NURS 6229 Study Guide Exam
Questions And Actual Answers 2025
Updated.
First line therapy for preschoolers with ADHD - Answer Behavioral therapy
Second line therapy for preschoolers with ADHD - Answer Methylphenidate 2.5 mg twice a
day;
Discontinue trial after 6 months to reassess underlying psychopathology
Titration stage - Answer Determines optimal dose and frequency of medication; followed by
maintenance stage
First line treatment for adolescents with ADHD - Answer Stimulants- Methylphenidate &
amphetamines (long acting); potential for abuse & diversion
First line treatment of adults with ADHD - Answer Amphetamines
Second line treatment of ADHD in adults - Answer Atomoxetine; esp with substance use
disorder
Long acting alpha agonist - Answer Clonidine ER or Guanfacine ER- Used to treat ADHD in
adjunct to sleep issues
ADR of stimulants - Answer (Methylphenidate & amphetamines) appetite suppression,
tachycardia, dizziness, HA, insomnia, growth suppression
ADR of nonstimulants - Answer (Atomoxetine) increased BP, tachycardia, HA, insomnia,
anorexia, growth suppression, prolonged QT interval
ADR of alpha agonists - Answer (Clonidine & guanfacine) bradycardia, hypotension, syncope,
AV block, dizziness, drowsiness
,●Maintaining a daily schedule
●Keeping distractions to a minimum
●Providing specific and logical places for the child to keep his or her schoolwork, toys, and
clothes
●Setting small, reachable goals (see 'Target goals' above)
●Rewarding positive behavior (eg, with a "token economy")
●Identifying unintentional reinforcement of negative behaviors
●Using charts and checklists to help the child stay "on task"
●Limiting choices
●Finding activities in which the child can be successful (eg, hobbies, sports)
●Using calm discipline (eg, time out, distraction, removing the child from the situation)
dextroamphetamine/amphetamine - Answer First line therapy for adults with ADHD; FDA
approved
First line therapy for school-age children with ADHD - Answer Methylphenidate
Rational drug selection for ADHD - Answer Primary-duration of action;
Formulation; patent preference; can child swallow pills?;
Treatment failure-change to different class
Treatment for cluster headaches - Answer Subcutaneous sumatriptan (Imitrex) SubQ/INH and
*100% oxygen via non rebreather are first-line therapy
Prophylaxis: CCB (Verapamil)
Side effects and ADR of triptans - Answer SE: paresthesia, asthenia, nausea, dizziness, chest or
neck tightness, heaviness, solemnness
ADR: rebound HA if used > 2 times a week
Contraindications of triptans - Answer ischemic vascular disorders, uncontrolled HTN,
cardiovascular disease, or cerebra vascular disease
ADR of NSAIDs - Answer Mild to moderate pain; GI upset; GI bleed with use of alcohol
, •Anticonvulsants (Valproate and topiramate)
What is used for abortive migraine therapy? - Answer NSAIDs- 1st line
Triptans
Combo of NSAID & Triptans
Antiemetic/dopamine receptor blocker (prochlorperazine, metoclopramide, chlorpromazine)
What are the ADR to thyroid hormones - Answer •Hyperthyroidism symptoms (HTN, angina,
flushing, palpitations, anxiety, HA, insomnia)
•Decreased bone density (osteoporosis) in post menopausal women on long term therapy
When should levothyroxine be taken? - Answer "Take in AM on empty stomach"
-ideally an hour before breakfast: Food can interfere with intestinal absorption.
Elevated TSH & decreased T4/T3 - Answer Hypothyroidism
Decreased TSH & increased T3/increased T4 - Answer Hyperthyroidism
Hyperthyroidism therapy? - Answer •Beta blocker (atenolol)- control adrenergic symptoms
•antithyroid drugs (thionamides)- methimazole
•radioiodine *responds best in elderly
•surgery
*monitor TSH & T4, CBC, liver/renal levels 4-6 weeks until maintenance therapy then every 3-6
months
Is it okay to take a missed dose of methimazole? - Answer NO, don't miss the dose
What is associated with sub clinical hypothyroidism? - Answer Afib, bone loss, impaired left
ventricular diastolic filling
Questions And Actual Answers 2025
Updated.
First line therapy for preschoolers with ADHD - Answer Behavioral therapy
Second line therapy for preschoolers with ADHD - Answer Methylphenidate 2.5 mg twice a
day;
Discontinue trial after 6 months to reassess underlying psychopathology
Titration stage - Answer Determines optimal dose and frequency of medication; followed by
maintenance stage
First line treatment for adolescents with ADHD - Answer Stimulants- Methylphenidate &
amphetamines (long acting); potential for abuse & diversion
First line treatment of adults with ADHD - Answer Amphetamines
Second line treatment of ADHD in adults - Answer Atomoxetine; esp with substance use
disorder
Long acting alpha agonist - Answer Clonidine ER or Guanfacine ER- Used to treat ADHD in
adjunct to sleep issues
ADR of stimulants - Answer (Methylphenidate & amphetamines) appetite suppression,
tachycardia, dizziness, HA, insomnia, growth suppression
ADR of nonstimulants - Answer (Atomoxetine) increased BP, tachycardia, HA, insomnia,
anorexia, growth suppression, prolonged QT interval
ADR of alpha agonists - Answer (Clonidine & guanfacine) bradycardia, hypotension, syncope,
AV block, dizziness, drowsiness
,●Maintaining a daily schedule
●Keeping distractions to a minimum
●Providing specific and logical places for the child to keep his or her schoolwork, toys, and
clothes
●Setting small, reachable goals (see 'Target goals' above)
●Rewarding positive behavior (eg, with a "token economy")
●Identifying unintentional reinforcement of negative behaviors
●Using charts and checklists to help the child stay "on task"
●Limiting choices
●Finding activities in which the child can be successful (eg, hobbies, sports)
●Using calm discipline (eg, time out, distraction, removing the child from the situation)
dextroamphetamine/amphetamine - Answer First line therapy for adults with ADHD; FDA
approved
First line therapy for school-age children with ADHD - Answer Methylphenidate
Rational drug selection for ADHD - Answer Primary-duration of action;
Formulation; patent preference; can child swallow pills?;
Treatment failure-change to different class
Treatment for cluster headaches - Answer Subcutaneous sumatriptan (Imitrex) SubQ/INH and
*100% oxygen via non rebreather are first-line therapy
Prophylaxis: CCB (Verapamil)
Side effects and ADR of triptans - Answer SE: paresthesia, asthenia, nausea, dizziness, chest or
neck tightness, heaviness, solemnness
ADR: rebound HA if used > 2 times a week
Contraindications of triptans - Answer ischemic vascular disorders, uncontrolled HTN,
cardiovascular disease, or cerebra vascular disease
ADR of NSAIDs - Answer Mild to moderate pain; GI upset; GI bleed with use of alcohol
, •Anticonvulsants (Valproate and topiramate)
What is used for abortive migraine therapy? - Answer NSAIDs- 1st line
Triptans
Combo of NSAID & Triptans
Antiemetic/dopamine receptor blocker (prochlorperazine, metoclopramide, chlorpromazine)
What are the ADR to thyroid hormones - Answer •Hyperthyroidism symptoms (HTN, angina,
flushing, palpitations, anxiety, HA, insomnia)
•Decreased bone density (osteoporosis) in post menopausal women on long term therapy
When should levothyroxine be taken? - Answer "Take in AM on empty stomach"
-ideally an hour before breakfast: Food can interfere with intestinal absorption.
Elevated TSH & decreased T4/T3 - Answer Hypothyroidism
Decreased TSH & increased T3/increased T4 - Answer Hyperthyroidism
Hyperthyroidism therapy? - Answer •Beta blocker (atenolol)- control adrenergic symptoms
•antithyroid drugs (thionamides)- methimazole
•radioiodine *responds best in elderly
•surgery
*monitor TSH & T4, CBC, liver/renal levels 4-6 weeks until maintenance therapy then every 3-6
months
Is it okay to take a missed dose of methimazole? - Answer NO, don't miss the dose
What is associated with sub clinical hypothyroidism? - Answer Afib, bone loss, impaired left
ventricular diastolic filling
