A patient presents to the emergency department complaining of a severe headache. She is diaphoretic and is unable to sit still. Her family tells the nurse that the client has been taking "some herb." Which herb does the nurse suspect the client has been taking?

A. Before breakfast or lunch

Methylphenidate (Ritalin), a stimulant medication commonly used to treat attention deficit hyperactivity disorder (ADHD), is usually administered before breakfast or lunch for maximum effectiveness. This schedule helps align the peak concentration of the medication with the times when increased focus and attention are often needed, such as during school hours.

B. With meals

While it can be administered with meals, the goal is often to have the medication take effect before meals to help with focus and attention during activities like school or work.

C. After dinner

Administering methylphenidate after dinner may interfere with the patient's ability to fall asleep, as the medication can cause insomnia. It is generally recommended to avoid administering it in the late afternoon or evening.

D. At bedtime

Administering methylphenidate at bedtime is not appropriate due to the potential for insomnia. The stimulant effect of the medication is not aligned with the patient's sleep-wake cycle.

A. Decreased ascites

Ascites (accumulation of fluid in the abdominal cavity) is more directly related to portal hypertension and liver cirrhosis. While lactulose may contribute to fluid balance, its primary therapeutic effect in hepatic encephalopathy is the reduction of ammonia levels.

B. Decreased ammonia level

Lactulose is a medication commonly used in the treatment of hepatic encephalopathy, a condition associated with liver disease. The therapeutic effect of lactulose in this context is to reduce blood ammonia levels. Lactulose works by promoting the excretion of ammonia in the form of ammonium ions in the colon, thereby lowering ammonia concentrations in the blood.

C. Decreased jaundice

Jaundice is often associated with liver dysfunction, but lactulose is not primarily used to address jaundice. Its primary role in liver disease is in the management of hepatic encephalopathy.

D. Decreased blood pressure

Blood pressure is not a direct therapeutic target of lactulose in the context of liver disease. Lactulose's primary therapeutic effect is related to reducing ammonia levels and managing hepatic encephalopathy.