Sample Answer for ASSSESSING AND TREATING CLIENTS WITH ADHD NURS 6630 Included After Question
Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. Different people may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for patients across the life span. For this Assignment, you consider how you might assess and treat patients presenting with ADHD.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
LEARNING RESOURCES
Required Readings
Prince, J. B., Wilens, T. E., Spencer, T. J., & Biederman, J. (2016). Stimulants and other medications for ADHD. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 99–112). Elsevier.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disordersLinks to an external site. (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Hodgkins, P., Shaw, M., McCarthy, S., & Sallee, F. R. (2012). The pharmacology and clinical outcomes of amphetamines to treat ADHD: Does composition matter? CNS DrugsLinks to an external site., 26(3), 245–268. https://doi.org/10.2165/11599630-000000000-00000
Martin, L. (2020). A 5-question quiz on ADHD. Psychiatric TimesLinks to an external site.. https://www.psychiatrictimes.com/view/5-question-quiz-adhd
Medication Resources
U.S. Food & Drug Administration. (n.d.). Drugs@FDA: FDA-approved drugsLinks to an external site.. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm
Links to an external site.
Note: To access the following medications, use the Drugs@FDA resource. Type the name of each medication in the keyword search bar. Select the hyperlink related to the medication name you searched. Review the supplements provided and select the package label resource file associated with the medication you searched. If a label is not available, you may need to conduct a general search outside of this resource provided. Be sure to review the label information for each medication as this information will be helpful for your review in preparation for your Assignments.
armodafinil
amphetamine (d)
amphetamine (d,l)
atomoxetine
bupropion
chlorpromazine
clonidine
guanfacine
haloperidol
lisdexamfetamine
methylphenidate (d)
methylphenidate (d,l)
modafinil
reboxetine
Required Media
Case Study: A Young Caucasian Girl with ADHDLinks to an external site.
Note: This case study will serve as the foundation for this week’s Assignment.
TO PREPARE FOR THIS ASSIGNMENT:
Review this week’s Learning Resources, including the Medication Resources indicated for this week.
Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with ADHD.
THE ASSIGNMENT: 5 PAGES
Examine Case Study: A Young Caucasian Girl with ADHD. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.
At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.
Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1 page)
Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #2 (1 page)
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #3 (1 page)
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Conclusion (1 page)
Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.
Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.
Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formattingLinks to an external site..
BY DAY 7
Submit your Assignment.
SUBMISSION INFORMATION
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To submit your completed assignment, save your Assignment as WK9Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NURS_6630_Week9_Assignment_Rubric
NURS_6630_Week9_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIntroduction to the case (1 page)Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
10 to >8.0 pts
Excellent Point range: 90–100
The response accurately, clearly, and fully summarizes in detail the case for the Assignment…. The response accurately and clearly explains in detail the specific patient factors that impact decision making when prescribing medication for this patient.
8 to >7.0 pts
Good Point range: 80–89
The response accurately summarizes the case for the Assignment…. The response accurately explains the specific patient factors that impact decision making with prescribing medication for this patient.
7 to >6.0 pts
Fair Point range: 70–79
The response inaccurately or vaguely summarizes the case for the Assignment…. The response inaccurately or vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.
6 to >0 pts
Poor Point range: 0–69
The response inaccurately and vaguely summarizes the case for the Assignment, or is missing…. The response inaccurately and vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.
10 pts
This criterion is linked to a Learning OutcomeDecision #1 (1–2 pages)• Which decision did you select?• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
20 to >17.0 pts
Excellent Point range: 90–100
The response accurately and clearly explains in detail the decision selected…. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected…. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients…. Examples provided fully support the decisions and responses provided.
17 to >15.0 pts
Good Point range: 80–89
The response accurately explains the decision selected…. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected…. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response…. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response…. The response accurately explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided support the decisions and responses provided.
15 to >13.0 pts
Fair Point range: 70–79
The response inaccurately or vaguely explains the decision selected…. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected…. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided may support the decisions and responses provided.
13 to >0 pts
Poor Point range: 0–69
The response inaccurately and vaguely explains the decision selected…. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing…. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing…. Examples provided do not support the decisions and responses provided, or is missing.
20 pts
This criterion is linked to a Learning OutcomeDecision #2 (1–2 pages)• Which decision did you select?• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
20 to >17.0 pts
Excellent Point range: 90–100
The response accurately and clearly explains in detail the decision selected…. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected…. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients…. Examples provided fully support the decisions and responses provided.
17 to >15.0 pts
Good Point range: 80–89
The response accurately explains the decision selected…. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected…. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response…. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response…. The response accurately explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided support the decisions and responses provided.
15 to >13.0 pts
Fair Point range: 70–79
The response inaccurately or vaguely explains the decision selected…. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected…. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided may support the decisions and responses provided.
13 to >0 pts
Poor Point range: 0–69
The response inaccurately and vaguely explains in detail the decision selected…. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing…. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing…. Examples provided do not support the decisions and responses provided, or is missing.
20 pts
This criterion is linked to a Learning OutcomeDecision #3 (1–2 pages)• Which decision did you select?• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
20 to >17.0 pts
Excellent Point range: 90–100
The response accurately and clearly explains in detail the decision selected…. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected…. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients…. Examples provided fully support the decisions and responses provided.
17 to >15.0 pts
Good Point range: 80–89
The response accurately explains the decision selected…. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected…. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response…. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response…. The response accurately explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided support the decisions and responses provided.
15 to >13.0 pts
Fair Point range: 70–79
The response inaccurately or vaguely explains the decision selected…. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected…. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided may support the decisions and responses provided.
13 to >0 pts
Poor Point range: 0–69
The response inaccurately and vaguely explains in detail the decision selected…. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing…. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing…. Examples provided do not support the decisions and responses provided, or is missing.
20 pts
This criterion is linked to a Learning OutcomeConclusion (1 page)• Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.
15 to >13.0 pts
Excellent Point range: 90–100
The response accurately and clearly summarizes in detail the recommendations on the treatment options selected for this patient…. The response accurately and clearly explains a justification for the recommendations provided, including clinically relevant resources that fully support the recommendations provided.
13 to >11.0 pts
Good Point range: 80–89
The response accurately summarizes the recommendations on the treatment options selected for this patient…. The response accurately explains a justification for the recommendation provided, including clinically relevant resources that support the recommendations provided.
11 to >10.0 pts
Fair Point range: 70–79
The response inaccurately or vaguely summarizes the recommendations on the treatment options selected for this patient…. The response inaccurately or vaguely explains a justification for the recommendations provided, including clinically relevant resources that inaccurately or vaguely support the recommendations provided.
10 to >0 pts
Poor Point range: 0–69
The response inaccurately and vaguely summarizes the recommendations on the treatment options selected for this patient, or is missing…. The response inaccurately and vaguely explains a justification for the recommendations provided, including clinically relevant resources that do not support the recommendations provided, or is missing.
15 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
5 to >4.0 pts
Excellent Point range: 90–100
Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
4 to >3.5 pts
Good Point range: 80–89
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time….Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.
3.5 to >3.0 pts
Fair Point range: 70–79
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.
3 to >0 pts
Poor Point range: 0–69
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided. 5 pts This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 to >4.0 pts
Excellent Point range: 90–100
Uses correct grammar, spelling, and punctuation with no errors.
4 to >3.5 pts
Good Point range: 80–89
Contains a few (1 or 2) grammar, spelling, and punctuation errors.
3.5 to >3.0 pts
Fair Point range: 70–79
Contains several (3 or 4) grammar, spelling, and punctuation errors.
3 to >0 pts
Poor Point range: 0–69
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
5 to >4.0 pts
Excellent Point range: 90–100
Uses correct APA format with no errors.
4 to >3.5 pts
Good Point range: 80–89
Contains a few (1 or 2) APA format errors.
3.5 to >3.0 pts
Fair Point range: 70–79
Contains several (3 or 4) APA format errors.
3 to >0 pts
Poor Point range: 0–69
Contains many (≥ 5) APA format errors.
5 pts
Total Points: 100
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A Sample Answer For the Assignment: ASSSESSING AND TREATING CLIENTS WITH ADHD NURS 6630
Title: ASSSESSING AND TREATING CLIENTS WITH ADHD NURS 6630
The management of attention deficit hyperactivity disorder (ADHD) among the pediatric population is quite challenging due to the limited amount of evidence supporting the safety of several recommended drugs for this disorder. To illustrate further the management of ADHD, the case of an 8-year-old Caucasian female has been provided. The patient presents with symptoms of ADHD as suggested by her teacher who completed the Conner’s Teacher Rating Scale-Revised. Her teacher claims that the patient is forgetful most of the time, and easily distracted with a very short concentration time. The patient also displays poor language, spelling, and arithmetic skills, hurting her overall school performance. The teacher also reported that lately, the patient has been failing to follow instructions, leaving her homework incomplete. Despite the patient’s parents refusing their daughter has ADHD, the patient reports that she gets bored most of the time at school with a lack of interest in school work. She however denies bullying of any kind at school with a good home life experience. With the findings of the conducted mental status examination and the Conner’s Teacher Rating Scale-Revised, the patient has been diagnosed with Attention deficit hyperactivity disorder, predominantly inattentive presentation.
Several factors were considered when deciding on the specific pharmacological agent and the right dosage to prescribe in the management of the patient’s condition. Such factors include the young age of the patient, her Caucasian race, her ADHD diagnosis, and the reported symptoms. The completed Conner’s Teacher Rating Scale-Revised can also help determine the severity of the patient’s condition which is crucial in determining the dosage of the selected drug. As such, this discussion aims at developing the most effective treatment plan for the 8-year-old patient in the management of ADHD, with a rationale for each decision made.
Decision#1
Selected Decision and Rationale
Administering Methylphenidate 10mg chewable tablets once a day in the morning was selected as the initial intervention. Methylphenidate is a stimulant to the central nervous system that acts via noncompetitive blockage of noradrenalin and dopamine reuptake into the terminals, by inhibiting the action of the dopamine and noradrenaline transporters thus raising dopamine and noradrenaline levels in the synaptic cleft (American Psychiatric Association, 2013; Cipriani et al., 2018). Previous evidence supports the substantial effectiveness of Methylphenidate in the management of children diagnosed with ADHD, with a great safety profile and high tolerability levels (Hodgkins et al., 2012). The drug is only recommended for children of age 6 and above (Grimmsmann & Himmel, 2021). Finally, with consideration of the patient’s Caucasian race, the drug is metabolized in the liver via the CYP3A4 pathway, which is predominant among this ethnic population, hence limiting the risks of toxicity (Bonati et al., 2018). The chewable tablet formulation is normally recommended for children to promote compliance (Kikuchi et al., 2021).
Intuniv was an inappropriate choice for this patient given that previous studies report that the drug being a non-stimulant is more effective in the management of ADHD when used together with a stimulant (Pelham III et al., 2022). Wellbutrin on the other hand is a norepinephrine-dopamine reuptake inhibitor (NDRI) discouraged among children below the age of 9 years old due to its elevated risks of seizures (Kikuchi et al., 2021).
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ASSSESSING AND TREATING CLIENTS WITH ADHD NURS 6630
Expected Outcome.
Up to 50% of the patient’s symptoms will be resolved within the following 4 weeks (Kikuchi et al., 2021). She will be able to concentrate for longer hours with increased attention and memory (Hodgkins et al., 2012). Her overall academic performance will also improve significantly.
Ethical Consideration
Based on the provisions of legal and ethical guidelines for nurses, the PMHNP is obliged to consider the patient ethnicity and race to promote culturally sensitive care (Bonati et al., 2018). The patient’s parents also have a legal right to information concerning the health of their child, for sound decision-making (American Psychiatric Association, 2013). Respecting the patient’s autonomy is key to promoting patient satisfaction.
Decision#2
Selected Decision and Rationale
Out of the options provided, the most effective second intervention was to change the treatment regimen to a long-acting Ritalin 20mg administered once daily in the morning. The patient has reported the potential effectiveness of the drug in managing ADHD symptoms (Hodgkins et al., 2012). However, since the dose is quite limited to resolving the patient’s symptoms all day, using a long-acting agent will help prolong the duration of action, improving the patient’s attention, concentration, and memory the entire day (Cipriani et al., 2018). Studies show that long-acting Methylphenidate lasts in the body system for up to 10 to 12 hours (American Psychiatric Association, 2013). The side effect reported of elevated heart rate is common among pediatric patients on methylphenidate which resolves as the patient continues taking the drug (Pelham III et al., 2022). Consequently, previous evidence confirms that using a long-acting age

