A nurse is teaching a client who has a new prescription for sertralihe to treat depression. For which of the following findings should the nurse instruct the client to monitor and report immediately as indicating serotonin syndrome?

A. "Did anything in particular make you feel this way?" - While exploring potential triggers for the client's feelings of uselessness is important, assessing for suicidal ideation takes precedence. However, this question can be asked after addressing the immediate safety concern.
B. "Do you ever think about harming yourself?" - This is the priority assessment question. Older adults experiencing feelings of uselessness and worthlessness may be at risk for suicidal ideation or self-harm. Asking about thoughts of self-harm allows the nurse to assess the client's safety and determine the need for immediate intervention.
C. "How long have you had these feelings of uselessness?" - While understanding the duration of the client's feelings is relevant, assessing for suicidal ideation is more critical in ensuring the client's safety.
D. "Would you tell me more about the changes you see in your body?" - Exploring the client's perception of physical changes is important for addressing body image concerns and promoting self-esteem. However, assessing for suicidal ideation takes precedence as it addresses the client's immediate safety.

A. Decreased impulsiveness: Methylphenidate is a central nervous system stimulant commonly used to treat attention deficit hyperactivity disorder (ADHD) in children. One of the therapeutic effects of methylphenidate is the reduction of impulsiveness, hyperactivity, and inattention, which are hallmark symptoms of ADHD. Therefore, a decrease in impulsiveness would indicate that the medication is effective.
B. Increased urine output: Methylphenidate is not expected to affect urine output. Increased urine output is not a typical finding indicating the effectiveness of methylphenidate.
C. Increased appetite: Methylphenidate commonly causes appetite suppression as a side effect. Therefore, an increase in appetite would not be indicative of the medication's effectiveness. In fact, a decrease in appetite is a common adverse effect of methylphenidate.
D. Decreased abdominal pain: Methylphenidate is not typically used to treat abdominal pain, and its effectiveness is not evaluated based on the relief of abdominal pain. The primary therapeutic effect of methylphenidate in ADHD is the improvement of attention, focus, and impulse control. Therefore, decreased abdominal pain would not be a reliable indicator of the medication's effectiveness.