Question 1

Vignette: A 9-year-old child with a history of Attention Deficit Hyperactivity Disorder (ADHD) is brought to the clinic by their parent. The child has difficulty maintaining attention in class and often interrupts others. Which of the following interventions should the nurse recommend first to assist with the child’s attention in the classroom?

A. Immediate referral for psychiatric evaluation

B. Initiation of a stimulant medication

C. Implementation of a reward system for positive behaviors

D. Restriction of all sugar from the diet

E. Increasing physical activity before school

Correct Answer: C. Implementation of a reward system for positive behaviors

Rationale: Behavioral strategies, such as implementing a reward system for positive behaviors, are often recommended as the first line of intervention for children with ADHD. This approach helps in reinforcing desired behaviors and provides immediate feedback, which can be very effective for children with ADHD. Medications, such as stimulants, may also be considered but are not the first step before trying behavioral strategies. Dietary changes and increased physical activity can be supportive measures but are not primary interventions for managing ADHD symptoms.

Question 2

Vignette: During a health assessment of a 7-year-old diagnosed with ADHD, the nurse discusses medication options with the parents. Which of the following medications is primarily prescribed for children diagnosed with ADHD?

A. Risperidone

B. Methylphenidate

C. Amitriptyline

D. Ciprofloxacin

E. Acetaminophen

Correct Answer: B. Methylphenidate

Rationale: Methylphenidate is a stimulant medication commonly prescribed for children with ADHD to help increase attention and decrease impulsiveness and hyperactivity. Risperidone is an antipsychotic used for other conditions, not first-line for ADHD. Amitriptyline is an antidepressant, ciprofloxacin is an antibiotic, and acetaminophen is a pain reliever and fever reducer, none of which are used to treat ADHD.

Question 3

Vignette: A school nurse is implementing strategies to support a child with ADHD. Which of the following strategies is most effective for helping the child manage tasks?

A. Assigning lengthy tasks to improve focus

B. Breaking tasks into smaller, manageable parts

C. Encouraging competitive activities to increase motivation

D. Limiting verbal instructions to one at a time

E. Providing tasks at the end of the day

Correct Answer: B. Breaking tasks into smaller, manageable parts

Rationale: Children with ADHD often struggle with large, overwhelming tasks due to their difficulty in maintaining focus for long periods. Breaking tasks into smaller, manageable parts helps them accomplish tasks step-by-step, promoting a sense of achievement and maintaining focus. This strategy is preferable over assigning lengthy tasks, which can lead to frustration and decreased motivation. Limiting verbal instructions and timing of tasks are helpful but secondary to structuring tasks in a manageable way.

Question 4

Vignette: The parents of a child with ADHD are concerned about the side effects of stimulant medications. Which of the following is a common side effect of stimulant medications for ADHD that the nurse should educate the parents about?

A. Weight gain

B. Increased appetite

C. Decreased appetite

D. Hypotension

E. Bradycardia

Correct Answer: C. Decreased appetite

Rationale: A common side effect of stimulant medications used to treat ADHD is decreased appetite, which can sometimes lead to weight loss. Nurses should educate parents about this potential side effect and suggest monitoring the child’s weight and nutritional intake. Weight gain, increased appetite, hypotension, and bradycardia are not commonly associated with the use of stimulant medications for ADHD.

Question 5

Vignette: A 10-year-old child with ADHD is struggling with completing homework assignments. Which of the following strategies should the nurse recommend to the parents to help improve homework completion?

A. Having the child complete homework in a quiet, distraction-free environment

B. Allowing the child to watch television while doing homework to increase stimulation

C. Completing homework assignments early in the morning

D. Assigning all homework tasks for the week in one day

E. Increasing the amount of homework to improve endurance

Correct Answer: A. Having the child complete homework in a quiet, distraction-free environment

Rationale: For children with ADHD, reducing environmental distractions is crucial to improve focus on tasks such as homework. A quiet, distraction-free environment helps the child concentrate better and enhances task completion. Watching television while doing homework, increasing the workload, or altering the timing significantly can exacerbate difficulties with focus and should be avoided.

Question 6

Vignette: A nurse is advising a high school student with ADHD on managing their condition. Which of the following tips should the nurse include about study habits?

A. Study in a group setting to increase social interaction

B. Utilize a planner to organize assignments and tests

C. Study for long periods without breaks to maintain focus

D. Listen to loud music while studying to block out distractions

E. Leave studying for tests until the night before to consolidate information

Correct Answer: B. Utilize a planner to organize assignments and tests

Rationale: For students with ADHD, using a planner is an effective strategy to keep track of assignments, tests, and deadlines, helping to manage time effectively and reduce stress. Group study, while beneficial for some, might be distracting for those with ADHD. Studying for long periods without breaks, listening to loud music, and cramming are not effective strategies for students with ADHD, as they can lead to burnout, increased distractions, and ineffective learning.

Question 7

Vignette: A pediatric nurse is providing education to parents of a newly diagnosed ADHD child about non-pharmacological management. Which of the following should the nurse include?

A. Enrolling the child in multiple sports to burn off energy

B. Maintaining a consistent daily routine

C. Keeping the child isolated from peers to improve focus

D. Allowing unlimited screen time to keep the child occupied

E. Changing the child’s diet to include more caffeine

Correct Answer: B. Maintaining a consistent daily routine

Rationale: Maintaining a consistent daily routine is beneficial for children with ADHD as it provides structure and predictability, which can help manage symptoms. Enrolling the child in too many activities can be overwhelming, and isolation from peers can affect social development negatively. Unlimited screen time and introducing more caffeine can exacerbate symptoms of ADHD, not alleviate them.

Question 8

Vignette: During a routine check-up for a 6-year-old with ADHD, the parents express concern about the child’s sleeping difficulties. Which of the following suggestions should the nurse offer to improve the child’s sleep?

A. Increase physical activity during the day

B. Offer a caffeinated beverage in the evening to tire the child out

C. Encourage daytime naps to ensure the child is well-rested

D. Increase screen time before bed to help the child wind down

E. Implement a flexible bedtime schedule

Correct Answer: A. Increase physical activity during the day

Rationale: Increasing physical activity during the day can help expend energy and improve sleep quality at night for children with ADHD. Caffeinated beverages can interfere with sleep, and increased screen time before bed can stimulate the brain, making it harder to fall asleep. Daytime naps and a flexible bedtime schedule can disrupt the child’s sleep patterns, while a consistent routine and physical activity promote better sleep habits.

Question 9

Vignette: A teacher reports that a child with ADHD is having difficulty following instructions in class. What is the best strategy the nurse can suggest to the teacher to improve the child’s ability to follow instructions?

A. Provide instructions in a complex, detailed format

B. Use visual aids and repeat instructions clearly

C. Only give instructions at the end of the class

D. Use a softer voice to not startle the child

E. Increase the speed of instruction delivery

Correct Answer: B. Use visual aids and repeat instructions clearly

Rationale: Using visual aids and repeating instructions clearly can greatly benefit children with ADHD by providing multiple ways to process the information and ensuring understanding. Complex instructions can be overwhelming, and timing of instruction delivery is less relevant than the clarity and presentation method. A softer voice or faster delivery does not necessarily aid in comprehension for a child with ADHD.

Question 10

Vignette: The nurse is creating a care plan for an adolescent with ADHD. Which of the following is an important goal for the adolescent?

A. To eliminate all hyperactive behaviors

B. To improve academic performance to an above-average level

C. To develop strategies for managing attention and impulsivity

D. To participate in as many extracurricular activities as possible

E. To decrease social interactions to improve focus

Correct Answer: C. To develop strategies for managing attention and impulsivity

Rationale: An important goal for an adolescent with ADHD is to develop effective strategies for managing attention and impulsivity, which can improve function in academic, social, and home environments. Eliminating all hyperactive behaviors is unrealistic and not necessary for successful management. Academic performance improvements are desired but focusing solely on becoming above average may not be realistic for all. Over-participation in activities or decreasing social interactions can lead to other issues and are not targeted goals for ADHD management.