A 10-year-old with Attention Deficit-Hyperactivity Disorder (ADHD) evaluated at the mental health clinic is exhibiting hyperactivity and distractibility. After 5 weeks of methylphenidate, the nurse should monitor for which desired outcome? (SELECT ALL THAT APPLY)

working on an arithmetic quiz for 20 minutes without getting out of their seat

family members report no episodes of pica

does not tell untrue information

completing a jigsaw puzzle with a friend

decreased manipulative behaviors

Answer and Explanation

Correct Answer : A,D,E

A) Working on an arithmetic quiz for 20 minutes without getting out of their seat: This outcome indicates improved focus and attention span, which are desired effects of methylphenidate in managing ADHD symptoms. The ability to stay seated and concentrate on a task for an extended period is a positive sign of the medication’s effectiveness.

B) Family members report no episodes of pica: Pica, the consumption of non-food items, is not typically associated with ADHD. Therefore, the absence of pica episodes is not a relevant outcome for evaluating the effectiveness of methylphenidate in this context.

C) Does not tell untrue information: While honesty is important, it is not a primary focus of ADHD treatment. Methylphenidate aims to improve attention, focus, and reduce hyperactivity, rather than directly addressing truthfulness.
D) Completing a jigsaw puzzle with a friend: Successfully completing a jigsaw puzzle with a friend demonstrates improved attention, focus, and social interaction skills. These are positive outcomes of methylphenidate treatment for ADHD, indicating better management of hyperactivity and distractibility.

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Correct Answer is B

Explanation

A) Furosemide 40 mg PO daily for a client whose blood pressure is 123/86: While furosemide is important for managing fluid status, the client's blood pressure is within a normal range, and this medication does not address any acute concerns.

B) Nitroglycerin 0.4 mg SL PRN for a client complaining of chest pain: This prescription should be implemented first because it addresses an immediate and potentially life-threatening symptom. Chest pain can indicate angina or myocardial infarction, making it critical to relieve this symptom promptly.

C) Metoprolol 25 mg PO bid for a client whose heart rate is 55 beats: While metoprolol is important for managing heart rate and hypertension, a heart rate of 55 beats/minute is on the lower end and could warrant caution. The priority would be to assess the need for medication before administering it.

D) Diltiazem 30 mg PO tid for a client whose heart rate is 90 beats/min: This medication is also important for managing heart rate and hypertension but is not the priority over addressing acute chest pain. The client’s heart rate is within a normal range, so this does not require immediate action compared to the nitroglycerin for chest pain.

A. Blood urea nitrogen (BUN) 20 mg/d B. Creatinine 2.6 mg/dl C. Hemoglobin 12.8 g/dl D. Potassium 3.8 mEq/L

Correct Answer is B

Explanation

A) Blood urea nitrogen (BUN) 20 mg/dL: While this BUN level is slightly elevated, it is not as concerning as the creatinine level. Elevated BUN can indicate dehydration or other issues but does not necessarily signal acute kidney injury.

B) Creatinine 2.6 mg/dL: This result is the most concerning because it indicates impaired kidney function. Normal creatinine levels are typically between 0.6 and 1.2 mg/dL. An elevated creatinine level suggests that the kidneys are not filtering waste effectively, which is a significant concern for a client with long-standing hypertension.

C) Hemoglobin 12.8 g/dL: This hemoglobin level is within the normal range for adults and does not present an immediate concern.

D) Potassium 3.8 mEq/L: This potassium level is also within the normal range (3.5 to 5.0 mEq/L) and does not raise any alarms in terms of electrolyte imbalances.

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A 10-year-old with Attention Deficit-Hyperactivity Disorder (ADHD) evaluated at the mental health clinic is exhibiting hyperactivity and distractibility. After 5 weeks of methylphenidate, the nurse should monitor for which desired outcome? (SELECT ALL THAT APPLY)

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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