NR 606 FINAL ACTUAL EXAM COMPLETE ACCURATE
QUESTIONS WITH WELL ELABORATED ANSWERS
(CORRECT VERIFIED ANSWERS) A NEW UPDATED
VERSION |GUARANTEED PASS A+
How is treatment typically handled when a child has ADHD AND a co-existing
mental health ailment? - ANSWER -Children with co-occurring conditions are
often treated first for ADHD and then for comorbidities, as treating ADHD
symptoms first may help reduce overall stress levels and provide a clearer picture
of the comorbid symptoms
What is the first-line treatment for ADHD? - ANSWER -A stimulant medication.
A non-stimulant is used if a stimulant is contraindicated or if a stimulant is not
effective.
However remember that treatment of ADHD is multi-modal, often requiring
medical, educational, behavioral, and psychological intervention.
________ can help lower distractibility and improve attention, working memory,
and impulsivity. - ANSWER -Non-stimulants
How would you treat a patient who is having argumentative or oppositional
symptoms? - ANSWER -A combination of stimulants and non-stimulants can be
used
What cardiac considerations should be considered before starting any patients on a
stimulant? - ANSWER -A cardiac workup should be completed.
An electrocardiogram (EKG) is required if cardiac history is present in a first-
degree relative. (it can help identify potential underlying heart conditions that
could be adversely affected by the medication, even if the patient appears healthy,
as stimulants can slightly increase heart rate and blood pressure, potentially
causing complications in individuals with undiagnosed heart issues; this practice is
recommended by the American Heart Association (AHA) to prioritize patient
safety. ) and ensure to document this.
What bio-metric considerations should be considered before starting any patients
on a stimulant? - ANSWER -Monitor BP, height and weight during every
,appointment. (ensure the child is not experiencing abnormal BP, ensure stimulant
is not affecting the child's growth and development. Ensure the medication is not
cause anorexia within the patient. Stimulants decrease appetite.
What mental health considerations should be considered before starting any
patients on a stimulant? - ANSWER -- Assess all clients for bipolar disorder before
treatment.
Central nervous system (CNS) stimulants may cause psychotic or manic
symptoms in clients with no prior history or may exacerbate behavior disturbance
symptoms and thought disorders in clients with pre-existing psychosis.
- CNS stimulants may exacerbate comorbid anxiety and substance use disorders.
What are two teaching points for patients if they begin to complain of insomnia
while on a stimulant? - ANSWER -Take the medication AT NIGHT or do not take
the medication past a certain time.
Increased irritability and insomnia can be treated with a low dose of nonstimulant
medication which will allow the client to fall asleep.
If a patient has current tics, what is a great teaching recommendation? - ANSWER
-Stimulants can cause or worsen tics; stimulants may unmask the presence of tics.
How soon would a patient/parents see the efficacy of a stimulant or non-
stimulant? - ANSWER -within the first week! These medications begin to work
30-60 minutes after ingestion and last for a duration of up to 4-12 hours.
If a patient needed to be switched from one stimulant medication to the next, how
would you do it? - ANSWER -Discontinue one medication and start the next
medication at the starting dose the next day. NOT THE SAME DAY
How would you educate the patient on how to discontinue an ADHD medication?
- ANSWER -Abrupt withdrawal can cause irritability and rebound symptoms after
prolonged use. Medication needs to be tapered via PMHNP.
If a patient's parent asked if their childs ADHD medication had a high possibility
for addiction, what would you say? - ANSWER -Several stimulant medications are
classified as Schedule II indicating that they have a high potential for abuse.
The PMHNP must adhere to federal and state-specific guidelines for prescribing
these medications.
,Careful monitoring is required. Occasional urine drug screens should be obtained
to verify the presence of amphetamines and the absence of other substances of
abuse.
What type of stimulants are at the highest risk for abuse or diversion? - ANSWER
-Ritalin, Adderall and Dexedrine
short-acting medications are at higher risk for diversion (Short-acting medications
for ADHD that are considered high risk for diversion include methylphenidate
(Ritalin), mixed amphetamine salts (Adderall), and dextroamphetamine
(Dexedrine), as they take effect quickly and wear off relatively fast, making them
more susceptible to misuse and potential for diversion.)
Sustained release medications are better for preventing this.
What are some common side effects of stimulants? - ANSWER -restlessness,
irritability, anxiety, insomnia, stomachache, headaches, tics, and worsening
aggression symptoms
a worsening of symptoms or "crash" may occur when the medication wears off,
especially with immediate-release (IR) medications
What is the best way to avoid anorexia when taking a stimulant? - ANSWER -take
medication with breakfast to decrease anorexia or associated weight loss
For younger children under the age of ______ the American Academy of
Pediatrics (AAP) recommends ________ in behavior management as a first-line
intervention for psychotherapy with ADHD. - ANSWER -6!!!!!!
PARENT TRAINING
Review what parents teaching parents receive when they participate in parent
training: - ANSWER -· Positive Communication
· Positive Reinforcement
· Structure and Discipline
, Behavior therapy, given by parents, teaches children to better control their own
behavior, leading to improved functioning at school home and in relationships.
Learning and practicing behavior therapy requires time and effort, but has lasting
benefits for the child.
In older children and adolescents, treatment often involves both medication and
psychotherapy. Psychotherapeutic interventions may include cognitive-behavioral
therapy (CBT), social and organizational skill training, and family therapy. -
ANSWER -
What is the DSM-5 for O.D.D.? - ANSWER -A pattern of angry/irritable mood,
argumentative/defiant behavior, or vindictiveness lasting at least 6 months as
evidenced by at least four symptoms of the following categories, and exhibited
during interaction with at least one individual who is not a sibling:Angry/Irritable
Mood
Often loses temper
Is often touchy or easily annoyed
3.
Is often angry and resentful
Argumentative/Defiant Behavior
4.
Often argues with authority figures or, for children and adolescents, with adults
5.
Often actively defies or refuses to comply with requests from authority figures or
with rules
6.
Often deliberately annoys others
7.
Often blames others for his or her mistakes or misbehavior
Vindictiveness
8.
Has been spiteful or vindictive at least twice within the past 6 months.
What is the frequency of symptoms needed for an official diagnosis of O.D.D? -
ANSWER -The symptoms have to present ONCE a week for at least 6 months for
people 5 years and older
If they are under 5 then the symptoms have to occur on most days for 6 months
QUESTIONS WITH WELL ELABORATED ANSWERS
(CORRECT VERIFIED ANSWERS) A NEW UPDATED
VERSION |GUARANTEED PASS A+
How is treatment typically handled when a child has ADHD AND a co-existing
mental health ailment? - ANSWER -Children with co-occurring conditions are
often treated first for ADHD and then for comorbidities, as treating ADHD
symptoms first may help reduce overall stress levels and provide a clearer picture
of the comorbid symptoms
What is the first-line treatment for ADHD? - ANSWER -A stimulant medication.
A non-stimulant is used if a stimulant is contraindicated or if a stimulant is not
effective.
However remember that treatment of ADHD is multi-modal, often requiring
medical, educational, behavioral, and psychological intervention.
________ can help lower distractibility and improve attention, working memory,
and impulsivity. - ANSWER -Non-stimulants
How would you treat a patient who is having argumentative or oppositional
symptoms? - ANSWER -A combination of stimulants and non-stimulants can be
used
What cardiac considerations should be considered before starting any patients on a
stimulant? - ANSWER -A cardiac workup should be completed.
An electrocardiogram (EKG) is required if cardiac history is present in a first-
degree relative. (it can help identify potential underlying heart conditions that
could be adversely affected by the medication, even if the patient appears healthy,
as stimulants can slightly increase heart rate and blood pressure, potentially
causing complications in individuals with undiagnosed heart issues; this practice is
recommended by the American Heart Association (AHA) to prioritize patient
safety. ) and ensure to document this.
What bio-metric considerations should be considered before starting any patients
on a stimulant? - ANSWER -Monitor BP, height and weight during every
,appointment. (ensure the child is not experiencing abnormal BP, ensure stimulant
is not affecting the child's growth and development. Ensure the medication is not
cause anorexia within the patient. Stimulants decrease appetite.
What mental health considerations should be considered before starting any
patients on a stimulant? - ANSWER -- Assess all clients for bipolar disorder before
treatment.
Central nervous system (CNS) stimulants may cause psychotic or manic
symptoms in clients with no prior history or may exacerbate behavior disturbance
symptoms and thought disorders in clients with pre-existing psychosis.
- CNS stimulants may exacerbate comorbid anxiety and substance use disorders.
What are two teaching points for patients if they begin to complain of insomnia
while on a stimulant? - ANSWER -Take the medication AT NIGHT or do not take
the medication past a certain time.
Increased irritability and insomnia can be treated with a low dose of nonstimulant
medication which will allow the client to fall asleep.
If a patient has current tics, what is a great teaching recommendation? - ANSWER
-Stimulants can cause or worsen tics; stimulants may unmask the presence of tics.
How soon would a patient/parents see the efficacy of a stimulant or non-
stimulant? - ANSWER -within the first week! These medications begin to work
30-60 minutes after ingestion and last for a duration of up to 4-12 hours.
If a patient needed to be switched from one stimulant medication to the next, how
would you do it? - ANSWER -Discontinue one medication and start the next
medication at the starting dose the next day. NOT THE SAME DAY
How would you educate the patient on how to discontinue an ADHD medication?
- ANSWER -Abrupt withdrawal can cause irritability and rebound symptoms after
prolonged use. Medication needs to be tapered via PMHNP.
If a patient's parent asked if their childs ADHD medication had a high possibility
for addiction, what would you say? - ANSWER -Several stimulant medications are
classified as Schedule II indicating that they have a high potential for abuse.
The PMHNP must adhere to federal and state-specific guidelines for prescribing
these medications.
,Careful monitoring is required. Occasional urine drug screens should be obtained
to verify the presence of amphetamines and the absence of other substances of
abuse.
What type of stimulants are at the highest risk for abuse or diversion? - ANSWER
-Ritalin, Adderall and Dexedrine
short-acting medications are at higher risk for diversion (Short-acting medications
for ADHD that are considered high risk for diversion include methylphenidate
(Ritalin), mixed amphetamine salts (Adderall), and dextroamphetamine
(Dexedrine), as they take effect quickly and wear off relatively fast, making them
more susceptible to misuse and potential for diversion.)
Sustained release medications are better for preventing this.
What are some common side effects of stimulants? - ANSWER -restlessness,
irritability, anxiety, insomnia, stomachache, headaches, tics, and worsening
aggression symptoms
a worsening of symptoms or "crash" may occur when the medication wears off,
especially with immediate-release (IR) medications
What is the best way to avoid anorexia when taking a stimulant? - ANSWER -take
medication with breakfast to decrease anorexia or associated weight loss
For younger children under the age of ______ the American Academy of
Pediatrics (AAP) recommends ________ in behavior management as a first-line
intervention for psychotherapy with ADHD. - ANSWER -6!!!!!!
PARENT TRAINING
Review what parents teaching parents receive when they participate in parent
training: - ANSWER -· Positive Communication
· Positive Reinforcement
· Structure and Discipline
, Behavior therapy, given by parents, teaches children to better control their own
behavior, leading to improved functioning at school home and in relationships.
Learning and practicing behavior therapy requires time and effort, but has lasting
benefits for the child.
In older children and adolescents, treatment often involves both medication and
psychotherapy. Psychotherapeutic interventions may include cognitive-behavioral
therapy (CBT), social and organizational skill training, and family therapy. -
ANSWER -
What is the DSM-5 for O.D.D.? - ANSWER -A pattern of angry/irritable mood,
argumentative/defiant behavior, or vindictiveness lasting at least 6 months as
evidenced by at least four symptoms of the following categories, and exhibited
during interaction with at least one individual who is not a sibling:Angry/Irritable
Mood
Often loses temper
Is often touchy or easily annoyed
3.
Is often angry and resentful
Argumentative/Defiant Behavior
4.
Often argues with authority figures or, for children and adolescents, with adults
5.
Often actively defies or refuses to comply with requests from authority figures or
with rules
6.
Often deliberately annoys others
7.
Often blames others for his or her mistakes or misbehavior
Vindictiveness
8.
Has been spiteful or vindictive at least twice within the past 6 months.
What is the frequency of symptoms needed for an official diagnosis of O.D.D? -
ANSWER -The symptoms have to present ONCE a week for at least 6 months for
people 5 years and older
If they are under 5 then the symptoms have to occur on most days for 6 months
