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When evaluating a patient who is taking orlistat, which is an intended therapeutic effect?
- A. Increased wakefulness
- B. Increased appetite
- C. Decreased weight
- D. Decreased hyperactivity
Correct Answer: C
Rationale: Orlistat is a nonstimulant drug used for weight loss by inhibiting fat absorption, making decreased weight the intended therapeutic effect. It does not affect wakefulness, appetite, or hyperactivity.
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A patient has a new prescription for phentermine as part of the treatment for weight loss. Which information will the nurse include when teaching this patient about a stimulant such as phentermine? (Select all that apply.)
- A. Take this medication after meals.
- B. Take this medication in the morning.
- C. This drug is taken along with supervised exercise and suitable diet.
- D. Use mouth rinses, sugarless gum, or hard candies to minimize dry mouth.
- E. Avoid foods that contain caffeine, such as coffee, tea, and colas.
Correct Answer: B,C,D,E
Rationale: Phentermine should be taken in the morning to avoid insomnia, alongside supervised exercise and diet for weight loss, and with measures like mouth rinses to manage dry mouth. Avoiding caffeine prevents additive stimulant effects. Taking it after meals is not necessary, as timing is not meal-dependent.
A 10-year-old patient will be started on methylphenidate hydrochloride therapy. The nurse will perform which essential baseline assessment before this drug is started?
- A. Eye examination
- B. Height and weight
- C. Liver function studies
- D. Hearing test
Correct Answer: B
Rationale: Methylphenidate may cause temporary growth suppression in children, making baseline height and weight assessment essential for monitoring. Eye exams, liver function studies, and hearing tests are not routinely required for this therapy.
A patient who started taking orlistat 1 month ago calls the clinic to report some 'embarrassing' adverse effects. She tells the nurse that she has had episodes of 'not being able to control my bowel movements.' Which statement is true about this situation?
- A. These are expected adverse effects that will eventually diminish.
- B. The patient will need to stop this drug immediately if these adverse effects are occurring.
- C. The patient will need to increase her fat intake to prevent these adverse effects.
- D. The patient will need to restrict fat intake to less than 30% of total calories to help reduce these adverse effects.
Correct Answer: D
Rationale: Orlistat's gastrointestinal side effects, such as fecal incontinence, are related to its mechanism of inhibiting fat absorption. Restricting dietary fat to less than 30% of total calories can reduce these effects. They are not expected to diminish entirely without dietary changes, stopping the drug is not necessary, and increasing fat intake would worsen the effects.
A 6-year-old boy has been started on an extended-release form of methylphenidate hydrochloride for the treatment of attention deficit hyperactivity disorder (ADHD). During a follow-up visit, his mother tells the nurse that she has been giving the medication at bedtime so that it will be 'in his system' when he goes to school the next morning. What is the nurse's appropriate evaluation of the mother's actions?
- A. She is giving him the medication dosage appropriately.
- B. The medication should not be taken until he is at school.
- C. The medication should be taken with meals for optimal absorption.
- D. The medication should be given 4 to 6 hours before bedtime to diminish insomnia.
Correct Answer: D
Rationale: Methylphenidate, a CNS stimulant, can cause insomnia if taken close to bedtime. Administering it 4 to 6 hours before bedtime helps minimize sleep disturbances while maintaining therapeutic levels during the day. Bedtime dosing, school-time dosing, or meal-dependent administration are not appropriate for extended-release formulations.
The order reads: 'Give atomoxetine 0.5 mg/kg/day once daily in the morning before school.' The child weighs 88 pounds. Identify how many milligrams will be administered per dose.
Correct Answer: 20 mg
Rationale: Convert 88 pounds to kilograms: 88 ?· 2.2 = 40 kg. Calculate dose: 0.5 mg/kg/day ?? 40 kg = 20 mg/day.