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.
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Related Questions
Correct Answer is B
Explanation
A. Acetaminophen is generally considered safe for patients with a history of peptic ulcer disease.
It does not irritate the gastrointestinal mucosa like nonsteroidal anti-inflammatory drugs (NSAIDs).
B. Patients with a history of liver disease should not receive acetaminophen or should use it with caution and under close supervision, as acetaminophen is metabolized in the liver. Liver
impairment can lead to decreased metabolism of acetaminophen, potentially resulting in drug accumulation and hepatotoxicity.
C. Acetaminophen is commonly used to relieve mild to moderate headaches. However, the appropriateness of acetaminophen use in this scenario depends on the patient's overall health status and any contraindications specific to the individual.
D. Acetaminophen is often used to reduce fever. A fever of 101°F (38.3°C) alone does not necessarily contraindicate acetaminophen use, but caution should be exercised in patients with liver disease.
Correct Answer is A
Explanation
A. Getting up slowly from a sitting or lying position is an important aspect of patient education for individuals taking tamsulosin, as this medication can cause orthostatic hypotension, leading to dizziness or fainting upon standing up quickly.
B. Tamsulosin is often taken once daily, approximately 30 minutes after the same meal each day, typically breakfast or the first meal of the day. Taking it with breakfast is not a requirement for
its efficacy.
C. There is no need to restrict fluids while on tamsulosin therapy. In fact, adequate hydration is generally encouraged.
D. Tamsulosin is not typically associated with causing hypertension. Instead, it is more commonly associated with hypotension, especially orthostatic hypotension.
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