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A nurse is meeting with a 15-year-old client who has ADHD. The client and their parent state they would like their medications stopped due to the unpleasant side effects. Which of the following statements should the nurse make?

Tell me more about what unpleasant effects you have been experiencing

Stop taking the medication immediately

I’ll get the physician to discuss this situation

It’s important to take the medication as prescribed

Answer and Explanation

The Correct Answer is A

a. Tell me more about what unpleasant effects you have been experiencing

Explanation of Choices

Choice A Reason: Tell Me More About What Unpleasant Effects You Have Been Experiencing

This response is the most appropriate because it opens a dialogue between the nurse, the client, and the parent. Understanding the specific side effects the client is experiencing allows the nurse to gather detailed information, which is crucial for assessing the situation accurately. This approach shows empathy and concern for the client’s well-being and can help identify whether the side effects are manageable or if an alternative treatment plan is needed. It also ensures that the client feels heard and supported.

Choice B Reason: Stop Taking the Medication Immediately

Advising the client to stop taking the medication immediately is not appropriate without a thorough assessment and consultation with the prescribing physician. Abruptly discontinuing ADHD medication can lead to withdrawal symptoms and a resurgence of ADHD symptoms, which can negatively impact the client’s daily functioning and overall health. Medication changes should always be made under medical supervision to ensure safety and effectiveness.

Choice C Reason: I’ll Get the Physician to Discuss This Situation

While involving the physician is an important step, this response alone does not address the immediate concerns of the client and parent. It is essential for the nurse to first understand the specific issues before referring to the physician. This ensures that the physician has all the necessary information to make an informed decision about the client’s treatment plan. Additionally, this response may come across as dismissive if not coupled with an initial assessment by the nurse.

Choice D Reason: It’s Important to Take the Medication as Prescribed

While it is true that taking medication as prescribed is important, this response does not acknowledge the client’s and parent’s concerns about side effects. It may come across as dismissive and could damage the trust between the client, parent, and healthcare provider. Addressing the side effects and exploring possible solutions or alternatives is crucial for maintaining adherence to the treatment plan and ensuring the client’s well-being.

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Correct Answer is A

Explanation

a. The CAGE Questionnaire

Explanation of Choices

Choice A Reason: The CAGE Questionnaire

The CAGE Questionnaire is a widely used screening tool for identifying potential alcohol use disorders. It consists of four questions that focus on key aspects of alcohol dependency: Cutting down, Annoyance by criticism, Guilty feelings, and Eye-openers (drinking first thing in the morning). This tool is quick to administer and has been validated in various clinical settings, making it an effective choice for initial screening of alcohol problems. The CAGE Questionnaire is particularly useful in preoperative assessments to identify patients who may be at risk for alcohol-related complications during and after surgery.

Choice B Reason: The Abnormal Involuntary Movement Scale

The Abnormal Involuntary Movement Scale (AIMS) is used to assess the severity of tardive dyskinesia and other involuntary movements, typically in patients taking antipsychotic medications. It is not designed to screen for alcohol use disorders. Therefore, it would not be appropriate for evaluating a client suspected of having a drinking problem.

Choice C Reason: The Clinical Institute Withdrawal Assessment Scale

The Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) is a tool used to assess the severity of alcohol withdrawal symptoms. While it is valuable for managing patients already known to have alcohol dependence, it is not a primary screening tool for identifying alcohol use disorders. The CIWA-Ar is more appropriate for monitoring patients during detoxification rather than initial screening.

Choice D Reason: Refer the Client for Physician Evaluation

Referring the client for a physician evaluation is a reasonable step if the nurse suspects a drinking problem. However, using a validated screening tool like the CAGE Questionnaire can provide immediate, actionable information that can guide the next steps in care. The CAGE Questionnaire can help determine the severity of the problem and whether a referral to a specialist is necessary.

Correct Answer is ["2"]

Explanation

Step 1: Identify the dosage required and the concentration available.

Required dosage: 40 mg
Available concentration: 20 mg/mL

Step 2: Calculate the volume to be administered.

Volume to be administered = Required dosage ÷ Available concentration
Volume to be administered = 40 mg ÷ 20 mg/mL

Step 3: Perform the division.

Volume to be administered = 40 ÷ 20
Volume to be administered = 2 mL

Step 4: Round the answer to the nearest whole number (if necessary).

Volume to be administered = 2 mL (no rounding needed)

The nurse should administer 2 mL.

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A nurse is meeting with a 15-year-old client who has ADHD. The client and their parent state they would like their medications stopped due to the unpleasant side effects. Which of the following statements should the nurse make?

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Correct Answer is A

Explanation

A nurse is preparing to administer fluoxetine 40 mg PO daily. The amount available is fluoxetine 20 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["2"]

Explanation

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