The parents of a child with ADHD bring the child for a follow-up visit. During the visit, they tell the nurse that the child receives his first dose of methylphenidate (Ritalin) at about 7:30 AM every morning before leaving for school. The teacher and school nurse have noticed a return in the child's overactivity and distractibility just before lunch. The child's second dose is scheduled for about 12 noon. Which of the following might the nurse suggest as a possible solution to control the child's symptoms a bit more effectively?

Correct Answer: B

Rationale: The correct answer is B: Switching to a longer acting preparation. By switching to a longer-acting preparation of methylphenidate, the child will receive a sustained release of the medication throughout the day, which can help control symptoms more effectively. This would prevent the dip in medication effectiveness before lunch. A: Giving the second dose at 1 PM or later may not be as effective in maintaining symptom control throughout the school day. C: Splitting the early morning dose in half may not provide consistent symptom control throughout the day. D: Switching to another class of medication is not necessary if the child is responding well to methylphenidate, and a longer-acting preparation of the same medication can be a more appropriate solution.

Correct Answer: C

Rationale: The correct answer is C: Provide standby assist with the client from bed. This is appropriate after administering lisinopril, which can cause dizziness or lightheadedness. Assisting the client from bed ensures safety. Placing cardiac monitoring (A) is not necessary unless there are specific indications. Monitoring oxygen saturation (B) is not directly related to lisinopril administration. Encouraging foods high in potassium (D) is not the immediate priority post-lisinopril administration.

Correct Answer: A

Rationale: The correct answer is A: "How much sleep do you usually get each night?" This question directly relates to circadian rhythms, which regulate the sleep-wake cycle and impact overall quality of life. Sleep patterns are influenced by circadian rhythms, and inadequate sleep can have negative effects on health. Choices B, C, and D do not directly address circadian rhythms or their impact on quality of life. B is related to cardiac issues, C to infections, and D to urinary problems. Therefore, A is the most relevant question to assess the effects of circadian rhythms on quality of life.

Correct Answer: A

Rationale: Step 1: The correct answer is A because there isn't enough empirical evidence to confirm the role of ethnicity and race in the prevalence of personality disorders. Step 2: Culture and ethnic background can influence the development of personality disorders, but current research is inconclusive. Step 3: Choice B is incorrect because it makes a generalized statement without providing evidence or sources to support it. Step 4: Choice C is incorrect because culture and ethnic background can indeed play a role in the development of personality disorders. Step 5: Choice D is incorrect because while genetic factors may contribute to personality disorders, cultural factors also play a significant role.

Correct Answer: A

Rationale: The correct answer is A: Gabapentin. Gabapentin is a medication commonly used to treat neuropathic pain, which is often associated with chronic pain in older patients. It is considered a safer alternative to opioids due to its lower risk of addiction and overdose. Acetaminophen (B) is an over-the-counter pain reliever but may not be sufficient for chronic pain. Morphine (C) and Fentanyl (D) are opioids, which have a higher risk of side effects, addiction, and overdose compared to Gabapentin. Therefore, Gabapentin is the most suitable choice for managing chronic pain in older patients.