A nurse is teaching a newly licensed nurse about directives. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

Choice A reason: Increased urine output is not a therapeutic effect of methylphenidate, a stimulant used for ADHD to improve focus and reduce impulsivity. It does not affect renal function or urine production, making this finding irrelevant to evaluating the medication’s effectiveness in a school-age child.

Choice B reason: Increased appetite is not expected with methylphenidate, which commonly suppresses appetite as a side effect. Effective ADHD treatment improves behavior, not appetite, so this finding does not indicate the medication’s success in managing the child’s ADHD symptoms.

Choice C reason: Decreased abdominal pain is unrelated to methylphenidate’s therapeutic effects, which target ADHD symptoms like impulsivity and inattention. While gastrointestinal side effects may occur, pain reduction is not a primary indicator of efficacy, making this an incorrect measure of effectiveness.

Choice D reason: Decreased impulsiveness is a primary indicator of methylphenidate’s effectiveness, as it stimulates the central nervous system to enhance focus and reduce hyperactive-impulsive behaviors in ADHD. This behavioral improvement aligns with therapeutic goals, making it the correct finding to evaluate progress.

Choice A reason: Iron supplements do not significantly interact with spironolactone, a potassium-sparing diuretic that risks hyperkalemia. Potassium supplements are concerning. Advising to avoid iron is unnecessary, risking confusion, critical to prevent in ensuring safe supplement use and focusing on potassium avoidance in clients on spironolactone.

Choice B reason: Spironolactone, a potassium-sparing diuretic, increases hyperkalemia risk; avoiding potassium supplements is critical to prevent arrhythmias or muscle weakness. Instructing this ensures safety, monitoring electrolyte levels, and preventing life-threatening complications, essential for managing clients on spironolactone with concurrent over-the-counter supplement use.

Choice C reason: Magnesium supplements have minimal interaction with spironolactone, unlike potassium, which risks hyperkalemia. Advising magnesium avoidance is unnecessary, potentially causing confusion or deficiency, critical to avoid in ensuring safe supplement guidance, focusing on potassium restriction for clients on spironolactone to prevent electrolyte imbalances.

Choice D reason: Calcium supplements do not significantly interact with spironolactone, unlike potassium, which increases hyperkalemia risk. Advising calcium avoidance risks unnecessary restriction, potentially affecting bone health, critical to prevent in ensuring accurate supplement advice, prioritizing potassium avoidance for safe spironolactone use in clients with heart conditions.