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.
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 D
Explanation
. Use physical restraints during severe outbursts to ensure safety. Physical restraints are not appropriate for managing behavioural issues in children with ODD. They can escalate the situation, cause physical harm, and damage the trust between the child and caregivers.
B. Assign daily chores that are challenging to encourage discipline. While chores can teach responsibility, assigning challenging tasks is not appropriate for managing ODD and could lead to frustration and further defiance.
C. Encourage solitary play to reduce social stressors. Solitary play might reduce social stress but does not address the underlying behavioural issues of ODD. Social skills and interactions need to be improved rather than avoided.
D. Put into practice consistent consequences for rule-breaking behaviour. Consistent consequences help the child understand the link between behaviour and outcomes, which is crucial for managing ODD. It provides structure and clear expectations, which are essential for children with behavioral issues.
Correct Answer is A
Explanation
A. Promoting social skills and communication development: This is a priority because individuals with Asperger's disorder often struggle with social interactions and communication. Interventions focus on improving these skills to enhance their quality of life and ability to function in society.
B. Administering medications to manage symptoms: While medications may be prescribed for co-occurring conditions (e.g., anxiety, ADHD), they are not typically the primary intervention for core symptoms of Asperger's disorder.
C. Implementing strict routines and schedules: Routine and structure can be beneficial for individuals with Asperger's disorder but are not the primary focus compared to social and communication skills.
D. Providing sensory stimulation to reduce hyperactivity: Sensory issues can be part of Asperger's disorder, but it is not the priority over social and communication development.
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