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Assessment 3 N450- ADHD (1)
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Assessment 3 N450- ADHD (1)
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Assessment 3 N450- ADHDADHD - ANS-A disorder that involves inattention and or hyperactivity and impulsivity. These
children are highly distractible and unable to contain their responses to stimuli.
Why is ADHD sometimes not detected until the child enters school (younger than 4) ? -
ANS-*Typical behaviors of ADHD is attributed to normal early childhood characteristics* so
clinicians hesitate to make a diagnosis of ADHD before 6 yo and Psychiatrist suggests to be
slow to make the diagnosis and in addition, consider parent training and specialized day care
before resorting to stimulant drugs.
How would the nurse began to question/assess a child with ADHD? - ANS-Ask them what a
typical day is like from start to finish.
4.Which of the following statements by Kevin's mother best indicates an accurate understanding
of the treatment that has been planned for Kevin?
a. "Kevin's medication, plus decreasing his environmental stimuli, will help him control his
behavior.
b. "If I can keep Kevin on a special restricted diet, he will outgrow his ADHD in 5 to 8 years.
c. "Kevin's medication will make him behave appropriately and like other kids his age."
d. "I am already looking forward to Kevin's puberty, when his bothersome symptoms will
disappear." - ANS-a. "Kevin's medication, plus decreasing his environmental stimuli, will help
him control his behavior.
b&d- ADHD is life-long and child will not outgrow it
c.Medications will help him focus but not help with his behavioral issues
Kevin's mother states that Kevin has difficulty remembering to complete tasks, such as brushing
his teeth, putting dirty clothes in his hamper, and feeding his dog. Which of the following would
be the most appropriate suggestion based on his developmental stage and diagnosis?
a. Give Kevin a small amount of money every time he remembers to follow through on a task.
b. Punish Kevin by placing him in "time out" each time he forgets to complete his assigned
chores.
c. Take away some of Kevin's privileges whenever he does not complete his chores.
d. Suggest they make a chart to collect sticker tokens for task completion, which can then be
traded in for special privileges. - ANS-d. (positive reinforcement of socially appropriate behavior)
- Studies support that Best outcomes occur with combination of therapies, i.e. medication,
counseling and behavior modification
, While talking with the school nurse, Kevin's mother states, "I feel like I caused Kevin's
problems." Which suggestion by the nurse would be most appropriate?
a. "You shouldn't feel that way. No one really knows what causes ADHD?"
b. "There's no reason to feel that way. Most experts feel there is no connection between
heredity or parenting skills and ADHD."
c. "Sometimes parents feel that way. I can give you information about a support group for
parents of children with ADHD."
d. "It may be true that ADHD is inherited, but there is nothing you can do about that now." -
ANS-c. "Sometimes parents feel that way. I can give you information about a support group for
parents of children with ADHD."
A & B is not appropriate in NCLEX. You should never tell someone how to feel
D is not appropriate because there are always more things to do- keep hope
Which of the following best indicates to the school nurse that the time of Kevin's
methylphenidate (Ritalin) administration may need to be adjusted?
a. Kevin has not eaten his lunch in several days, stating, "I am just not hungry."
b. Kevin's math grade has risen from 62% to 82% since the beginning of the school year.
c. According to Kevin's mother, he has been sleeping well every night.
d. At noon recess, Kevin has been socializing effectively with his peers. - ANS-a. (loss of
appetite is a potential side effect)
Ritalin - ANS-a cerebral stimulant (blocks reuptake of dopamine) that increases concentration &
attention span while decreasing impulsivity ( does this well, i.e. focuses attention!)
Ritalin availability - ANS-Available as:
Ritalin b.i.d.- orally before breakfast & lunch, unless experiencing anorexia, then after meals
Ritalin LA- extended release taken once a day
Ritalin SR- sustained released, also taken b.i.d.
Ritalin transdermal patch- keep on 9 hours (12 hour duration)
*Generally prescribed beginning at 6 yrs. old & over
Nurse teaching on Ritalin administration - ANS--give after meals, as needed, to minimize
decrease in appetite effect
-Administer in the morning and last dose 6 hours before bed time to avoid insomnia
-the child should decrease caffeine consumption
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