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.
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 .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Follow the established protocol for reporting suspected child abuse or neglect to the appropriate authorities: This is the correct approach according to child protection guidelines. School personnel are mandated reporters and must report suspected abuse or neglect to protect the child's safety.
B. Convince the child to disclose the cause of the injuries through gentle questioning and persuasion: This approach can inadvertently pressure the child and is not recommended as it may lead to further distress or inaccurate information.
C. Respect the child's privacy and wait for them to share information about the injuries voluntarily: While respecting privacy is important, child protection takes precedence when there are signs of abuse or neglect.
D. Document and discuss the observations with the child's teacher to gather more information: While documentation is important, it should not delay reporting suspected abuse or neglect to the appropriate authorities.
Correct Answer is D
Explanation
A. "Age-related cognitive changes may lead to alterations in mental status." Age-related cognitive changes, such as mild cognitive impairment, can increase the risk of delirium, but the statement is too general. Delirium is typically acute and caused by specific factors like medication, infection, or metabolic imbalances, not just normal age-related changes . Therefore, this choice is incorrect.
B. "Lack of rigorous exercise may lead to alterations in mental status." While lack of exercise can impact overall health and well-being, it is not a direct risk factor for delirium. Delirium is more closely associated with acute medical conditions, medication interactions, or environmental factors . Therefore, this choice is incorrect.
C. "Decreased social interaction may lead to profound isolation and psychosis." Decreased social interaction can lead to isolation and mental health issues like depression, but it is not a direct cause of delirium. Delirium typically results from acute physiological changes rather than social factors . Therefore, this choice is incorrect.
D. "Taking multiple medications may lead to adverse interactions or toxicity." Polypharmacy, or taking multiple medications, is a significant risk factor for delirium in older adults due to the potential for adverse drug interactions and toxicity. This can lead to acute changes in mental status characteristic of delirium . This choice is correct.
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