HESI Case Studies–Psychiatric/Mental Health-Attention Deficit Hyperactivity Disorder (Joe)

1. What information is important for the registered nurse (RN) to obtain about Joe’s accidents? (Select all)
-Explanation of previous accidents
-Precipitating events to the accidents
-What Joe means by the word “accident”
-Has Joe intentionally tried to harm himself?
2. What are hallmark characteristics of ADHD? (Select all)
-Pattern of impulsiveness
-Interruptive and intrusive in peers’ games
3. The nurse recognizes which statement by Joe supports his diagnosis of ADHD?
“I get bored easily.”
4. “I know I am clumsy; I wish there were a pill for that.” How should the nurse respond to Joe’s statement?
Acknowledge the client’s frustration
5. The nurse recognizes which statement by Joe supports his previous diagnosis of ADHD?
“I quickly break up with a lot of girlfriends.”

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6. Which activities should the nurse recognize as having a high priority in a safety assessment for Joe?(Select all)
-History of motor vehicle violations
-Recreational activities
-Sexual activity
-Drug and alcohol use
7. Which issue should the nurse assign the highest priority in Joe’s problem list?
At risk for injury
8. Which nursing intervention(s) should the RN implement to meet Joe’s biopsychosocial needs? (Select all)
-Printed handouts
-Internet resources
9. Joe makes the statement “Gee, I thought the only thing we were going to do was start my medicine.”
“Treatment involves more than taking medication.”
10. What are important biological parameters for the nurse to assess after a client has started taking methylphenidate (Concerta)? (Select all)
-Painful and prolonged erection
-Blood pressure and heart rate
-Numbness in fingers and toes
-Weight
11. Given Joe’s inattentiveness and short attention span, what is the most important strategy for the nurse to use when planning care?
Interventions should be time-limited
12. Which nursing diagnosis should the nurse address when planning for Joe’s care?
Impaired social interaction related to poor communication skills
13. What information should the nurse include in the teaching plan? (Select all)
-Abuse of methylphenidate (Concerta) may lead to dependence
-Methylphenidate (Concerta) is a controlled substance
14. Joe asks the nurse what caused him to acquire ADHD. How should the nurse respond to Joe’s question?
Unknown
15. Joe asks the nurse when he should take his medication. How should the nurse respond?
In the morning
16. Joe’s mother remarks that it might be difficult for Joe to remember to take his medicine. How should the nurse respond to the mother’s statement?
“The person taking the medication has to be responsible for taking it correctly.”
17. How should the nurse respond?
“Stimulants are the gold standard for treating ADHD.”
18. Which problem has priority for the nurse when helping Joe improve his communication skills?
Intrusiveness
19. After observing Joe exhibit behaviors that indicate his self-esteem may have suffered as a result of his ADHD, which intervention(s) should the nurse implement to improve his self-esteem? (Select all)
-Encourage the client to list three of his possible attributes
-Practice attentive listening when Joe is talking
20. The nurse can measure improvement in Joe’s social skills by which statement?
“I have had the same girlfriend for 6 months now.”
21. When assessing Joe for improvement in his self-esteem, what is the best approach for the nurse to use?
“Tell me about the things that have improved this semester.”
22. How should the nurse respond to Joe’s comment?
“What changes are of concern to you?”
23. What is the first behavior the nurse should ask about when assessing Joe’s sleep problem?
Medication schedule
24. How should the nurse respond to Joe’s question?
“Psychotherapy that focuses on ADHD may help eliminate medication.”
25. What should the nurse assess at Joe’s follow up visit? (Select all)
-Nutritional status
-Mood/anxiety disorders
-Coping mechanisms
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