A child has been taking methylphenidate 5 mg at 8 AM, 12 PM, and ...

[sammy]

A child has been taking methylphenidate 5 mg at 8 AM, 12 PM, and 4 PM for 30 days after a new diagnosis of AD/HD and comes to the clinic for evaluation.
 
  The child's mother reports that the child exhibits some nervousness and insomnia but is doing much better in school. The primary care NP should suggest: a. discontinuing the 4 PM dose.
  b. increasing the dose to 10 mg each time.
  c. giving 10 mg at 8 AM and 5 mg at noon.
  d. changing the dosing to 15 mg twice daily.

Question 2

A 50-year-old woman reports severe, frequent hot flashes and vaginal dryness. She is having irregular periods. She has no family history of CHD or breast cancer and has no personal risk factors. The primary care NP should recommend:
 
  a. estrogen-only HT.
  b. low-dose oral contraceptive therapy.
  c. selective serotonin reuptake inhibitor therapy until menopause begins.
  d. estrogen-progesterone HT.

[Benayers]

Answer to Question 1

A
Nervousness and insomnia are the most common adverse effects and are usually controlled by reducing the dose or omitting the afternoon or evening dose.

Answer to Question 2

B
Oral contraceptive pills are not approved by the U.S. Food and Drug Administration for management of perimenopausal symptoms except to treat irregular menstrual bleeding. This patient has a low risk for CHD and breast cancer, so oral contraceptive pills are relatively safe. She is also at risk for pregnancy, so oral contraceptive pills can help to prevent that.

[sammy]

Excellent

[mochi09]

Gracias!