NR-606 FINAL EXAM ADVANCED PRACTICE NURSING
REVIEW // A+ GRADED PRESENTATION // CLINICAL
DECISION-MAKING DIAGNOSTIC REASONING EVIDENCE-
BASED CARE AND PATIENT MANAGEMENT FOR STUDENT
MASTERY // ACADEMIC YEAR 2025/2026
How would you treat a patient who is having argumentative or
oppositional symptoms? - THE CORRECT ANSWER -A combination of
stimulants and non-stimulants can be used
What cardiac considerations should be considered before starting any
patients on a stimulant? - THE CORRECT 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? - THE CORRECT 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? - THE CORRECT 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? - THE CORRECT 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? -
THE CORRECT 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? - THE CORRECT 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? - THE CORRECT 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? - THE CORRECT 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? - THE CORRECT
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? -
THE CORRECT 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? - THE CORRECT
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? - THE
CORRECT 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. - THE CORRECT
ANSWER -6!!!!!!
PARENT TRAINING
Review what parents teaching parents receive when they participate in
parent training: - THE CORRECT 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. - THE CORRECT ANSWER -
What is the DSM-5 for O.D.D.? - THE CORRECT 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
REVIEW // A+ GRADED PRESENTATION // CLINICAL
DECISION-MAKING DIAGNOSTIC REASONING EVIDENCE-
BASED CARE AND PATIENT MANAGEMENT FOR STUDENT
MASTERY // ACADEMIC YEAR 2025/2026
How would you treat a patient who is having argumentative or
oppositional symptoms? - THE CORRECT ANSWER -A combination of
stimulants and non-stimulants can be used
What cardiac considerations should be considered before starting any
patients on a stimulant? - THE CORRECT 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? - THE CORRECT 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? - THE CORRECT 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? - THE CORRECT 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? -
THE CORRECT 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? - THE CORRECT 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? - THE CORRECT 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? - THE CORRECT 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? - THE CORRECT
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? -
THE CORRECT 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? - THE CORRECT
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? - THE
CORRECT 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. - THE CORRECT
ANSWER -6!!!!!!
PARENT TRAINING
Review what parents teaching parents receive when they participate in
parent training: - THE CORRECT 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. - THE CORRECT ANSWER -
What is the DSM-5 for O.D.D.? - THE CORRECT 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
