The nurse is teaching the parents of a child recently diagnosed with ADHD who has been prescribed methylphenidate (Ritalin). Which should the nurse include in teaching about the side effects of methylphenidate?

Correct Answer: A

Rationale: Methylphenidate (Ritalin) is a stimulant medication commonly used in the treatment of ADHD. One of the possible side effects of methylphenidate is an increase in nervousness or jitteriness. This side effect is more common at the beginning of treatment or when the dosage is increased. It is important for parents to be aware of this potential side effect and to inform the healthcare provider if it becomes bothersome for the child. Other common side effects of methylphenidate may include decreased appetite, insomnia, and stomach upset.

Correct Answer: D

Rationale: Hyperkalemia is a condition characterized by elevated levels of potassium in the blood. This can have serious effects on the heart, leading to cardiac arrhythmias which can be life-threatening. In acute renal failure, the kidneys are not able to properly regulate potassium levels in the blood, leading to a potential buildup of potassium, resulting in hyperkalemia. The nurse should recognize cardiac arrhythmias as a critical sign of hyperkalemia in a child with acute renal failure and take prompt action to address this electrolyte imbalance. Dyspnea, seizure, and oliguria are not typically directly correlated with hyperkalemia.

Correct Answer: D

Rationale: Preoperative teaching for Jose, a 4-year-old child, scheduled for a cardiac catheterization should be adapted to his level of development so that he can understand. Children at this age have limited cognitive and emotional understanding, so using simple language, visuals, and play-based strategies is essential. It is important to provide age-appropriate information to reduce anxiety and improve cooperation during the procedure. Preoperative teaching should focus on preparing Jose for what he will see, hear, and experience in a way that is tailored to his developmental stage. Involving play tools such as medical play dolls or child-friendly illustrations can help Jose grasp the concept of the procedure and alleviate fears. It is important to involve both Jose and his parents in the teaching process to ensure they understand how to support and prepare him for the procedure.

Correct Answer: A

Rationale: The nurse's reply should be based on the statement that "the child needs opportunities to play with peers." It is important for children to engage in play and social interactions with their peers for their overall development, including social, emotional, cognitive, and physical growth. By allowing the child with congenital heart disease to play with other children, under appropriate supervision, the child can still have enriching experiences while ensuring their safety and well-being. It is essential to strike a balance between enabling the child to participate in activities and managing any potential risks associated with their condition. A supportive environment that encourages play and socialization with peers can contribute positively to the child's development and quality of life.

Correct Answer: C

Rationale: In the management of anaphylaxis, the immediate medication of choice for administration is epinephrine. Epinephrine is a potent vasoconstrictor and bronchodilator which helps restore blood pressure and open up the airways during an anaphylactic reaction. It is the first-line treatment to reverse the potentially life-threatening effects of an allergic reaction. Other medications, like diphenhydramine or dobutamine, may be used as adjuncts later in the treatment, but epinephrine is crucial for immediate administration to stabilize the child's condition.