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.

Answer and Explanation

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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Free Nursing Study Resources

Correct Answer is ["A","B","D"]

Explanation

A. Constipation is a common adverse effect of opioid medications, including hydrocodone.

Opioids can slow down bowel motility, leading to constipation.

B. Lightheadedness is a common side effect of opioids, particularly when a patient first starts

taking them or when the dose is increased. It can be due to the central nervous system depressant effects of the medication.
C. Pain relief is the therapeutic effect of acetaminophen/hydrocodone, not an adverse effect.

D. Urinary retention can occur with opioid use due to their effects on the urinary sphincters and bladder muscle tone. Patients may experience difficulty urinating or incomplete emptying of the bladder.
E. Diarrhea is not a common adverse effect of acetaminophen/hydrocodone. In fact, opioids more commonly cause constipation rather than diarrhea.

A. Signs of bone marrow depression B. Increased risk of suicidal thoughts and behaviors C. Increased risk of cardiovascular events, such as strokes D. Indications of drug addiction and dependency

Correct Answer is B

Explanation

A. Signs of bone marrow depression are not typically associated with antiepileptic drugs. This adverse effect is more commonly seen with medications such as chemotherapy agents.
B. Increased risk of suicidal thoughts and behaviors is a well-documented concern with antiepileptic drugs, particularly when used for psychiatric indications or in certain patient populations. The FDA has issued warnings regarding this risk, and healthcare providers should monitor patients for changes in mood, behavior, and suicidal ideation.
C. While some antiepileptic drugs may have cardiovascular effects, such as prolongation of the QT interval, the FDA warning specifically highlights the risk of suicidal thoughts and behaviors rather than cardiovascular events like strokes.

D. Indications of drug addiction and dependency are not typically associated with antiepileptic drugs. These medications are not central nervous system depressants and do not produce the euphoria or withdrawal symptoms characteristic of addictive substances.

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Naxlex Comprehensive Predictor Exams

The opioid acetaminophen/hydrocodone is prescribed for a patient who has had surgery. The nurse informs the patient that which common adverse effects can occur with this medication? (Select all that apply.)

Correct Answer is ["A","B","D"]

Explanation

The U.S. Food and Drug Administration has issued a warning for users of antiepileptic drugs. Based on this report, the nurse will monitor for which potential problems with this class of drugs?

Correct Answer is B

Explanation

When evaluating a patient who is taking orlistat, which is an intended therapeutic effect?

A nurse is preparing to administer meperidine 35 mg IM to a client every 6 hr PRN for pain. Available is meperidine injection 75 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

The nurse is assessing a patient for contraindications to drug therapy with acetaminophen. Which patient should not receive acetaminophen?

A patient has been taking lithium for 1 year, and the most recent lithium level is 0.9 mEq/L. Which statement about the laboratory result is correct?

The nurse is caring for a client experiencing sympathetic nervous system stimulation. What assessment finding supports this diagnosis? Select all that apply. (Select All that Apply.)

A patient has been treated with antiparkinson medications for 3 months. What therapeutic responses should the nurse look for when assessing this patient?