What is the nurse's priority focused assessment for side effects in a child taking methylphenidate (Ritalin) for ADHD?
Neuroleptic malignant syndrome
Dystonia, akinesia, and extrapyramidal symptoms
Bradycardia and hypotensive episodes
Sleep disturbances and weight loss
The Correct Answer is D
A. Neuroleptic malignant syndrome is a rare, life-threatening reaction associated with antipsychotic medications, not stimulants like methylphenidate.
B. Dystonia, akinesia, and extrapyramidal symptoms are primarily seen with antipsychotic use, not with ADHD stimulant medications.
C. Bradycardia and hypotensive episodes – Stimulants more commonly cause tachycardia and hypertension, not bradycardia or hypotension.
D. Sleep disturbances and weight loss are common side effects of methylphenidate due to its stimulant properties. Monitoring sleep patterns, appetite, and growth is a priority in children taking this medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Aripiprazole is an atypical antipsychotic with a lower risk of weight gain, metabolic syndrome, and hypertension compared with olanzapine or clozapine, making it suitable for a patient who is overweight and hypertensive. It effectively treats positive symptoms such as auditory hallucinations and may improve social functioning.
B. Olanzapine is effective for schizophrenia but is associated with significant weight gain, hyperlipidemia, and worsening hypertension, making it less appropriate for this patient.
C. Clozapine is reserved for treatment-resistant schizophrenia due to risks of agranulocytosis, myocarditis, and metabolic side effects; it is not first-line for this patient.
D. Ziprasidone has a lower risk of metabolic side effects than olanzapine or clozapine, but it carries a risk of QT prolongation, which may be concerning in hypertensive patients with potential cardiac risks.
Correct Answer is B
Explanation
A. Suicide precautions should never be discontinued at this time; in fact, suicide risk is highest when energy improves before mood fully stabilizes.
B. Increased energy after starting antidepressants raises suicide risk, as the patient may now have the ability to act on suicidal thoughts. Continuous supervision is the priority for safety.
C. Discharge planning is premature at this stage; safety comes first.
D. Art and music therapy may be beneficial long-term but do not address the immediate suicide risk.
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