The parents of a child with ADHD bring the child for a follow-up visit. During the visit, they tell the nurse that the child receives his first dose of methylphenidate (Ritalin) at about 7:30 AM every morning before leaving for school. The teacher and school nurse have noticed a return in the child?s overactivity and distractibility just before lunch. The child?s second dose is scheduled for about 12 noon. Which of the following might the nurse suggest as a possible solution to control the child?s symptoms a bit more effectively?
- A. Giving the second dose at 1 PM or later.
- B. Switching to a longer acting preparation.
- C. Splitting the early morning dose in half.
- D. Switching to another class of medication
Correct Answer: B
Rationale: Switching to a longer-acting preparation of methylphenidate can provide more consistent symptom control throughout the morning, addressing the return of symptoms before lunch. Delaying the second dose (option A) may prolong symptoms, splitting the dose (option C) may not provide adequate coverage, and switching medication classes (option D) is unnecessary without further evaluation.
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A child diagnosed with autism is hospitalized in an inpatient mental health unit. When developing the plan of care for this child, which of the following would the nurse most likely include?
- A. Ensuring that a variety of caregivers are available for the child
- B. Providing a consistent, structured environment with predictable routines
- C. Allowing the child frequent visits off the unit to provide stimulation
- D. Sending the child to the time out area if the child repeats phrases continually
Correct Answer: B
Rationale: Children with autism thrive in consistent, structured environments with predictable routines, as these reduce anxiety and support behavioral stability. Option A is counterproductive, as multiple caregivers can disrupt consistency. Option C may overstimulate the child, and option D is inappropriate for managing repetitive behaviors typical of autism.
A group of nurses is reviewing medications used to treat attention deficit hyperactivity disorder. The students demonstrate understanding of the information when they identify methylphenidate as which of the following?
- A. Selective serotonin reuptake inhibitor
- B. Psychostimulant
- C. Noradrenergic reuptake inhibitor
- D. Alpha agonist
Correct Answer: B
Rationale: Methylphenidate is a psychostimulant used to treat ADHD by increasing dopamine and norepinephrine levels to improve attention and impulse control. Option A (SSRI) is for depression, option C (noradrenergic reuptake inhibitor) describes drugs like atomoxetine, and option D (alpha agonist) includes drugs like clonidine.
A group of nursing students is reviewing information about disruptive behavior disorders. The students demonstrate understanding of the topic when they identify which of the following as an externalizing disorder?
- A. Anxiety
- B. Depression
- C. Schizophrenia
- D. Conduct disorder
Correct Answer: D
Rationale: Conduct disorder is an externalizing disorder characterized by behaviors like aggression and rule-breaking, which are outwardly directed. Anxiety (option A), depression (option B), and schizophrenia (option C) are internalizing or psychotic disorders, not externalizing.
A nurse is assessing an 8-year-old girl with a mood disorder. Which of the following would the nurse most likely expect to assess?
- A. Statement from the child that she feels sad
- B. Behavioral problems
- C. Recurrent obsessions
- D. Ritualistic behavior
Correct Answer: A
Rationale: Mood disorders in children, such as depression, often present with verbalized feelings of sadness (option A). Behavioral problems (option B) may occur but are less specific. Options C and D are more characteristic of obsessive-compulsive disorder, not a mood disorder.
The history of a child newly diagnosed with ADHD reveals that the child is experiencing sleeping difficulties. Which agent would the nurse most likely use?
- A. Methylphenidate
- B. Atomoxetine
- C. Bupropion
- D. Clonidine
Correct Answer: D
Rationale: Clonidine, an alpha-2 agonist, is often used to manage sleep difficulties in children with ADHD, as it has sedative effects. Methylphenidate (option A) and atomoxetine (option B) are stimulants or non-stimulants for ADHD symptoms but may worsen sleep. Bupropion (option C) is an antidepressant and not typically used for ADHD-related sleep issues.
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