A 10-year-old with Attention Deficit-Hyperactivity Disorder (ADHD) evaluated at the mental health clinic is exhibiting hyperactivity and distractibility. After 5 weeks of methylphenidate, the nurse should monitor for which desired outcome? (SELECT ALL THAT APPLY)

working on an arithmetic quiz for 20 minutes without getting out of their seat

family members report no episodes of pica

does not tell untrue information

completing a jigsaw puzzle with a friend

decreased manipulative behaviors

Answer and Explanation

Correct Answer : A,D,E

A) Working on an arithmetic quiz for 20 minutes without getting out of their seat: This outcome indicates improved focus and attention span, which are desired effects of methylphenidate in managing ADHD symptoms. The ability to stay seated and concentrate on a task for an extended period is a positive sign of the medication’s effectiveness.

B) Family members report no episodes of pica: Pica, the consumption of non-food items, is not typically associated with ADHD. Therefore, the absence of pica episodes is not a relevant outcome for evaluating the effectiveness of methylphenidate in this context.

C) Does not tell untrue information: While honesty is important, it is not a primary focus of ADHD treatment. Methylphenidate aims to improve attention, focus, and reduce hyperactivity, rather than directly addressing truthfulness.
D) Completing a jigsaw puzzle with a friend: Successfully completing a jigsaw puzzle with a friend demonstrates improved attention, focus, and social interaction skills. These are positive outcomes of methylphenidate treatment for ADHD, indicating better management of hyperactivity and distractibility.

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Correct Answer is A

Explanation

A) Second intercostal space right of sternum: This is the correct location for auscultating an aortic murmur. The aortic area is best heard at the second intercostal space on the right side of the sternum, where the sound of blood flow through the aortic valve is most prominent.

B) Fourth intercostal space, left mid-clavicular line: This location is typically associated with the mitral valve area, not the aortic area. While important for other heart sounds, it does not correspond to where an aortic murmur would be heard loudest.

C) Third intercostal space, left of sternum: This area is generally associated with the pulmonic area, not the aorta. Murmurs from the aortic valve would not be best heard here.

D) Second intercostal space left of sternum: This location is associated with the pulmonic area as well. An aortic murmur would not be best auscultated here, making this option incorrect for identifying an aortic murmur specifically.

A. The client is retaining fluids and will need a fluid restriction. B. The client has developed an expected side effect of the medication. C. The client is experiencing angioedema and notifies the healthcare provider. D. The client will need to have the dose of the medication reduced.

Correct Answer is C

Explanation

A. The client is retaining fluids and will need a fluid restriction: While fluid retention can occur with certain medications, the specific symptoms of tingling lips and edema suggest a different issue, making this option less relevant.

B. The client has developed an expected side effect of the medication: Tingling of the lips and lip edema are not typical expected side effects of losartan. This medication can cause side effects like dizziness or hypotension, but angioedema is a serious concern that can occur.

C. The client is experiencing angioedema and notifies the healthcare provider: This is the most appropriate interpretation of the symptoms. Angioedema is a potentially serious allergic reaction that can occur with medications such as losartan, which is an angiotensin II receptor blocker. Immediate notification of the healthcare provider is crucial for further evaluation and management.

D. The client will need to have the dose of the medication reduced: While reducing the dose might be considered in some cases of side effects, the symptoms described indicate a potentially severe reaction that requires immediate attention rather than simply adjusting the dosage.

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A 10-year-old with Attention Deficit-Hyperactivity Disorder (ADHD) evaluated at the mental health clinic is exhibiting hyperactivity and distractibility. After 5 weeks of methylphenidate, the nurse should monitor for which desired outcome? (SELECT ALL THAT APPLY)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse auscultates a heart murmur on a client with cardiovascular disease. At which anatomic landmark will an aortic murmur be heard the loudest?

Correct Answer is A

Explanation

The nurse administers losartan 50 mg PO to a client. One hour after administration, the client calls the nurse and complains of tingling of the lips. Noting that the client's lips are edematous, the nurse recognizes that the client is experiencing which issue?

Correct Answer is C

Explanation

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