Question 1

An adolescent female is brought to the emergency department after experiencing a panic attack while at school.She had forgotten to study for a test in Biology.The mother indicates that her daughter is easily distracted,often forgets schoolwork,and has difficulty completing assignments and following instructions.She asks if her daughter should be on medication for ADHD.What is the nurse's best response?

Accepted Answer

A

Question 2

An infant in the neonatal intensive care unit is prescribed caffeine (Cafcit)IV as treatment for apnea.Which medical orders should the nurse plan for,based on the addition of this medication? Note: Credit will be awarded only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

B,C

Question 3

During a routine dressing change,the nurse notes a vesicular rash across the abdomen of a client who is 2 days postop after hysterectomy.The client's a.m.meds,including modafinil (Provigil),ibuprofen,and a multivitamin with iron,are due in 30 minutes.What nursing action is essential?

Accepted Answer

The appearance of a vesicular rash in a post-op client is concerning for possible infection or allergic reaction to medication. Modafinil (Provigil) is a stimulant medication used to treat narcolepsy and other sleep disorders, and is not essential for the client's immediate care. Therefore, holding the medication and notifying the healthcare provider about the rash is the most appropriate nursing action at this time.

Question 4

An adolescent client who has been taking amphetamine sulfate (Adderall)since age 7 now presents with new-onset type 1 diabetes mellitus.What should be of highest priority in the nurse's education regarding the diabetes for this client?

Accepted Answer

Amphetamine sulfate (Adderall) may affect blood sugar levels and may need to be changed or closely monitored in patients with type 1 diabetes. It is important for the nurse to educate the client and family about the potential interaction between Adderall and insulin and the importance of medication management with the healthcare provider. The other options (B, C, and D) are important considerations in the care of a client with diabetes, but changing the medication takes priority in this case.

Question 5

A school-age client who is taking amphetamine sulfate (Adderall)for treatment of ADHD is seen in the clinic for routine follow-up.The nurse will automatically perform which functions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The nurse should measure height and weight to monitor growth and development, and assess vital signs specifically heart rate and BP because amphetamine sulfate can cause cardiovascular effects. Labs for cardiovascular status and fasting blood glucose may be ordered if indicated, but not automatically performed at routine follow-up visits. 24-hour urine collection for proteinuria is not relevant to monitoring the effects of amphetamine sulfate.

Question 6

A client with a history of benign prostatic hyperplasia (BPH),gout,hyperlipidemia,and palpitations is being seen for symptoms of narcolepsy.Before starting on methylphenidate (Concerta)for treatment of narcolepsy,which testing would the nurse anticipate?

Accepted Answer

Methylphenidate can increase heart rate and blood pressure, so a cardiac workup, including an EKG, is necessary before initiating treatment. Due to the client's history of palpitations, it is important to ensure that there are no pre-existing cardiac abnormalities that could be exacerbated by the medication. The other options are not directly relevant to the use of methylphenidate for narcolepsy.

Question 7

An adult client who is seen by the primary care provider for complaints of inability to focus and concentrate on college studies is prescribed atomozetine (Strattera).Which client comment indicates that the nurse should provide additional information about the drug?

Accepted Answer

Atomoxetin (Strattera) may cause insomnia, so continuing to take melatonin, which is also used to promote sleep, could exacerbate this side effect. The nurse should advise the client to discuss sleep management strategies with the provider instead of taking additional medications. Option A indicates the client is aware of potential driving impairment and will wait before driving, option B indicates understanding of the potential for liver damage and need to report jaundice, and option C indicates a desire for weight loss which may or may not occur as a side effect of this medication.

Question 8

A mother tells the school nurse that she is concerned over her daughter's use of an inhaler for asthmatic episodes.The daughter is taking amphetamine and dextroamphetamine (Adderall XR)for ADHD.The mother states that since beginning the Adderall,every time the daughter uses her inhaler,she gets very agitated,jittery,and anxious.Which response by the nurse is the most appropriate?

Accepted Answer

Option D provides an explanation that inhalers used for asthma can cause similar central nervous system stimulation as medications for ADHD, and the daughter's symptoms are likely due to the additive effect of having both medications. It suggests that the combination of medications can be adjusted, rather than discontinuing treatment for either condition. Option A suggests switching to another medication without considering the effects of the combination of medications. Option B suggests discontinuing treatment for ADHD, which may not be necessary. Option C suggests discontinuing Adderall during asthma exacerbation, which may not address the underlying problem of the medications interacting with each other.

Question 9

The mother of a pediatric client prescribed clonidine (Kapvay)for treatment of ADHD makes these remarks.Which statements indicate that the nurse should provide additional information about the drug? Note: Credit will be awarded only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

- Clonidine (Kapvay) is known to cause sedation or sleepiness as a common side effect, so the statement about the medication not making the child sleepy indicates a misunderstanding.- Clonidine is not typically prescribed with planned drug holidays (periods of time off the medication) for ADHD treatment, which is more common with stimulant medications. This suggests a need for clarification.

Question 10

A friend of the nurse expresses concern that her husband might have narcolepsy.Which behavior would indicate to the nurse that he needs further workup by his health care provider?

Accepted Answer

Falling asleep at inappropriate times, such as when driving or waiting for a stoplight, is a hallmark symptom of narcolepsy. The husband's behavior indicates that he may have narcolepsy and should be further evaluated by his healthcare provider. Options A, B, and C are not specific to narcolepsy and could be indicative of other conditions or lifestyle factors.

Question 11

A mother expresses concern that her school-age child may need to be started on medication for ADHD.When asked to describe the child's behaviors that lead to this concern,the mother makes these statements.Which would the nurse interpret as a potential indicator of ADHD?

Accepted Answer

The behavior described by the mother - not being able to complete assignments that require sitting and writing, doodling on paper, or badgering others - is a potential indicator of ADHD. The other statements do not necessarily indicate ADHD, but could be related to other issues such as lack of motivation or forgetfulness.

Question 12

An older adult client with Parkinson disease is seen because the daughter states the client cannot stay awake in the daytime.The client is sleeping most of the day,and is having trouble sleeping at night.The client has no history of cardiac events or psychiatric disorders.Vital signs,electrolytes,liver and renal test results are within normal limits.The client is slightly underweight for height.The nurse would anticipate a prescription for which medication?

Accepted Answer

Modafinil is a stimulant medication used to promote wakefulness in individuals with excessive daytime sleepiness, including those with Parkinson disease. It has been shown to be effective in improving daytime sleepiness and reducing nighttime wakefulness in these patients. Sodium oxybate is used for narcolepsy/cataplexy, while methylphenidate is a stimulant used for attention deficit hyperactivity disorder (ADHD) and selegiline is a medication for Parkinson disease, but does not address the issue of excessive daytime sleepiness.

Question 13

Atomoxetine (Strattera)has been prescribed for a school-age client newly diagnosed with ADHD.Which comment by the mother would indicate that the nurse should provide more teaching about this medication?

Accepted Answer

Atomoxetine (Strattera) is not a stimulant medication and is less likely to be abused recreationally compared to stimulant medications used for ADHD. Therefore, the mother's concern about it being popular as a recreationally abused drug indicates a misunderstanding about the nature of Atomoxetine, suggesting the need for more education on this aspect.

Question 14

A client recently prescribed methylphenidate (Ritalin)for treatment of ADHD complains of an inability to go to sleep at night.Which nursing actions are indicated? Note: Credit will be awarded only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The nurse should assess for potential contributing factors such as caffeine intake, timing of medication, and non-pharmacologic methods for inducing sleep. It is also important to follow up with the healthcare provider to discuss the client's sleep disturbance and potential medication adjustments. While melatonin may be a suggestion, it is not the first-line intervention and should be discussed with the healthcare provider before recommending to the client.

Question 15

A pregnant client says,"There is a strong history of ADHD in my husband's family.What can I do to help my baby avoid developing it?" How should the nurse respond? Note: Credit will be awarded only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of A pregnant client says,"There is a strong...

Question 16

Which client comment would alert the nurse that atomoxetine (Strattera)should be held and the health care provider notified?

Accepted Answer

This client comment indicates suicidal ideation and requires immediate attention from the healthcare provider. Atomoxetine (Strattera) is commonly used to treat attention deficit hyperactivity disorder (ADHD) but can also increase the risk of suicidal thoughts and behaviors in some individuals. Holding the medication and notifying the healthcare provider is necessary to ensure the client's safety. The other client comments, while potential side effects of the medication, do not pose an immediate risk to the client's well-being.

Question 17

The mother of a school-age client tells the school nurse,"My son is so hyperactive.I can't see any harm in putting him on medication,especially since the stimulants have so few side effects." Which response by the nurse is the most appropriate?

Accepted Answer

The answer of The mother of a school-age client tells...

Question 18

A client is brought to the emergency department with severe hypertension,nervousness,tremors,tachycardia,and post-seizure.According to the paramedics,the client was found lying next to an open bottle of amphetamine and dextroamphetamine (Adderall).The client is not coherent,but admits to taking the Adderall.The nurse should prepare to administer which treatments? Note: Credit will be awarded only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of A client is brought to the emergency...

Question 19

The nurse provides information regarding methylphenidate (Concerta)to the parents of a school-age client.Which statements indicate that the parents have good understanding of the information? Note: Credit will be awarded only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse provides information regarding methylphenidate (Concerta)to...

Question 20

A school-age client comes to the clinic for routine follow-up after being placed on amphetamine sulfate (Adderall)2 weeks ago for a diagnosis of ADHD.The client weighed 15 pounds over normal for height prior to the start of the Adderall.The mother states concern that the client is no longer snacking,barely finishes meals,and "will lose too much weight." What is the nurse's best response to this concern?

Accepted Answer

The nurse should educate the mother that it is common for amphetamines to suppress the appetite and cause weight loss. However, it is important for the client to maintain a healthy weight. The nurse should suggest offering small, frequent meals to prevent excessive weight loss and explain that the diminished appetite may improve over time. Monitoring for weight loss is also important, but scheduling appointments every week may not be necessary unless significant weight loss occurs. Option A is not the best choice because weekly appointments may cause unnecessary stress for the client and family. Option B is incorrect because losing a significant amount of weight is not normal and may indicate a need for intervention. Option D is incorrect because it implies that the client's weight will automatically return to normal, which may not always be the case.

Quiz 24: Central Nervous System Stimulants and Drugs for Attention Deficit

During a routine dressing change,the nurse notes a vesicular rash across the abdomen of a client who is 2 days postop after hysterectomy.The client's a.m.meds,including modafinil (Provigil) ,ibuprofen,and a multivitamin with iron,are due in 30 minutes.What nursing action is essential?

An adolescent client who has been taking amphetamine sulfate (Adderall) since age 7 now presents with new-onset type 1 diabetes mellitus.What should be of highest priority in the nurse's education regarding the diabetes for this client?

A client with a history of benign prostatic hyperplasia (BPH) ,gout,hyperlipidemia,and palpitations is being seen for symptoms of narcolepsy.Before starting on methylphenidate (Concerta) for treatment of narcolepsy,which testing would the nurse anticipate?

An adult client who is seen by the primary care provider for complaints of inability to focus and concentrate on college studies is prescribed atomozetine (Strattera) .Which client comment indicates that the nurse should provide additional information about the drug?

A friend of the nurse expresses concern that her husband might have narcolepsy.Which behavior would indicate to the nurse that he needs further workup by his health care provider?

A mother expresses concern that her school-age child may need to be started on medication for ADHD.When asked to describe the child's behaviors that lead to this concern,the mother makes these statements.Which would the nurse interpret as a potential indicator of ADHD?

Atomoxetine (Strattera) has been prescribed for a school-age client newly diagnosed with ADHD.Which comment by the mother would indicate that the nurse should provide more teaching about this medication?

A client recently prescribed methylphenidate (Ritalin) for treatment of ADHD complains of an inability to go to sleep at night.Which nursing actions are indicated? Note: Credit will be awarded only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A pregnant client says,"There is a strong history of ADHD in my husband's family.What can I do to help my baby avoid developing it?" How should the nurse respond? Note: Credit will be awarded only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Which client comment would alert the nurse that atomoxetine (Strattera) should be held and the health care provider notified?

The mother of a school-age client tells the school nurse,"My son is so hyperactive.I can't see any harm in putting him on medication,especially since the stimulants have so few side effects." Which response by the nurse is the most appropriate?