The nurse is caring for an adolescent client diagnosed with attention-deficit/hyperactivity disorder (ADHD), who is prescribed methylphenidate (Ritalin) therapy. The client reports and questions the nurse why they have lost 10 pounds in 2-months. Which of the following should be the appropriate response by the nurse?

The pharmacological action of Ritalin causes a decrease in appetite.

Side effects of Ritalin cause nausea; therefore, caloric intake is decreased.

Increased ability to concentrate allows the client to focus on activities rather than food.

Hyperactivity seen in ADHD causes increased caloric expenditure.

Answer and Explanation

The Correct Answer is A

A. The pharmacological action of Ritalin causes a decrease in appetite. Methylphenidate (Ritalin) is a stimulant medication commonly prescribed for ADHD. One of its well-documented side effects is appetite suppression, which can lead to weight loss. This is the most accurate and direct explanation for the weight loss observed in the adolescent client.

B. Side effects of Ritalin cause nausea; therefore, caloric intake is decreased. While nausea can occur with methylphenidate, it is not the primary reason for weight loss. The main mechanism is appetite suppression rather than a direct reduction in caloric intake due to nausea. This response is less accurate than option A.

C. Increased ability to concentrate allows the client to focus on activities rather than food: While methylphenidate can improve concentration, this explanation does not directly address the physiological cause of weight loss. It is the decrease in appetite due to the drug's effects on neurotransmitters that leads to weight loss, not the increased focus on activities .

D. Hyperactivity seen in ADHD causes increased caloric expenditure: Hyperactivity itself can lead to higher caloric expenditure, but this is not directly related to the weight loss caused by methylphenidate. The primary reason for the weight loss in this case is the appetite suppression due to the medication, not increased activity .

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Correct Answer is D

Explanation

A. Evaluate liver function: Although liver function tests can be important, they are not the immediate priority in anorexia nervosa unless there is a specific indication of liver disease or failure. Liver function abnormalities might occur in advanced cases due to malnutrition, but electrolyte imbalances are more immediately life-threatening.

B. Check for blood glucose levels: Blood glucose levels are important, but severe electrolyte imbalances, such as hypokalemia, pose a more immediate risk and require urgent attention to prevent cardiac and neurological complications.

C. Assess for signs of infection: While important, infection is not typically a primary concern in the initial assessment of someone with anorexia unless there are specific signs or symptoms indicating infection.

D. Monitor for electrolyte alterations: Electrolyte imbalances, such as hypokalemia (low potassium) and hypocalcemia (low calcium), can be life-threatening and are common in individuals with anorexia due to malnutrition, vomiting, or use of laxatives. These imbalances can lead to cardiac arrhythmias and other serious complications, making this the priority.

A. Paranoid personality disorder B. Schizotypal personality disorder C. Avoidant personality disorder D. Antisocial personality disorder

Correct Answer is B

Explanation

A. Paranoid personality disorder: Paranoid personality disorder is characterized by pervasive distrust and suspiciousness of others. Individuals with this disorder may have delusions of persecution but typically do not have bizarre or magical beliefs such as mind reading. Therefore, this choice is incorrect.

B. Schizotypal personality disorder: Schizotypal personality disorder is characterized by eccentric behavior, odd beliefs, and magical thinking, including ideas like being able to read minds. The client’s statement is indicative of the type of odd beliefs and thoughts associated with this disorder. This choice is correct.

C. Avoidant personality disorder: Avoidant personality disorder is marked by extreme shyness, fear of rejection, and social inhibition. Individuals with this disorder do not typically exhibit bizarre thoughts or delusions such as mind reading. Therefore, this choice is incorrect.

D. Antisocial personality disorder: Antisocial personality disorder is characterized by a disregard for the rights of others, deceitfulness, impulsivity, and a lack of remorse. It is not typically associated with delusional or magical thinking such as believing one can read minds. Therefore, this choice is incorrect.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with Anorexia. When reviewing the labs for a client with Anorexia, what is the nurse's priority?

Correct Answer is D

Explanation

A nurse is caring for a client who screams, "I can read your minds!" The nurse should identify this finding as a manifestation of which of the following personality disorders?

Correct Answer is B

Explanation

A nurse is speaking with the parents of a 4-year-old child who has a terminal illness. The parents tell the nurse they have taken their son's name off the list for little league baseball next season. Which of the following responses should the nurse make?

A nurse is caring for a client who has been brought to the inpatient mental health unit by law enforcement officers after becoming aggressive in a local bar. The nurse should identify that this finding is consistent with which of the following disorders?

A nurse is caring for a child in a psychiatric unit. Which of the following interventions should the nurse anticipate when caring for children diagnosed with ADHD? (Select all that apply)

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Which is an evidence-based approach for further assessment by a school nurse, who notices bruises and scars on a 5-year-old child's body, but the child refuses to disclose how they received them?

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The Nurse Manager is discussing in their monthly staff nurses meeting the importance of understanding a client's culture. How do cultural considerations play a crucial role in understanding and addressing abusive situations involving older adults?