NURS 6630 Final Exam – Walden University (Latest 2025-2026) 100% Verified
Questions & Correct Answers A+ Guaranteed
Question 10
Scenario: A 10-year-old boy with ADHD is prescribed methylphenidate. After a few
weeks, his parents report that his symptoms have improved, but he has difficulty
sleeping.
Question: What is the most appropriate action?
Options:
Increase the dose of methylphenidate
Add a low-dose sedative at bedtime
Switch to a non-stimulant medication
✅ Advise the parents to give the medication earlier in the day
✅Correct Answer:
Advise the parents to give the medication earlier in the day
Explanation:
Methylphenidate is a stimulant, and one of its common side effects is insomnia,
especially if taken too late in the day. Giving the medication earlier allows its effects to
wear off by bedtime, minimizing sleep disruption.
Why the other options are not ideal:
Increasing the dose: Would likely worsen the insomnia.
Adding a sedative: Not first-line; introduces additional medications and side effects.
Switching to a non-stimulant: May be considered later, but not before trying a timing
adjustment.
, ✅The safest and most appropriate initial intervention is to adjust the timing of the
dose.
Question 11
Scenario: A patient on clozapine presents with fever and sore throat.
Question: What should the clinician suspect and do?
Options:
✅Suspect agranulocytosis and order an immediate CBC
Treat symptomatically and continue clozapine
Discontinue clozapine and start antibiotics
Increase the dose of clozapine
✅Correct Answer:
Suspect agranulocytosis and order an immediate CBC
Explanation:
Clozapine is associated with a serious and potentially life-threatening side effect:
agranulocytosis (a severe drop in white blood cells, especially neutrophils).
Early signs may include fever and sore throat, which indicate possible infection due to
neutropenia.
The first step is to order a complete blood count (CBC) immediately to assess the
white blood cell count.
Why the other options are incorrect:
Treat symptomatically and continue clozapine: Dangerous—delays appropriate
intervention.
Discontinue and start antibiotics: Discontinuation may be warranted after confirming
agranulocytosis, but not before lab confirmation.
Questions & Correct Answers A+ Guaranteed
Question 10
Scenario: A 10-year-old boy with ADHD is prescribed methylphenidate. After a few
weeks, his parents report that his symptoms have improved, but he has difficulty
sleeping.
Question: What is the most appropriate action?
Options:
Increase the dose of methylphenidate
Add a low-dose sedative at bedtime
Switch to a non-stimulant medication
✅ Advise the parents to give the medication earlier in the day
✅Correct Answer:
Advise the parents to give the medication earlier in the day
Explanation:
Methylphenidate is a stimulant, and one of its common side effects is insomnia,
especially if taken too late in the day. Giving the medication earlier allows its effects to
wear off by bedtime, minimizing sleep disruption.
Why the other options are not ideal:
Increasing the dose: Would likely worsen the insomnia.
Adding a sedative: Not first-line; introduces additional medications and side effects.
Switching to a non-stimulant: May be considered later, but not before trying a timing
adjustment.
, ✅The safest and most appropriate initial intervention is to adjust the timing of the
dose.
Question 11
Scenario: A patient on clozapine presents with fever and sore throat.
Question: What should the clinician suspect and do?
Options:
✅Suspect agranulocytosis and order an immediate CBC
Treat symptomatically and continue clozapine
Discontinue clozapine and start antibiotics
Increase the dose of clozapine
✅Correct Answer:
Suspect agranulocytosis and order an immediate CBC
Explanation:
Clozapine is associated with a serious and potentially life-threatening side effect:
agranulocytosis (a severe drop in white blood cells, especially neutrophils).
Early signs may include fever and sore throat, which indicate possible infection due to
neutropenia.
The first step is to order a complete blood count (CBC) immediately to assess the
white blood cell count.
Why the other options are incorrect:
Treat symptomatically and continue clozapine: Dangerous—delays appropriate
intervention.
Discontinue and start antibiotics: Discontinuation may be warranted after confirming
agranulocytosis, but not before lab confirmation.
