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?

The last dose of medication should be given 4 to 6 hours before bedtime to diminish insomnia.

The medication should be taken with meals for optimal absorption.

The medication should not be taken until he is at school.

She is giving him the medication dosage appropriately.

Answer and Explanation

The Correct Answer is A

A. The last dose of medication should be given 4 to 6 hours before bedtime to diminish insomnia: Methylphenidate is a stimulant medication commonly used to treat ADHD.
Administering it at bedtime may interfere with sleep onset and lead to insomnia. It's important to follow the prescribed dosing schedule to optimize symptom control during waking hours while minimizing adverse effects on sleep.
B. The medication should be taken with meals for optimal absorption: While taking

methylphenidate with meals may help reduce gastrointestinal side effects, the timing of administration relative to bedtime is more relevant to address in this scenario.
C. The medication should not be taken until he is at school: Delaying medication until the child is at school may result in inadequate symptom control during the morning when ADHD
symptoms are often most problematic.

D. She is giving him the medication dosage appropriately: Administering methylphenidate at bedtime is not appropriate and may lead to insomnia rather than optimizing symptom control during the day.

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Correct Answer is B

Explanation

A. Diarrhea is not typically associated with ergotamine toxicity. Gastrointestinal symptoms such as nausea and vomiting are more common adverse effects of ergotamine use.
B. Delirium is a potential sign of ergotamine toxicity. At toxic levels, ergotamine can cause central nervous system symptoms such as confusion, hallucinations, and delirium.
C. Hypotension may occur as an adverse effect of ergotamine due to its vasoconstrictive properties. However, hypotension alone may not indicate ergotamine toxicity.
D. Bradycardia is not a typical adverse effect of ergotamine. Ergotamine is more commonly associated with vasoconstriction and can lead to hypertension or tachycardia rather than bradycardia.

A. The 21-year-old patient who has never had surgery before B. The 40-year-old patient who is to have a kidney stone removed C. The 82-year-old patient who is to have gallbladder removal D. The 35-year-old patient who stopped smoking 8 years ago

Correct Answer is C

Explanation

A. The 21-year-old patient who has never had surgery before: While lack of previous surgery experience may contribute to anxiety, it doesn't inherently increase the risk of altered response to anesthesia.
B. The 40-year-old patient who is to have kidney stone removed: While the type of surgery may influence anesthesia considerations, being 40 years old alone doesn't significantly increase the risk of altered response to anesthesia.
C. The 82-year-old patient who is to have gallbladder removal: Advanced age is a significant risk factor for altered response to anesthesia due to age-related changes in physiology, metabolism, and drug clearance.
D. The 35-year-old patient who stopped smoking 8 years ago: While smoking history can impact anesthesia considerations, stopping smoking 8 years ago likely reduces the associated risks compared to current smokers.

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Naxlex Comprehensive Predictor Exams

A patient has been taking ergotamine to relieve their migraines. Which of the following adverse effects would indicate to the nurse that the drug may have entered into toxic levels?

Correct Answer is B

Explanation

When assessing patients in the preoperative area, the nurse knows that which patient is at a higher risk for an altered response to anesthesia

Correct Answer is C

Explanation

A patient is experiencing status epilepticus. The nurse prepares to give which drug of choice for the treatment of this condition?

Before administering a client's prescribed nonselective adrenergic blocker, what should the nurse assess?

A nurse is providing teaching to a client who has a new diagnosis of Parkinson's disease. On which of the following medications should the nurse prepare to instruct the client?

During the immediate postoperative period, the Post Anesthesia Care Unit nurse is assessing a patient who had hip surgery. The patient is experiencing tachycardia, tachypnea, and muscle rigidity, and his temperature is 103°F (39.4°C). The nurse will prepare for what immediate treatment?

The nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor (MAOI). Which food choice would indicate the need for additional teaching?

The nurse is reviewing the use of central nervous system stimulants. Which of these are indications for this class of drugs? (Select all that apply.)