Summary NR 546 Final Exam Study Guide 2024/2025 with
Verified answers
which NT play a role in the symptoms & treatment of ADHD? - Answer norepinephrine &
dopamine
ADHD symptoms 4 categories - Answer selective attention, hyperactivity, lack of zsustained
attention, impulsivity
what is the youngest age ADHD can appear at? - Answer 3 y/o
what plays an important role in the development of ADHD? - Answer genetics
Describe selective attention? - Answer lack of attention to detail, careless mistakes, not
listening, losing things, diverting attention, forgetful
Describe lack of sustained attention? - Answer poor problem solving, difficulty completing
tasks, disorganization, difficulty sustaining mental effort
what is impulsivity ? - Answer excessive talking, blurting things out, not waiting one's turn,
interrupting
what is hyperactivity? - Answer fidgeting, leaving one's seat, running, climbing, trouble playing
quietly
•George talks excessively, blurts out answers in class, and has hurt a friend's feelings when he
wouldn't wait his turn at recess. this is an example of which ADHD symptoms? - Answer
impulsivity
, •Mary was reprimanded by her boss for not listening during their last meeting and making
careless mistakes on their current project. Mary apologizes and says she's been feeling very
forgetful lately. this is an example of which ADHD symptoms? - Answer selective attetion
Jim is a college student who can't find the motivation to complete his homework or pay attention
in class. this is an example of which ADHD symptoms? - Answer lack of sustained attention
Layla just started school and her parent's received a call from her teacher about her behavior.
The teacher states Layla runs and climbs on the chairs and desks, has trouble playing quietly, and
refuses to stay in her seat. this is an example of which ADHD symptoms? - Answer hyperactivity
(ADHD: Lifespan Considerations) •Which symptom decreases markedly with age? - Answer
hyperactivity
(ADHD lifespan consideration) primary symptoms are? - Answer inattention, restlessness,
cognitive & emotional impulsivity, executive functioning deficits, and self-regulation
(ADHD Lifespan) What might adults who struggle with executive functioning difficulties and
disorganization also experience? - Answer occupational stress and anxiety
ADHD symptoms may arise from abnormalities within circuits in the_________, which affect
________ - Answer prefrontal cortex (PFC) , executive function.
ADHD symptoms become noticeable around what age and why? - Answer 6-7 y/o, possibly due
to abnormalities in the prefrontal cortex circuits or errors in the synaptic pruning process.
Anxiety and ADHD are regulated by which loop? - Answer corticostriatal-thalamocortical
(CSTC) loop
what NT are associated with inefficient information processing in the prefrontal circuits? -
Answer Norepinephrine (NE) and dopamine (DA)
,•What scheduled drug level are stimulant medications?
•Are refills permitted? - Answer •Stimulants are schedule II-controlled substances
•Refills are NOT permitted
what diagnostic test must be obtained? - Answer •Must obtain a thorough health hx first
•Assess for cardiac disease and, if present, obtain an EKG
•Blood pressure, height, and weight should be monitored regularly
•Assess for bipolar disorder before treatment
•Treatment efficacy will be noted within the first week of treatment
•Can cause or worsen tics
•What is the correct protocol for switching patients from one stimulant medication to another? -
Answer •When switching stimulants, discontinue the current medication and start the new
medication at a starting dose the next day.
•What two forms are stimulant medications available in? - Answer •Stimulant medications
available to treat ADHD are available as immediate-release or sustained-release formulations
•Are short-acting or long-acting stimulants at a higher risk for diversion?
•How should these medications be monitored? - Answer •Short-acting medications are at higher
risk for diversion.
•Occasional urine drug screens should be obtained to verify the presence of amphetamines and
the absence of other substances of abuse
Common side effects include? - Answer restlessness, irritability, anxiety, insomnia,
stomachache, headaches, tics, and worsening of aggression symptoms
•Clients may note a worsening of symptoms when the medication wears off
•If this more likely to occur with immediate or sustained-release medications? - Answer •Clients
may note a worsening of symptoms, or "crash" when the medication wears off, especially with
immediate-release (IR) medications
, •When should clients take stimulant medications? - Answer •Medications may cause appetite
changes and subsequent weight loss. Take medication with breakfast to decrease anorexia
•Methylphenidate - Answer •Low risk of adverse effects
•Examples
•Ritalin- available in IR and XR and in beads that can be sprinkled on food
•Concerta- IR and DR combined
•Daytrana- patch applied in AM remove after 9 hours
•Dexmethylphenidate - Answer •IR and ER forms available
-more potent than Ritalin
-high risk of adverse effects
•Amphetamine (adzenys) - Answer •orally-disintegrating ER for children who cannot swallow
pills
-avoid prescribing when MOAI has been used with 14 days
•Dextroamphetamine (Adderall)- - Answer •IR and ER
•Often dosed in AM (IR or XR) with a PM or PM PRN (IR) dose if medication effects diminish
prior to the end of school, duty, or the workday
-most abused and diverted prescription stimulants
•Lisdexamfetamine (Vyvanse)- - Answer •biologically inactive until metabolized by the body
(prodrug)
-less abuse and diversion potential than other stimulants
-higher cost medication
Reminder: - Answer : if a patient is on immediate release medications, the duration of action
may be shorter. If the patient complains that their symptoms only improve temporarily but come
