Chapter 36-CNS Stimulants

Question 1

1. A child is diagnosed with attention-deficit/hyperactivity disorder (ADHD). The prescriber orders a central nervous system stimulant. Which statement by the child’s parent indicates a need for further teaching?
   a.
   “I should report insomnia and poor appetite to his provider.”
   b.
   “I will make sure he takes his medication after breakfast every day.”
   c.
   “This drug will make him less impulsive while he’s at school.”
   d.
   “This medication will help my child focus so he can learn new behaviors.”

Answer 1

C

Question 2

2.	A patient who is morbidly obese is admitted for treatment. The prescriber orders lisdexamfetamine [Vyvanse]. The nurse will be concerned if this patient shows signs of:
a.
anorexia.
b.
dyspnea.
c.
insomnia.
d.
loquaciousness.

Answer 2

B

Question 3

3.	A child will begin taking methylphenidate [Ritalin] for attention-deficit/hyperactivity disorder. Important baseline information about this patient will include:
a.
results of an electrocardiogram (ECG).
b.
family history of psychosis.
c.
height and weight.
d.
renal function.

Answer 3

C

Question 4

4. A child has been taking SD methylphenidate [Ritalin], 10 mg at 0800 and 1200 and 5 mg at 1600, for 2 months. The parents tell the nurse that the child sometimes misses the noon dose while at school. The child’s appetite is normal. The teacher has reported a slight improvement in hyperactivity and impulsivity. What will the nurse do?
   a.
   Ask the prescriber whether this child could be given methylphenidate [Concerta].
   b.
   Contact the prescriber to suggest using a nonstimulant medication.
   c.
   Reinforce the need to take all doses as prescribed.
   d.
   Suggest drug holidays for the child on weekends.

Answer 4

A

Question 5

5. A nurse is teaching the parents of a child who has attention-deficit/hyperactivity disorder about methylphenidate [Concerta]. Which statement by the child’s parents indicates understanding of the teaching?
   a.
   “The effects of this drug will wear off in 4 to 6 hours.”
   b.
   “The tablet needs to be swallowed whole, not crushed or chewed.”
   c.
   “This medication has fewer side effects than amphetamines.”
   d.
   “We should call the provider if we see parts of the medicine in our child’s stools.”

Answer 5

B

Question 6

6. An adult patient will begin taking atomoxetine [Strattera] for attention-deficit/hyperactivity disorder. What will the nurse teach this patient?
   a.
   Appetite suppression does not occur, because this drug is not a stimulant.
   b.
   Stopping the drug abruptly will cause an abstinence syndrome.
   c.
   Suicidal thoughts may occur and should be reported to the provider.
   d.
   Therapeutic effects may not be felt for 1 to 3 weeks after beginning therapy.

Answer 6

D

Question 7

7. A nurse working the night shift begins taking modafinil [Alertec]. The nurse is telling a coworker about the medication. Which statement is correct?
   a.
   “I can take it during pregnancy.”
   b.
   “It doesn’t have cardiovascular side effects.”
   c.
   “It is safe and has no serious adverse effects.”
   d.
   “It will not interfere with my normal sleep.

Answer 7

D

Question 8

8.	A university student who is agitated and restless and has tremors is brought to the emergency department. The patient’s heart rate is 110 beats per minute, the respiratory rate is 18 breaths per minute, and the blood pressure is 160/95 mm Hg. The patient reports using concentrated energy drinks to stay awake during finals week. What complication will the nurse monitor for in this patient?
a.
CNS depression
b.
Cardiac arrest
c.
Respiratory failure
d.
Seizures

Answer 8

D

Question 9

9. A young adult begins taking clonidine [Kapvay] to treat ADHD symptoms after suffering anorexia with methylphenidate [Ritalin]. What will the nurse include when teaching this patient about taking clonidine?
   a.
   “Avoid consuming alcohol while taking this medication.”
   b.
   “Insomnia may still occur while taking this drug.”
   c.
   “You will need to pick up a written prescription every 30 days.”
   d.
   “You may crush the tablets and put them in food.”

Answer 9

A

Question 10

1.	A parent thinks a school-aged child has ADHD. The nurse asks the parent to describe the child’s behaviors. Which behaviors are characteristic of ADHD? (Select all that apply.)
a.
Anxiety
b.
Compulsivity
c.
Hyperactivity
d.
Inattention
e.
Impulsivity

Answer 10

C. D. E.

Question 11

2.	A nurse is providing education to a group of patients regarding amphetamines. To evaluate the group’s understanding, the nurse asks a participant what effects amphetamines would have on her. The participant shows that she understands the effects of these drugs if she gives which answers? (Select all that apply.)
a.
“Amphetamines increase fatigue.”
b.
“Amphetamines suppress the perception of pain.”
c.
“Amphetamines increase appetite.”
d.
“Amphetamines increase the heart rate.”
e.
“Amphetamines elevate mood.”

Answer 11

B. D. E.