NURS 651 EXAM 1 STUDY GUIDE
Standardized ADHD assessment scales - Answers -Needed from several different
resources (parents, caregivers, teachers, childcare programs, and/or sports and
coaches). to ensure impairment in multiple domains, and other pertinent evaluations,
such as school testing and psychological or other mental health evaluations
Genetics - Answers -Research indicates that it is primarily a genetic disorder with
environmental factors that modulate the biochemical predisposition
Neurobiological - Answers -Structural and functional imaging demonstrate smaller brain
volume in the accumbens, amygdala, and hippocampus in addition to the caudate and
putamen regions. Anomalous brain development (reductions in gray matter) in
preschoolers 4-5 years old correlated with behavioral symptoms.
ADHD pathophysiology - Answers -genetic variations include deletions and duplications
in DNA segment involved with manufacture and regulation of the catecholamine,
neurotransmitters, noradrenaline, and dopamine. There are also less neurotransmitters
in certain brain regions. Dopamine and noradrenaline help alert, maintain attention and
appropriate internal arousal and inhibit external distraction
Environental - Answers -Risk factors include alcohol, tobacco use during pregnancy.
premature and low birth wt exposure to lead in pregnancy or early childhood, brain
injury and ACEs. Maternal inflammation during pregnancy is theorized to cause reduced
infant brain circuitry thus affecting key pathways connecting the executive hub and
deeper emotional processing regions and affecting working memory.
Faster paced demands of society impact ADHD - Answers -longer school days,
increasingly complex tasks, higher pupil to teacher ration, more lecture vs active
learning, and increased homework.
Physical exam for ADHD - Answers -general observation of childs behavior may or may
not present with in clinical setting, observe interactions with parent
Skin ADHD - Answers -cafe au lait spots, or signs of abuse
Ear Nose and Throat ADHD - Answers -signs of past recurring otitis media (scarring of
TM), signs of respiratory allergies, enlarged tonsils, sleep apnea
Neurologic ADHD - Answers -Mental status, speech and language, motor skills, and
general cognition and mental process as appropriate for age
ADHD diagnostic screening tools - Answers -Vanderbilt ADHD scales, The ADHD
rating scale IV, Conner parent and teacher rating scales, and the child attention profile.
consistent use of one is recommended. parents and teacher complete independently
, Anticipatory Guidance ADHD - Answers -routines, rules, and family relationships are
key. home should be a safe place where one feels valued, life with ADHD is stressful for
the child and the family and keeping family ties strong helps ease the stress.
Family meetings AG ADHD - Answers -provide opportunity to discuss structure,
rewards, and consequences, as well as to plan and problem solve.
ADHD environment management - Answers -a calm, predictable home with clear,
consistent morning and evening routines is extremely helpful for the child with ADHD.
an organized place for everyday things to go is another way to provide structure.
homework observe for mental fatigue
Areas of strength ADHD - Answers -Should be developed (music, sports, computer)
rather than always focusing on areas of weakness. Clubs, camps and appropriate work
provides avenues for development of skills and new friendships. Build self-esteem
Stimulants - adverse effects - Answers -decreased appetite, weight loss, insomnia,
stomachache, and ha/ may need cardiology if family history
non-stimulant - Answers -Atomoxetine (norepinephrine reuptake inhibitor) for children
6+ and should be given with food. Adverse effects decreased appetite, GI complaints,
somnolence, dizziness, and mild HTN or tachy. There are some reports of liver tox and
increased risk of SI.
Classroom behavior management - Answers -helps improve attention to instruction and
work productivity as well as decrease disruptive behavior, Common techniques include
increased structure with use of behavior contracts with goals and reinforcements; token
economy (earning or losing points, that can be exchanged for privileges or items);
creating periodic behavior report card daily or weekly, and or study or organizational
skills training
Adaptive technology ADHD - Answers -can assist the child with ADHD and should be
included in any 504 or IEP. Examples include voice-activated and word prediction
software to help with writing papers, note taking pens that download into a computer,
visual thinking tools, electronic organizers, cellphones, or Ipads with times and
reminders and a multitude of apps
obsession's - Answers -are recurrent thoughts, images or impulses that are disturbing
to the child and difficult to dislodge. often involve a sense of risk or fear of harm to the
child or family members; concerns about contamination are common.
Compulsions - Answers -are repetitive behaviors or mental acts that the child feels
driven to perform with the aim of reducing the anxiety associated with obsession's and
include behaviors such as washing, counting, or arranging objects.
Standardized ADHD assessment scales - Answers -Needed from several different
resources (parents, caregivers, teachers, childcare programs, and/or sports and
coaches). to ensure impairment in multiple domains, and other pertinent evaluations,
such as school testing and psychological or other mental health evaluations
Genetics - Answers -Research indicates that it is primarily a genetic disorder with
environmental factors that modulate the biochemical predisposition
Neurobiological - Answers -Structural and functional imaging demonstrate smaller brain
volume in the accumbens, amygdala, and hippocampus in addition to the caudate and
putamen regions. Anomalous brain development (reductions in gray matter) in
preschoolers 4-5 years old correlated with behavioral symptoms.
ADHD pathophysiology - Answers -genetic variations include deletions and duplications
in DNA segment involved with manufacture and regulation of the catecholamine,
neurotransmitters, noradrenaline, and dopamine. There are also less neurotransmitters
in certain brain regions. Dopamine and noradrenaline help alert, maintain attention and
appropriate internal arousal and inhibit external distraction
Environental - Answers -Risk factors include alcohol, tobacco use during pregnancy.
premature and low birth wt exposure to lead in pregnancy or early childhood, brain
injury and ACEs. Maternal inflammation during pregnancy is theorized to cause reduced
infant brain circuitry thus affecting key pathways connecting the executive hub and
deeper emotional processing regions and affecting working memory.
Faster paced demands of society impact ADHD - Answers -longer school days,
increasingly complex tasks, higher pupil to teacher ration, more lecture vs active
learning, and increased homework.
Physical exam for ADHD - Answers -general observation of childs behavior may or may
not present with in clinical setting, observe interactions with parent
Skin ADHD - Answers -cafe au lait spots, or signs of abuse
Ear Nose and Throat ADHD - Answers -signs of past recurring otitis media (scarring of
TM), signs of respiratory allergies, enlarged tonsils, sleep apnea
Neurologic ADHD - Answers -Mental status, speech and language, motor skills, and
general cognition and mental process as appropriate for age
ADHD diagnostic screening tools - Answers -Vanderbilt ADHD scales, The ADHD
rating scale IV, Conner parent and teacher rating scales, and the child attention profile.
consistent use of one is recommended. parents and teacher complete independently
, Anticipatory Guidance ADHD - Answers -routines, rules, and family relationships are
key. home should be a safe place where one feels valued, life with ADHD is stressful for
the child and the family and keeping family ties strong helps ease the stress.
Family meetings AG ADHD - Answers -provide opportunity to discuss structure,
rewards, and consequences, as well as to plan and problem solve.
ADHD environment management - Answers -a calm, predictable home with clear,
consistent morning and evening routines is extremely helpful for the child with ADHD.
an organized place for everyday things to go is another way to provide structure.
homework observe for mental fatigue
Areas of strength ADHD - Answers -Should be developed (music, sports, computer)
rather than always focusing on areas of weakness. Clubs, camps and appropriate work
provides avenues for development of skills and new friendships. Build self-esteem
Stimulants - adverse effects - Answers -decreased appetite, weight loss, insomnia,
stomachache, and ha/ may need cardiology if family history
non-stimulant - Answers -Atomoxetine (norepinephrine reuptake inhibitor) for children
6+ and should be given with food. Adverse effects decreased appetite, GI complaints,
somnolence, dizziness, and mild HTN or tachy. There are some reports of liver tox and
increased risk of SI.
Classroom behavior management - Answers -helps improve attention to instruction and
work productivity as well as decrease disruptive behavior, Common techniques include
increased structure with use of behavior contracts with goals and reinforcements; token
economy (earning or losing points, that can be exchanged for privileges or items);
creating periodic behavior report card daily or weekly, and or study or organizational
skills training
Adaptive technology ADHD - Answers -can assist the child with ADHD and should be
included in any 504 or IEP. Examples include voice-activated and word prediction
software to help with writing papers, note taking pens that download into a computer,
visual thinking tools, electronic organizers, cellphones, or Ipads with times and
reminders and a multitude of apps
obsession's - Answers -are recurrent thoughts, images or impulses that are disturbing
to the child and difficult to dislodge. often involve a sense of risk or fear of harm to the
child or family members; concerns about contamination are common.
Compulsions - Answers -are repetitive behaviors or mental acts that the child feels
driven to perform with the aim of reducing the anxiety associated with obsession's and
include behaviors such as washing, counting, or arranging objects.
