A nurse is assessing an adolescent's self-esteem. Which of the following factors should the nurse identify as influencing the self-esteem of adolescents? (Select All that Apply.)

A. Peer relationships and social acceptance: Adolescents place significant value on peer acceptance and friendships. Positive peer interactions can enhance self-esteem, while rejection or bullying can lower it, making social dynamics a key influencing factor. B. Physical appearance and body image: Pubertal changes and body image concerns strongly impact adolescent self-esteem. Satisfaction or dissatisfaction with appearance can affect confidence, social interactions, and emotional well-being. C. Socioeconomic status and family income: Socioeconomic factors influence access to resources, extracurricular activities, and social experiences. Limited financial means can affect adolescents’ sense of belonging and self-worth. D. Academic achievements and grades: Success or difficulties in school can shape self-esteem. High academic performance can boost confidence, whereas repeated academic struggles may negatively affect an adolescent’s self-image and motivation. E. Parental approval and family support: Family dynamics, emotional support, and parental involvement are critical for healthy self-esteem. Positive reinforcement and nurturing relationships help adolescents develop a secure sense of self.