent's serious illness may:

    1. A. Remain largely unaffected
    2. B. Fully understand and cope well
    3. C. Need no outside support
    4. D. Take on adult roles or act out
    Show answer

    Answer: D. Take on adult roles or act out

    Support resources help.

60. Which adolescent presentation warrants highest concern?

    1. A. Sleeping late on weekends
    2. B. Giving away possessions
    3. C. Arguments with parents
    4. D. Frequent mood swings
    Show answer

    Answer: B. Giving away possessions

    Suicide warning signs. Expressed hopelessness and withdrawal are also warning signs.

61. Which approach to an adolescent with a possible overdose is best?

    1. A. Expressing disapproval to deter use
    2. B. Involving police before treatment
    3. C. Direct, nonjudgmental questions
    4. D. Lecturing about the dangers
    Show answer

    Answer: C. Direct, nonjudgmental questions

    Honesty improves care. Ask what was taken and when.

62. A 15-year-old collapses suddenly during basketball practice and is pulseless. What is the priority?

    1. A. Feel for a carotid pulse for a full minute first
    2. B. Start CPR and apply an AED as soon as possible
    3. C. Check a blood glucose before anything else
    4. D. Give two rescue breaths, then recheck a pulse
    Show answer

    Answer: B. Start CPR and apply an AED as soon as possible

    Sudden collapse in a young athlete is presumed cardiac arrest until proven otherwise (causes include hypertrophic cardiomyopathy, coronary artery anomalies, and commotio cordis). Immediate CPR and early defibrillation determine survival. A pulse check should take no more than 10 seconds, CPR for a pulseless teen starts with compressions rather than rescue breaths, and checking glucose first delays defibrillation. (Replaces an item repeating s04-q003/q019 on prefrontal maturation.)