The Nurse Educator in the Emergency Department is explaining to a group of student nurses, "What the primary role of a Sexual Assault Nurse Examiner (SANE) is when intervening with a victim of violence?" Student nurses reply that the primary role of the SANE nurse is:

A. The pharmacological action of Ritalin causes a decrease in appetite. Methylphenidate (Ritalin) is a stimulant medication commonly prescribed for ADHD. One of its well-documented side effects is appetite suppression, which can lead to weight loss. This is the most accurate and direct explanation for the weight loss observed in the adolescent client.

B. Side effects of Ritalin cause nausea; therefore, caloric intake is decreased. While nausea can occur with methylphenidate, it is not the primary reason for weight loss. The main mechanism is appetite suppression rather than a direct reduction in caloric intake due to nausea. This response is less accurate than option A.

C. Increased ability to concentrate allows the client to focus on activities rather than food: While methylphenidate can improve concentration, this explanation does not directly address the physiological cause of weight loss. It is the decrease in appetite due to the drug's effects on neurotransmitters that leads to weight loss, not the increased focus on activities .

D. Hyperactivity seen in ADHD causes increased caloric expenditure: Hyperactivity itself can lead to higher caloric expenditure, but this is not directly related to the weight loss caused by methylphenidate. The primary reason for the weight loss in this case is the appetite suppression due to the medication, not increased activity .

A. Permanent short-term memory loss: While certain substances, particularly chronic alcohol use, can lead to memory impairment, permanent short-term memory loss is not a typical complication of heroin use. Heroin primarily affects the respiratory system and can lead to other health risks such as overdose and infection. Therefore, this choice is incorrect.

B. Nasal septum perforation: Nasal septum perforation is typically associated with the intranasal use of substances like cocaine, which can damage the nasal tissues. Heroin is more commonly injected or smoked, and nasal perforation is not a primary health risk associated with its use. Therefore, this choice is incorrect.

C. Acute pancreatitis: Acute pancreatitis is commonly associated with excessive alcohol consumption rather than heroin use. Heroin primarily affects the central nervous and respiratory systems rather than the pancreas. Therefore, this choice is incorrect.

D. Respiratory depression/arrest: Heroin use poses a significant risk of respiratory depression and arrest, which can be fatal. It depresses the central nervous system and slows down breathing, potentially leading to severe hypoxia and death, especially in the case of overdose. This choice is correct.