NURS6630 study guide for final exam

NURS6630 study guide for final exam-Patient is a 10-year-old female with diagnosed ADHD who was started on Ritalin 5 mg twice a day over 2 months ago. She is still experiencing the triad of symptoms associated with ADHD ...

NURS6630 study guide for final exam-Patient is a 10-year-old female with diagnosed ADHD who was started on Ritalin 5 mg twice a day over 2 months ago. She is still experiencing the triad of symptoms associated with ADHD (impaired attention, impulsivity, and excessive motor activity). Her mother reports that she is now having difficulty in falling asleep since starting the medication. She has been on no other anti-ADHD medications and the mother reports full compliance with medication regimen. What is the appropriate recommendation to make based on this scenario? Response Feedback: upper right column: “Consideration of another stimulant or ATMX is recommended when symptoms aren’t responsive or the patient experiences clinically significant side effects to initial medication. Given their pharmacodynamic differences, if an MPH product was initially selected, then moving to an amphetamine-based medication is appropriate.” - Choice A would be recommended if the patient had improvement in any of her symptoms, but the scenario makes it obvious she is not getting better, even after 2 months of therapy - Choice B is staying within the same stimulant class, therefore, would likely not see a big improvement in symptoms - Choice C is not considered first-line. Patient has never tried the amphetamine- based stimulant, so she has not exhausted first-line options yet. □ Question 2 Drug addiction includes many prescription medications and illegal substances. Of the drugs listed, which ones can be withdrawn abruptly WITHOUT medical intervention to prevent withdraw seizures? Response Feedback: □ Question 3 “Amphetamines can be withdrawn abruptly” Which medication below would you use in addition to benzodiazepine treatment if the patient is experiencing psychosis during alcohol withdrawal delirium? Response Feedback: “Haloperidol 50 to 10 mg PO or IM may be added and repeated after 1 to 2 hours when psychosis or agitation is present.” □ Question 4 Select all the criteria for what is considered “At-Risk Drinking.” Response Feedback: Women: > 7 drinks in any given week Men: > 4 drinks per day Women: > 4 drinks per day Men: > 14 drinks per week III is wrong because it’s > 3 drinks per day for women □ Question 5 Of the following neurotransmitters, which one(s) are known to be severely disrupted in the disease Dementia with Lewy Bodies? Acetylcholine Glutamate Dopamine GABA Norepinephrine Response under pathophysiology subtitle: “It is clear that both the cholinergic and This study source was downloaded by 100000861521266 from CourseHero.com on 02-22-2023 05:07:25 GMT -06:00 Feedback: dopaminergic neurotransmitter systems are severely disrupted.” □ Question 6 A new patient presents to your clinic today. The patient is a 13-year-old boy who complains that he has no interest in anything. The patient states, “I just want to sleep more than I normally do, and I don’t care much for playing my video games anymore.” His mother states he cannot focus on anything for more than a few minutes at a time, and that he often gets in trouble at school because he cannot sit still. What would you recommend at this time? Response Feedback : under Attention-Deficit/Hyperactivity Disorder Plus Depression subtitle: “In ADHD patients, depression is not an artifact, and it must be distinguished from demoralization.” Page 99 under overview also mentions, “Before using medications, clinicians should complete a thorough clinical evaluation that includes a complete history of symptoms, a differential diagnosis, a review of prior assessments/treatments, a medical history, and a desc