China is a country experiencing urgent and rapid urbanisation as it integrates Western ways of knowing and being. These rapid changes pose particular challenges for adolescents negotiating constructs of identity between worldviews. This paper will present a report on observations made on a recent scoping visit by two nurse academics to three Chinese cities. An ecological framework will be used to discuss and critique emerging health issues for adolescents. These were identified as 'early love', 'internet use and abuse', 'physical violence' and 'stealing'. Community health nurses are challenged to make sense of these issues and how best to support adolescents, their families and communities. Contexts of care for community health nurses are also problematic as adolescent education takes priority as a driver for economic growth. Accordingly, this paper will also explore enablers and barriers for this group of community health nurses.