A school-age client comes to the clinic for routine follow-up ...

[casperchen82]

A school-age client comes to the clinic for routine follow-up after being placed on amphetamine sulfate (Adderall) 2 weeks ago for a diagnosis of ADHD. The client weighed 15 pounds over normal for height prior to the start of the Adderall.
 
  The mother states concern that the client is no longer snacking, barely finishes meals, and will lose too much weight. What is the nurse's best response to this concern?
  1. Make an appointment each week for us to monitor against too much weight loss.
  2. It is normal for clients to lose weight when taking Adderall.
  3. Over time, the diminished appetite might be reduced. Begin by offering small, frequent meals, and monitor for excessive weight loss.
  4. The Adderall will help the client to return to normal weight for his height.

Question 2

A mother expresses concern that her school-age child may need to be started on medication for ADHD. When asked to describe the child's behaviors that lead to this concern, the mother makes these statements.
 
  Which would the nurse interpret as a potential indicator of ADHD?
  1. When I ask him to do his chores, he finishes his game before he starts.
  2. His teacher says that he isn't able to complete assignments that require him to sit and write for 5 to10 minutes at a time. He doodles on his paper or badgers others in the classroom instead of working on his assignment.
  3. In the last month, he has twice forgotten to ask me to give him his lunch money for the day.
  4. When I tell him to clean the house, he doesn't clean under furniture or under the rim of the toilet. He only dusts some of the furniture, but not all of it.

[dpost18]

Answer to Question 1

Correct Answer: 3
Rationale 1: There is no reason to bring the client in for weighing each week. The mother can monitor for weight loss and call the health care provider for concerns.
Rationale 2: Weight loss is a side effect of amphetamines, but this does not directly address the concern.
Rationale 3: Offering small, frequent meals and monitoring for weight loss are the most appropriate actions.
Rationale 4: Stating that the Adderall will help the client return to normal weight is not an appropriate comment. Clients who are school-age typically go through a stage of excess fat stores just prior to a growth spurt.
Global Rationale: Offering small, frequent meals and monitoring for weight loss are the most appropriate actions. There is no reason to bring the client in for weighing each week. The mother can monitor for weight loss and call the health care provider for concerns. Weight loss is a side effect of amphetamines, but this does not directly address the concern. Stating that the Adderall will help the client return to normal weight is not an appropriate comment. Clients who are school-age typically go through a stage of excess fat stores just prior to a growth spurt.

Answer to Question 2

Correct Answer: 2
Rationale 1: Clients with ADHD either forget to perform the chore or fail to finish the chore.
Rationale 2: Clients with ADHD avoid tasks that require mental effort for a long period of time and fail to finish schoolwork; they have trouble keeping attention on a task.
Rationale 3: Clients with ADHD often forget things needed for daily activities, not just occasionally.
Rationale 4: Cleaning the house without accuracy in details would be normal for a school-age child. Clients with ADHD would be more apt to start and not finish, or to forget to clean at all.
Global Rationale: Clients with ADHD avoid tasks that require mental effort for a long period of time and fail to finish schoolwork; they have trouble keeping attention on a task. Clients with ADHD either forget to perform the chore or fail to finish the chore. Clients with ADHD often forget things needed for daily activities, not just occasionally. Cleaning the house without accuracy in details would be normal for a school-age child. Clients with ADHD would be more apt to start and not finish, or to forget to clean at all.

[casperchen82]

Excellent

[amcvicar]

Gracias!