CH 57 Drugs for Attention Deficit Hyperactivity and Narcolepsy (E4)
A 12-year-old has been prescribed dextroamphetamine (Adderall) therapy, and the nurse is now reviewing the correct schedule for taking the drug. The child should most likely take the initial daily dose of dextroamphetamine at what times? A) 07:00 and 11:30 B) 07:30, 11:30, 16:30, and 20:00 C) 08:00 and 20:00 D) 09:00, 14:00, and 19:00
A
Which of the following are expected adverse effects of amphetamine sulfate? SELECT ALL THAT APPLY. A) weight loss B) anorexia C) dry mouth D) bradycardia E) constipation
A, B, C
Which behavior would a nurse expect in the child who takes methylphenidate (Ritalin) every morning? A) sitting and playing with toys for 90 minutes B) getting along well with peers C) expressing anger in an appropriate manner D) not throwing toys across the room
B
A client should be educated concerning the effect of combining theophylline with what chemical substance? A) methylphenidate B) atomoxetine C) modafinil D) caffeine
D
A high school age client, brought to the emergency department (ED) by friends after taking a "whole handful of dextroamphetamine (Adderall)," is now lapsing in and out of consciousness. The ED nurse should prioritize what assessment related to dextroamphetamine overdose? A) blood glucose monitoring B) cognitive assessment C) lung function testing D) cardiac monitoring
D
Which characteristics would the nurse recognize as primary symptoms of narcolepsy? SELECT ALL THAT APPLY. A) excessive daytime drowsiness B) fatigue C) cataplexy D) hypnagogic hallucinations E) sleep paralysis
A, B, C, D, E
A nurse is teaching the guardians and their school-age child about a new prescription for lisdexamfetamine (Vyvanse). Which of the following information should the nurse include in the teaching? SELECT ALL THAT APPLY. A) An adverse effect of this medication is CNS stimulation. B) Administer the medication before bedtime. C) Monitor blood pressure while taking this medication. D) Therapeutic effects of this medication will take 1 to 3 weeks to fully develop. E) This medication raises the levels of dopamine in the brain.
A, C, E
An 8-year-old boy has been taking dexmethylphenidate (Adderall) 5 mg daily for 3 months. His mother is concerned that this dosage is not adequately treating his symptoms of attention deficit hyperactivity disorder. Which of the following behaviors would support the mother's concerns? A) increased concentration during school B) weight gain of 8 lbs over the past 3 months C) increased activity D) bradycardia
C
A 13-year-old child is prescribed atomoxetine (Strattera) to be at 07:00. When will this medication reach its peak plasma level? A) 08:00 to 09:00 B) 09:45 to 10:30 C) 10:30 to 11:45 D) 13:00 to 14:00
A
A boy comes to the school nurse's office and states, "I did not take my Ritalin today." Which of the following is the most appropriate nursing intervention? A) Call the child's parent or guardian to try to find out if the boy has taken his medicine. B) Give the child his morning dose because it is in the office. C) Send him back to class and tell him it is not necessary to take the medication. D) Call the child's physician to obtain a one-time dose of methylphenidate.
A
A child is prescribed an amphetamine for attention deficit hyperactivity disorder (ADHD). Which effect provides evidence that the medications are working? A) improved grades B) increased sleep quality C) lethargy D) polyphagia
A
A 13-year-old has been prescribed dextroamphetamine (Adderall) for the treatment of attention deficit hyperactivity disorder (ADHD) since age 10, achieving significant improvements in behavior and mood. When assessing the child during a scheduled follow-up appointment, the nurse should prioritize what physical assessment to monitor for a potential adverse reaction to the therapy? A) abdominal girth and assessment for peripheral edema B) measurement of height and body weight C) visual acuity and hearing ability D) assessment of deep tendon reflexes and peripheral pulses
B
A client is being prescribed dextroamphetamine (Adderall) for the treatment of attention deficit hyperactivity disorder (ADHD). During health education, the nurse should make the client aware of the black box warning relating to what potential risk issue? A) kidney failure B) potential for abuse C) stroke with excessive doses D) unstable blood glucose levels
B
A client, prescribed dextroamphetamine (Adderall) for attention deficit hyperactivity disorder (ADHD), has developed a common adverse effect of the medication since beginning therapy. Which initial intervention should the client be encouraged to implement? A) Taking an over-the-counter (OTC) laxative daily. B) Increase fiber intake. C) Take diphenoxylate hydrochloride. D) Take metronidazole.
B
A nurse is caring for a school-age child who has a new prescription for atomoxetine (Strattera). The nurse should monitor the client for which of the following manifestations as an adverse effect of this medication? A) Kidney toxicity B) Liver damage C) Seizure activity D) Adrenal insufficiency
B
A nurse is teaching the caregiver of a school-age child about transdermal methylphenidate (Ritalin). Which of the following instructions should the nurse include? A) Apply one patch twice per day. B) Leave the patch on for 9 hr. C) Apply the patch to the child's waist. D) Use opened tray within 6 months.
B
A nurse is teaching the guardians of a child who has a new prescription for desipramine (Norpramin). The nurse should include that which of the following adverse effects is the priority to report to the provider? A) Constipation B) Suicidal thoughts C) Photophobia D) Dry mouth
B
Which of the following groups are most commonly used for drug management of the hyperactive child? A) central nervous system (CNS) depressants B) CNS stimulants C) anticonvulsants D) major tranquilizers
B
A teenage client, treated with dextroamphetamine (Adderall) for attention deficit hyperactivity disorder (ADHD) for the last 10 years, is now diagnosed with hyperthyroidism. What intervention should be implemented with this client to provide safe management of all conditions? A) Discontinue the high-calorie diet. B) Assess the client for pulmonary edema. C) Discontinue the dextroamphetamine. D) Administer a proton pump inhibitor.
C
The child is diagnosed with attention deficit hyperactivity disorder (ADHD). Which medication will most likely be administered in conjunction with treatment? A) ACE inhibitors B) selective serotonin reuptake inhibitors (SSRIs) C) central nervous system (CNS) stimulants D) monoamine oxidase inhibitors (MAOIs)
C
When a 7-year-old child, already of short stature, is prescribed amphetamine sulfate, which intervention will promote growth? A) administering growth hormone B) encouraging daily exercise C) maintaining a 2200-calorie diet D) drug holidays when on school breaks
D
Which finding is indicative of an adverse effect of dextroamphetamine (Adderall)? A) increased appetite B) respiratory depression C) sedation D) cardiac dysrhythmias
D
Patient teaching for children taking methylphenidate (Ritalin) for attention deficit hyperactivity disorder should include which of the following? A) Give the child the drug at bedtime. B) Drowsiness may be a side effect. C) If necessary, the child may take over-the-counter cold products without problems. D) Provide for periodic drug-free holidays.
D
The nurse working with the family of a child prescribed methylphenidate (Ritalin) should implement what strategy to address possible adverse effects? A) a strategy to ensure that the child maintains normal bladder function B) a plan to address the child's loss of appetite C) a plan to enhance the child's self-esteem D) a strategy to regularly monitor the child's blood glucose levels
B
When the nurse is caring for a child receiving a central nervous system stimulant for attention deficit hyperactivity disorder, which assessment is most important to monitor? A) liver function B) weight loss C) fever D) seizure activity
B
Which aspect of client teaching should be provided to a client diagnosed with narcolepsy? A) Take 250 mg of caffeine daily. B) Avoid working shifts. C) Take a lengthy nap every afternoon. D) Increase the methylphenidate dose as needed.
B
Which of the following groups are most commonly used for drug management of the patient with narcolepsy? A) central nervous system (CNS) depressants B) CNS stimulants C) anticonvulsants D) major tranquilizers
B
Which of the following statements indicate the patient is in need of further patient teaching regarding medication for attention deficit hyperactivity disorder? A) I should not crush my tablets. B) I can skip doses when I am feeling good. C) I should not change my dosage without consulting my health care provider. D) I should consult with my health care provider before taking any new medications.
B
A child, diagnosed with attention deficit hyperactivity disorder (ADHD), has been prescribed methylphenidate (Ritalin). The child's mother tells the nurse that she does not understand why a stimulant would help since, "my child is completely overstimulated, not under-stimulated!" What should the nurse explain to the mother about the therapeutic use of methylphenidate? A) Methylphenidate helps with the symptoms of ADHD, but the reasons for this are not well understood. B) Methylphenidate stimulates the parasympathetic nervous system, resulting in increased control of behavior. C) Methylphenidate stimulates the limbic system, which regulates control over behavior and affect. D) Methylphenidate enhances the function of dopamine, which regulates cognition.
A
A mother who calls the clinic to report that her son has recently started medication to treat attention deficit hyperactivity disorder (ADHD) fears her son is experiencing side effects of the medication. Which of the following side effects are typically related to medications used for ADHD? A) poor appetite B) frequency of urination C) weight gain D) sedation
A
A nurse is teaching an adolescent client who has a new prescription for clomipramine (Anafranil) for OCD. Which of the following instructions should the nurse include to minimize an adverse effect of this medication? A) Wear sunglasses when outdoors. B) Check your temperature daily. C) Take this medication in the morning. D) Add extra calories to your diet.
A
An adult client, diagnosed with narcolepsy, admits being embarrassed to receive this diagnosis and is adamant that no one find out about it. The nurse should respond to the client by explaining what aspect of the etiology? A) "This is the result of neurological factors over which you have no direct control." B) "In a lot of cases, making improvements to your sleep habits can resolve narcolepsy." C) "This is something that runs in certain families, and it's not your fault that this has happened." D) "This usually stems from suppressed emotions, so counseling usually helps greatly."
A
What is the purpose of a "drug holiday" for a teenager prescribed an amphetamine for attention deficit hyperactivity disorder (ADHD)? A) to minimize weight loss B) to prevent hyperthyroidism C) to allow electrolyte imbalances to resolve D) to slow bone resorption
A
What is the central nervous system stimulant of choice to treat narcolepsy? A) atomoxetine (Strattera) B) guarana C) caffeine D) modafinil (Provigil)
D
