A client is prescribed methylphenidate for attention-deficit/hyperactivity disorder (ADHD). The client tells the nurse that they sometimes take more than the prescribed dose to study for exams. What is the nurse's best response?

Correct answer: a) "You should not take more than the prescribed dose because it can cause serious side effects."

Rationale: Methylphenidate is a stimulant that can increase alertness, attention, and energy. However, taking more than the prescribed dose can cause adverse effects such as insomnia, anxiety, palpitations, hypertension, psychosis, and seizures.

Incorrect choices:
b) "You should talk to your doctor about adjusting your dose if you feel that it is not effective.": This may encourage the client to continue misusing the medication and may not address the underlying causes of their academic difficulties.
c) "You should stop taking this medication because it is addictive and can lead to dependence.": This may discourage the client from adhering to their treatment plan and may not acknowledge the benefits of the medication for their condition.
d) "You should use other strategies to improve your concentration and memory, such as exercise and meditation.": This may imply that the medication is unnecessary or ineffective and may not address the risks of misusing the medication.

Correct answers:

a) Store prescription drugs in a secure place away from children and pets;

d) Follow the directions on the prescription label and do not adjust the dose without

consulting the prescriber;

e) Inform the prescriber and pharmacist about any allergies or other medications being

taken

Rationale: These are examples of safe practices that can prevent prescription drug misuse, abuse, diversion, and adverse reactions.

Incorrect choices:
b) Dispose of unused or expired prescription drugs in the trash or toilet: This is not a safe practice, as it can pose environmental and health hazards. The nurse should advise the clients to follow the FDA guidelines for proper disposal of prescription drugs, such as using drug take-back programs or mixing them with unpalatable substances before throwing them away in a sealed container.
c) Share prescription drugs with family or friends who have similar symptoms: This is not a safe practice, as it can lead to inappropriate use, overdose, interactions, or allergic reactions. The nurse should emphasize that prescription drugs are intended for individual use only and that self-medication or medication borrowing is dangerous.