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. Bupropion is primarily used as an antidepressant and smoking cessation aid. It is not typically used for opioid withdrawal.
B. Methadone is a synthetic opioid agonist commonly used in the management of opioid withdrawal. It helps to alleviate withdrawal symptoms and can be used as part of a long-term maintenance program for opioid dependence.
C. Disulfiram is used in the treatment of alcohol dependence by creating unpleasant effects when alcohol is consumed. It is not indicated for opioid withdrawal.
D. Phenobarbital is a barbiturate with sedative and anticonvulsant properties. While it can be used to manage certain withdrawal symptoms, such as seizures associated with alcohol withdrawal, it is not typically used as a first-line treatment for opioid withdrawal.
Correct Answer is C
Explanation
A. These are adverse effects that usually subside after a few weeks: While some adverse effects of phenobarbital may diminish over time, the symptoms described by the patient are more likely related to its impact on REM sleep.
B. The drug must be stopped immediately because of possible adverse effects: Stopping phenobarbital abruptly can lead to withdrawal symptoms and potential rebound seizures; discontinuation should be done gradually under medical supervision.
C. This drug causes deprivation of REM sleep and may cause the inability to deal with normal stress: Phenobarbital is known to disrupt REM sleep, leading to emotional lability, irritability, and difficulty coping with stress.
D. This drug causes the rapid eye movement (REM) sleep period to increase, resulting in nightmares and restlessness: Phenobarbital actually decreases REM sleep, which can lead to disturbances in sleep patterns and mood changes.
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