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A child with attention deficit hyperactivity disorder is taking methylphenidate (Ritalin) in divided doses. If the child takes the first dose at 8 am, which behavior might the school nurse expect to see at noon?
- A. Increased impulsivity or hyperactive behavior
- B. Lack of appetite for lunch
- C. Sleepiness or drowsiness
- D. Social isolation from peers
Correct Answer: A
Rationale: Ritalin's short half-life means its effects may wear off by noon, leading to increased impulsivity or hyperactivity.
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Which of the following symptoms are characteristic of ADHD? Select all that apply.
- A. Enuresis
- B. Inattentiveness
- C. Encopresis
- D. Overactivity
- E. Impulsiveness
Correct Answer: B,D,E
Rationale: ADHD is defined by inattentiveness, overactivity, and impulsiveness, while enuresis and encopresis are unrelated elimination disorders.
The nurse has been working with the family of a small child with a psychiatric disorder. The nurse is feeling very frustrated because the parents refuse to implement effective parenting skills that the nurse has taught. What is the best action for the nurse at this time?
- A. Review effective disciplinary practices with the parents again.
- B. Refer the parents to a family therapist.
- C. Try to remember that the parents are trying to the best of their ability to carry out the suggestions.
- D. Explore alternative living arrangements for the child.
Correct Answer: C
Rationale: Recognizing parents' efforts and challenges fosters empathy and supports continued collaboration without premature escalation.
Which statement would indicate that medication teaching for the parents of a 6-year-old child with attention deficit hyperactivity disorder (ADHD) has been effective?
- A. We'll teach him the proper way to take the medication, so he can manage it independently.
- B. We'll be sure he takes Ritalin at the same time every day, just before bedtime.
- C. We're so glad that Ritalin will eliminate the problems of ADHD.
- D. We'll be sure to record his weight on a weekly basis.
Correct Answer: D
Rationale: Monitoring weight weekly addresses Ritalin's potential to suppress appetite, ensuring proper growth management.
The nurse is assessing a 16-month-old child during a well-baby checkup. Which of the following behaviors would be consistent with autism spectrum disorder? Select all that apply.
- A. The child displays little eye contact with others.
- B. The child thrives on changes in routine.
- C. The child makes few facial expressions toward others.
- D. The child does not like repetition.
- E. The child answers questions verbally.
Correct Answer: A,C,D
Rationale: Autism spectrum disorder is characterized by limited eye contact, few facial expressions, and a preference for repetition, not thriving on change or verbal responses at this age.
Which of the following are common coexisting psychiatric disorders for adults with ADHD? Select all that apply.
- A. Social phobia
- B. Bipolar disorder
- C. Obsessive-compulsive disorder
- D. Major depression
- E. Alcohol dependence
Correct Answer: A,B,D,E
Rationale: Adults with ADHD commonly have coexisting conditions like social phobia, bipolar disorder, major depression, and alcohol dependence, but not typically obsessive-compulsive disorder.