A nurse is reinforcing teaching with an adolescent who has ADHD and a new prescription for methylphenidate. Which of the following actions by the adolescent should the nurse identify as a potential barrier is communication?

The adolescent interrupts the nurse to ask question

The adolescent occasionally turns away from the nurse and stares at the wall

The adolescent taps on the arm of the chair throughout the conversation

The adolescent rocks in their chair while speaking with the nurse.

Answer and Explanation

The Correct Answer is C

A) "The adolescent interrupts the nurse to ask a question": Interrupting is common in adolescents with ADHD, as impulsivity is a characteristic of the disorder. While this behavior can be disruptive, it does not necessarily present a barrier to communication. The adolescent may be seeking clarification, and the nurse can guide them to ask questions at appropriate times.

B) "The adolescent occasionally turns away from the nurse and stares at the wall": This behavior may indicate that the adolescent is distracted or disengaged, but it does not necessarily block communication. It's important for the nurse to assess the adolescent’s attention and attempt to re-engage them if needed.

C) "The adolescent taps on the arm of the chair throughout the conversation": Tapping or other repetitive movements are often seen in individuals with ADHD and can be a significant barrier to effective communication. This behavior can be distracting for both the adolescent and the nurse, making it difficult to maintain focus on the conversation and absorb information. The nurse should address this by encouraging a calmer, more focused posture during discussions.

D) "The adolescent rocks in their chair while speaking with the nurse": Rocking can be a self-soothing behavior or a way to help manage restlessness, common in ADHD. While it can be distracting, it is less likely to be a major barrier to communication than tapping, which may be more intrusive. The nurse should assess if the behavior affects the adolescent’s ability to focus or engage.

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Correct Answer is B

Explanation

A) Nutritionist:
While a nutritionist can provide valuable advice on feeding, including breastfeeding or formula feeding, the primary issue here is not related to nutritional guidance but rather the financial concern about paying for baby formula. A nutritionist may provide support, but they are not typically responsible for addressing financial needs or coordinating resources for assistance.

B) Case manager:
The case manager is the most appropriate team member to refer to in this situation. A case manager is responsible for assessing the client’s needs and connecting them with resources such as financial assistance, community support programs, or social services. Since the client is unable to afford baby formula, the case manager can help by referring the client to programs that may provide formula at no cost or at a reduced price, such as the Women, Infants, and Children (WIC) program.

C) Primary care provider:
The primary care provider may offer support and referrals but would generally not be the first point of contact for addressing financial barriers to obtaining baby formula. The primary care provider can provide medical advice related to the client's postpartum care and the infant's health, but they are not typically the best person to address financial concerns directly.

D) Pediatric nurse practitioner:
A pediatric nurse practitioner focuses on providing care for the child, not necessarily addressing the financial needs of the family. While they can provide guidance on infant care and feeding, the issue of financial support for formula is outside their role. The case manager would be the more appropriate referral to assist with financial concerns.

Correct Answer is []

Explanation

The client reports joint pain in the knee and wrist with a history of gout in the family. The elevated uric acid level (7.2 mg/dL) supports a diagnosis of gout, a condition caused by uric acid crystal deposition in the joints. The negative ANA and normal ESR make inflammatory autoimmune conditions like rheumatoid arthritis and systemic lupus erythematosus unlikely.

Actions to Take:

Instruct the client to avoid foods high in purines.

Purine-rich foods (e.g., red meat, shellfish, organ meats) contribute to increased uric acid production, exacerbating gout symptoms. Dietary modifications can help reduce flare-ups and long-term complications.

Instruct the client to apply topical analgesics.

Topical analgesics can provide localized pain relief and reduce discomfort in affected joints. They serve as an adjunct to systemic medications in managing acute symptoms.

Parameters to Monitor:

Uric acid levels.

Monitoring uric acid levels helps assess the effectiveness of dietary changes and medications in preventing flare-ups and reducing joint damage.

Joint deformities.

Chronic gout can lead to joint destruction and tophi formation, so assessing for deformities helps track disease progression and the need for further interventions.

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A nurse is reinforcing teaching with an adolescent who has ADHD and a new prescription for methylphenidate. Which of the following actions by the adolescent should the nurse identify as a potential barrier is communication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who is 2 days postpartum. The client tells the nurse she cannot afford to pay for baby formula. The nurse should refer the client to which of the following members of the interprofessional team?

Correct Answer is B

Explanation

Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client’s progress.

Correct Answer is []

Explanation

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For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client:

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