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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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. 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.
Correct Answer is ["A","D","E"]
Explanation
A. Oral contraceptives: Phenobarbital can decrease the effectiveness of oral contraceptives, increasing the risk of contraceptive failure and unintended pregnancy.
B. Antihistamines: While phenobarbital can induce hepatic enzymes, leading to increased
metabolism of some antihistamines, this interaction is less clinically significant compared to the interactions with oral contraceptives, opioids, and diuretics.
C. Warfarin: Phenobarbital can induce the metabolism of warfarin, potentially reducing its anticoagulant effects and necessitating closer monitoring of international normalized ratio (INR) levels.
D. Opioids: Phenobarbital can increase the metabolism of opioids, leading to reduced analgesic effects and potentially causing inadequate pain control.
E. Diuretics: Phenobarbital can accelerate the metabolism of diuretics, potentially reducing their efficacy and necessitating adjustments in dosage or monitoring of electrolyte levels.
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