The nurse is assessing a school aged child with ADHD. The child is prescribed dexamethylphenidate 10mg before breakfast and lunch. Which of the following findings is of MOST concern to the nurse?

Sleeping 8 to 10 hours a night

Heart rate 90 beats per minute at rest

Blood pressure reading of 140/90

Weight gain of 2 kgs since last visit

Answer and Explanation

The Correct Answer is C

A. Sleeping 8 to 10 hours a night is within the normal range for a school-aged child.
B. A resting heart rate of 90 beats per minute is within the normal range for a child.
C. A blood pressure reading of 140/90 is concerning as it indicates hypertension, which can be a side effect of stimulant medications like dexamethylphenidate.
D. A weight gain of 2 kgs is not immediately concerning in a growing child, though weight should be monitored.

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Correct Answer is C

Explanation

A. A blood pressure of 100/56 and a small weight gain may indicate fluid retention, but they are not immediately life-threatening.
B. A heart rate of 150 beats/minute with crying can be normal for a child of this age, especially during emotional distress.
C. An apical pulse of 70 beats/minute and vomiting are concerning because they may indicate digoxin toxicity. A low heart rate (bradycardia) in a child on digoxin requires immediate attention.
D. An hourly urine output of 45 mL/hour is adequate and not concerning in this context.

A. Avoiding further palpation of the abdomen B. Obtaining an accurate height and weight C. Monitoring vital signs D. Assessing the urine for the presence of blood

Correct Answer is A

Explanation

A. Avoiding further palpation of the abdomen is crucial to prevent rupture of the tumor and potential spread of cancer cells.
B. Obtaining an accurate height and weight is important but not as critical as preventing tumor rupture.
C. Monitoring vital signs is essential but not the priority intervention in this context.
D. Assessing the urine for the presence of blood is important for overall assessment but not the most critical intervention compared to avoiding tumor rupture.

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The nurse is assessing a school aged child with ADHD. The child is prescribed dexamethylphenidate 10mg before breakfast and lunch. Which of the following findings is of MOST concern to the nurse?

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