The nurse is caring for an adolescent client diagnosed with attention-deficit/hyperactivity disorder (ADHD), who is prescribed methylphenidate (Ritalin) therapy. The client reports and questions the nurse why they have lost 10 pounds in 2-months. Which of the following should be the appropriate response by the nurse?

The pharmacological action of Ritalin causes a decrease in appetite.

Side effects of Ritalin cause nausea; therefore, caloric intake is decreased.

Increased ability to concentrate allows the client to focus on activities rather than food.

Hyperactivity seen in ADHD causes increased caloric expenditure.

Answer and Explanation

The Correct Answer is A

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 .

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Correct Answer is C

Explanation

A. Phase I: This is the tension-building phase, where minor incidents of abuse occur, and the victim often tries to placate the abuser to avoid escalation.

B. Phase III: This is the honeymoon phase, where the abuser may apologize, show remorse, and promise that the abuse will not happen again. The victim may also experience a period of denial and hope for change.

C. Phase II: This is the acute battering incident, where the abuse reaches a peak and the victim is physically harmed. The client's statement and the injury indicate they are in this phase.

D. Phase IV: There is no recognized "Phase IV" in the cycle of abuse. The standard model includes tension-building, acute battering, and the honeymoon phases.

A. Reprimand the client about the potential damage that has occurred due to overexercising her body. B. Praise the client for looking at herself in a mirror. C. Restrict the client from being weighed. D. Ask the client to agree to talk to a nurse whenever she feels the urge to exercise.

Correct Answer is D

Explanation

A. Reprimand the client about the potential damage that has occurred due to overexercising her body. Reprimanding the client is not therapeutic and can increase feelings of guilt or shame, potentially exacerbating the condition. A more supportive and understanding approach is needed to address the behavior. Therefore, this choice is incorrect.

B. Praise the client for looking at herself in a mirror. Praising the client for looking at herself in the mirror is not specifically relevant to managing the overexerting behavior and does not address the core issues of anorexia nervosa. It may also reinforce body image concerns. Therefore, this choice is incorrect.

C. Restrict the client from being weighed. Weighing restrictions are common in the treatment of anorexia nervosa to reduce anxiety around weight gain. However, this action alone does not directly address the overexercising behavior. Instead, comprehensive behavioral and therapeutic strategies should be employed. Therefore, this choice is incorrect.

D. Ask the client to agree to talk to a nurse whenever she feels the urge to exercise. Encouraging the client to discuss her urges to exercise with a nurse provides an opportunity for therapeutic intervention and support. It helps in addressing the behavior in a constructive manner and provides a means for the client to seek help when struggling with their impulses. This choice is correct.

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Naxlex Comprehensive Predictor Exams

A client comes into the Emergency Department diagnosed with a fractured right wrist and states, "I am fine, really, because it is all my fault. I knew he was in a bad mood and I got in his way." The nurse should recognize which cycle of battery is this client in?

Correct Answer is C

Explanation

A nurse is caring for a client diagnosed with anorexia nervosa and overexercises to avoid gaining weight. Which of the following should be the appropriate action by the nurse?

Correct Answer is D

Explanation

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