A nurse is reinforcing teaching with an adolescent who has ADHD and a new prescription for methylphenidate. Which of the following actions by the adolescent should the nurse identify as a potential barrier is communication?

The adolescent interrupts the nurse to ask question

The adolescent occasionally turns away from the nurse and stares at the wall

The adolescent taps on the arm of the chair throughout the conversation

The adolescent rocks in their chair while speaking with the nurse.

Answer and Explanation

The Correct Answer is C

A) "The adolescent interrupts the nurse to ask a question": Interrupting is common in adolescents with ADHD, as impulsivity is a characteristic of the disorder. While this behavior can be disruptive, it does not necessarily present a barrier to communication. The adolescent may be seeking clarification, and the nurse can guide them to ask questions at appropriate times.

B) "The adolescent occasionally turns away from the nurse and stares at the wall": This behavior may indicate that the adolescent is distracted or disengaged, but it does not necessarily block communication. It's important for the nurse to assess the adolescent’s attention and attempt to re-engage them if needed.

C) "The adolescent taps on the arm of the chair throughout the conversation": Tapping or other repetitive movements are often seen in individuals with ADHD and can be a significant barrier to effective communication. This behavior can be distracting for both the adolescent and the nurse, making it difficult to maintain focus on the conversation and absorb information. The nurse should address this by encouraging a calmer, more focused posture during discussions.

D) "The adolescent rocks in their chair while speaking with the nurse": Rocking can be a self-soothing behavior or a way to help manage restlessness, common in ADHD. While it can be distracting, it is less likely to be a major barrier to communication than tapping, which may be more intrusive. The nurse should assess if the behavior affects the adolescent’s ability to focus or engage.

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Correct Answer is A

Explanation

A) Position the client on their left side.
This is the most appropriate action. The client's symptoms (dizziness, racing heart, and paleness) are consistent with supine hypotensive syndrome, which occurs when the pregnant uterus compresses the inferior vena cava while lying on the back, reducing venous return to the heart. Positioning the client on their left side relieves the pressure on the vena cava, restores normal blood flow, and alleviates these symptoms. This is a common intervention during pregnancy to prevent such complications.

B) Check the client's temperature.
While checking the client’s temperature may be necessary if an infection is suspected, the symptoms described are more indicative of supine hypotensive syndrome rather than an infection. Therefore, checking the temperature is not the priority action in this scenario.

C) Instruct the client to take a brisk walk.
Encouraging the client to take a brisk walk is not an appropriate response to the symptoms described. In fact, moving or exerting oneself might worsen dizziness or lead to further complications. The priority is to relieve the pressure on the vena cava by changing the client's position, not by physical activity.

D) Provide the client with a glass of orange juice.
Although providing orange juice might help if the client is experiencing hypoglycemia, there is no indication from the symptoms described that the client has low blood sugar. The client's symptoms are more likely due to positional changes that affect circulation during pregnancy, and the best immediate action is to change the client's position rather than offering food or drink.

A. "Wash the site daily with warm water B. "Wash skin markings off after each treatment. C. "Apply lotion to the site after treatment." D. "Cover the site with a transparent dressing

Correct Answer is A

Explanation

A) "Wash the site daily with warm water": The nurse should instruct the client to wash the radiation treatment site gently with warm water and mild soap (without scrubbing or using harsh soaps). This helps to cleanse the skin without irritating it. Keeping the skin clean can help prevent infection and minimize irritation during the course of radiation therapy. It's important not to use hot water or harsh chemicals, as the skin in the treated area can be sensitive.

B) "Wash skin markings off after each treatment": Skin markings are placed on the client's skin by the radiation oncologist to ensure the radiation is targeted precisely. These marks should not be washed off, as they are necessary for the planning and delivery of radiation. Washing off the marks could affect the accuracy of the treatment.

C) "Apply lotion to the site after treatment": While it may seem like a good idea to apply lotion to moisturize the skin, clients undergoing radiation therapy should avoid applying any lotions, creams, or ointments to the radiation site unless specifically prescribed by their healthcare provider. Some lotions or creams may contain chemicals that could irritate the skin further or interfere with the radiation treatment. Only approved products should be used.

D) "Cover the site with a transparent dressing": Covering the radiation treatment site with a transparent dressing is typically not recommended unless the client has an open wound or is instructed to do so by the healthcare provider. The treated skin should be left exposed to air to promote healing unless advised otherwise. Covering the site could trap moisture, leading to skin irritation or infection.

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A nurse is reinforcing teaching with an adolescent who has ADHD and a new prescription for methylphenidate. Which of the following actions by the adolescent should the nurse identify as a potential barrier is communication?

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Explanation

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