Chapter 41: Medications for Attention-Deficit/Hyperactivity Disorder

Chapter 41: Medications for Attention-Deficit/Hyperactivity Disorder

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. An adult patient reports feeling unfocused all the time, loses things, and has difficulty completing tasks and says that this is interfering with family relations and work. The symptoms have been present as long as the patient can remember, although there is no previous documentation of attention-deficit/hyperactivity disorder (AD/HD) in this patient’s medical history. The primary care nurse practitioner (NP) should:

ANS:  B

Although childhood AD/HD is a prerequisite for diagnosis in an adult, it is increasingly recognized that many adults have the disorder without having been diagnosed as children. The NP should evaluate the patient’s symptoms and treat if indicated. The patient does not have symptoms of depression. Methylphenidate should not be given unless the patient meets the diagnostic criteria.

DIF:    Cognitive Level: Applying (Application)                           REF:   449

2. A child is taking methylphenidate (Ritalin) for AD/HD. The child’s parent calls the primary care NP to report increased behavior problems and delusional thinking. The NP should:

ANS:  B

Exacerbation of behavioral and processing symptoms can occur in patients with preexisting psychosis, and manic and behavioral symptoms may occur in patients who do not have an underlying psychiatric disorder. This is true with all stimulant medications, so increasing the dose, switching to another stimulant, or switching to a long-acting form are not indicated.

DIF:    Cognitive Level: Applying (Application)                           REF:   453

3. A primary care NP sees a child for an annual well-child check-up. The child has been taking methylphenidate for AD/HD for 3 months. The NP should discontinue the medication if which symptom is present?

ANS:  A

Methylphenidate is contraindicated in patients who have motor tics or a diagnosis of Tourette’s syndrome. Decreased appetite, occasional headaches, and changes in blood pressure are not concerning.

DIF:    Cognitive Level: Understanding (Comprehension)             REF:   452

4. A child is diagnosed with AD/HD after being expelled from school for disruptive behaviors. The child’s parents are reluctant to start medication because of the stigma attached. The primary care NP should suggest:

ANS:  B

Concerta is a long-acting stimulant, and children taking it can avoid having to take a dose of medication at school. The other choices are shorter acting and may require dosing during school.

DIF:    Cognitive Level: Applying (Application)                           REF:   453