Nokea
The nurse advises the parents to look for which change as evidence that methylphenidate hydrochloride (Ritalin) is achieving its desired effect?
- A. The child is less easily distracted.
- B. The child does not seem fatigued.
- C. The child's moods are more stable.
- D. None of the above
Correct Answer: A
Rationale: Reduced distractibility indicates improved focus, the primary goal of Ritalin.
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Which assessment finding best indicates that a child taking methylphenidate hydrochloride (Ritalin) is experiencing undesirable side effects?
- A. The child has altered elimination patterns.
- B. The child develops intolerance to certain foods.
- C. The child has an elevated blood pressure.
- D. The child has evidence of skin breakdown.
Correct Answer: C
Rationale: Elevated blood pressure is a concerning side effect of Ritalin.
Which response by the nurse provides the best explanation of the child's behavior?
- A. Thumb sucking is a primitive form of self-stimulation and security.
- B. Thumb sucking is a regressive behavior with a comforting effect.
- C. Thumb sucking substitutes for the missing fluids due to postoperative restriction of fluids.
- D. Thumb sucking satisfies the child's increased need for a familiar touch.
Correct Answer: B
Rationale: Thumb sucking is a regressive behavior triggered by stress, offering comfort.
Which suggestion is most appropriate for the nurse to offer the parents in this situation?
- A. Avoid controlling the child.
- B. Praise accomplishments as deserved.
- C. Avoid discussing peer comments.
- D. Show disapproval of negative labels.
Correct Answer: B
Rationale: Praising accomplishments boosts self-esteem and counters ridicule.
If and when the autistic child actually makes an effort to self-feed, which of the following suggestions is most appropriate for the nurse to make?
- A. Note if the self-feeding effort is repeated.
- B. Stop feeding the child thereafter.
- C. Demonstrate approval in some way.
- D. Offer food more frequently during the day.
Correct Answer: C
Rationale: Positive reinforcement encourages repetition of desired behaviors.
Which nursing goal is the highest priority at this time?
- A. To improve the client's distorted body image
- B. To help the client use healthier coping techniques
- C. To restore normal nutrition and health
- D. To help the client develop assertiveness
Correct Answer: C
Rationale: Restoring nutrition is critical to address life-threatening malnutrition.