A 6-year-old boy has been started on an extended-release form of methylphenidate hydrochloride for the treatment of attention deficit hyperactivity disorder (ADHD). During a follow-up visit, his mother tells the nurse that she has been giving the medication at bedtime so that it will be "in his system" when he goes to school the next morning. What is the nurse's appropriate evaluation of the mother's actions?
The last dose of medication should be given 4 to 6 hours before bedtime to diminish insomnia.
The medication should be taken with meals for optimal absorption.
The medication should not be taken until he is at school.
She is giving him the medication dosage appropriately.
The Correct Answer is A
A. The last dose of medication should be given 4 to 6 hours before bedtime to diminish insomnia: Methylphenidate is a stimulant medication commonly used to treat ADHD.
Administering it at bedtime may interfere with sleep onset and lead to insomnia. It's important to follow the prescribed dosing schedule to optimize symptom control during waking hours while minimizing adverse effects on sleep.
B. The medication should be taken with meals for optimal absorption: While taking
methylphenidate with meals may help reduce gastrointestinal side effects, the timing of administration relative to bedtime is more relevant to address in this scenario.
C. The medication should not be taken until he is at school: Delaying medication until the child is at school may result in inadequate symptom control during the morning when ADHD
symptoms are often most problematic.
D. She is giving him the medication dosage appropriately: Administering methylphenidate at bedtime is not appropriate and may lead to insomnia rather than optimizing symptom control during the day.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C"]
Explanation
A. Increased heart rate: Sympathetic nervous system stimulation typically leads to increased heart rate as part of the "fight or flight" response.
B. Decrease in urinary bladder muscle tone: Sympathetic stimulation would typically cause relaxation of the urinary bladder, leading to increased muscle tone.
C. Increased blood pressure: Sympathetic nervous system activation results in vasoconstriction and increased cardiac output, leading to elevated blood pressure.
D. Decreased salivation: Sympathetic stimulation can lead to decreased salivation as part of the "fight or flight" response, but it's not a consistent finding.
E. Decreased bowel sounds: Sympathetic activation can inhibit gastrointestinal motility, leading to decreased bowel sounds, but it's not a universal finding in sympathetic stimulation.
Correct Answer is C
Explanation
A. Take the medication in the morning to prevent insomnia: This instruction is not directly
related to minimizing anticholinergic effects; it's more about managing the timing of medication administration.
B. Use cooling measures to decrease fever: Anticholinergic effects do not typically cause fever, so this instruction is not relevant.
C. Chew sugarless gum to moisten the mouth: Anticholinergic medications can cause dry mouth (xerostomia), and chewing gum can stimulate saliva production, alleviating this side effect.
D. Take an antacid to relieve nausea: Anticholinergic effects can include nausea, but taking an antacid is not a specific strategy for managing this side effect.
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