NR606 Week 8 Final Exam 2025/2026 Prep: Complete
Questions with Verified Answers and Detailed A+
Explanations
Stimulant Medications: Methylphenidate
-Low risk of adverse effects
-Available formulations:
• Ritalin - available in immediate release (IR) and extended release (XR) available in beads that may be
sprinkled on food for children who cannot swallow pills
• Concerta biphasic - combined immediate and delayed release in one medication
• Daytrana - patch applied in AM and removed after 9 hour
Stimulant Medications: Dexmethylphenidate (Focalin)
-Available in IR and ER
-More potent than Ritalin
-High risk of adverse effects
Stimulant Medications: Amphetamine (Adzenys)
-available in orally disintegrating ER formula for children who cannot swallow pills
-Avoid prescribing when an MAOI has been used within 14 days
Stimulant Medications: Dextroamphetamine (Adderall)
-Available in IR and extended-release formulations
-Often dosed in morning (IR or XR) with an evening or evening prn (IR) dose if med effects diminish prior
to end of school, study or the workday
-Most abused & diverted prescription stimulant
Stimulant Medications: Lisdexamfetamine (Vyvanse)
-Biologically inactive until metabolized by the body (Prodrug)
-Less abuse & diversion potential than other stimulants
-Higher-cost medication
,Non-stimulant medication: Atomoxetine (Strattera)
-Noradrenergic (NRI)
-Initial drug of choice for adults with ADHD
-no abuse potential
-tolerated well when prescribed in BID dosing
-appropriate choice for comorbid substance abuse
-may augment the effects of antidepressants & antianxiety meds
-can be dosed at bedtime if fatigue is noted
-unlikely to worsen tics
Non-stimulant medication: Clonidine
-α 2 agonist
• May be taken as monotherapy or with stimulant medications
-enhances precortical function for better mental focus
-appetite neutral
-may help with sleep disturbances, administer at bedtime
-adverse effects:
• sedation, brain fog
-monitor of BP closely during initial titration, risk of hypotension
-tapered to avoid rebound hypertension post discontinuation
Non-stimulant medication: guanfacine
-α 2 agonist
• May be taken as monotherapy or with stimulant medications
-may also be used for children with tics, sleep disturbances, or aggression
-tolerability & convenience enhanced by once-daily oral controlled-release formulation
-adverse effects:
• sedation, headache, decreased appetite
-reduced side-effect profile comparable to clonidine
-bedtime administration to avoid daytime sedation
Non-stimulant medication: Bupropion (Wellbutrin)
-Norepinephrine Dopamine Reuptake Inhibitor
-off-label use for ADHD in adults
-appropriate for clients with concurrent depression or tobacco abuse
Attention-deficit/hyperactivity disorder (ADHD)
-one of the most common neuropsychiatric disorders
-approximately 9.4% of children in the U.S.
-more frequently males than females, ratio 2:1
-symptom burden mild to severe
-characterized by consistent pattern of inattention &/or hyperactivity & impulsivity that interferes with
functioning & development
,• affect development of proper cognitive, behavioral, emotional, social, & academic function
-hyperactivity and impulsivity ADHD subtype symptoms: excessive fidgeting or talking, feelings of
restlessness and impatience, frequent interruption, and difficultly playing quietly
-inattentive ADHD subtype symptoms: difficulty organizing tasks, maintaining a routine, and paying
attention to detail
• may not be distinguishable until eight or nine years of age
-primarily disrupts neuronal connections within the frontal lobe & prefrontal cortex
Without early identification and proper treatment, ADHD can cause disruptions in:
academic performance
family stress
difficulties in social relationships
accidental injuries
ADHD is associated with:
increased rates of depression & SUD
Symptoms of ADHD
-Selective Attention
• Lack of attention to detail
• Careless mistakes
• Not listening
• Losing things
• Diverting attention
• Forgetfulness
-Lack of Sustained Attention
• Poor problem solving
• Difficulty completing tasks
• Disorganization
• Difficulty sustaining mental effort
-Impulsivity
• Excessive talking
• Blurting things out
• Not waiting for one's turn
• Interrupting
-Hyperactivity
• Fidgeting
• Leaving one's seat
• Running, climbing
• Trouble playing quietly
, When is ADHD most often diagnosed
-preschool and elementary school
• inattentive features become more prominent
ADHD Lifespan Considerations: Symptoms Change with Age
-Young children with ADHD
• often have developmental delays
• may engage in behaviors less mature than peers
-Teens with ADHD at risk for:
• poor academic performance
• problems with driving
• difficulties with social situations
• risky sexual behavior
• substance abuse
->75% of children with ADHD experience symptoms in adulthood
-Adolescents & Adults with ADHD
• may struggle with executive function, attention, working memory
• problems with day-to-day functioning, performance at work, relationships
ADHD is a deficiency of neurotransmitters, mainly _________ & _________
dopamine and norepinephrine
ADHD diagnostic criteria
-A pattern of at least six symptoms of inattention and/or hyperactivity-impulsivity that interfere with
functioning or development.
-Symptoms persist for six months or longer.
-Symptoms interfere with social, academic, or occupational functioning.
-Symptoms are present in two or more settings
• for instance, home & school
Kelsey is a 7-year-old first-grader who is the youngest of four children. During parent-teacher
conferences, her teacher reported that she is polite, respectful, and gets along well with her peers.
She has a hard time keeping her desk neat and she frequently misplaces her supplies and loses library
books. She must often be told more than once to complete instructions. Her work is appropriate for
her grade level, but she often makes careless mistakes on her assignments. She struggles with math
and avoids doing arithmetic assignments. Her parents endorse that Kelsey's room is "sloppy" but do
not notice any of the other concerns in the home environment.
What is the most likely diagnosis for Kelsey?
ADHD predominantly inattentive presentation
ADHD predominantly hyperactive-impulsive
Questions with Verified Answers and Detailed A+
Explanations
Stimulant Medications: Methylphenidate
-Low risk of adverse effects
-Available formulations:
• Ritalin - available in immediate release (IR) and extended release (XR) available in beads that may be
sprinkled on food for children who cannot swallow pills
• Concerta biphasic - combined immediate and delayed release in one medication
• Daytrana - patch applied in AM and removed after 9 hour
Stimulant Medications: Dexmethylphenidate (Focalin)
-Available in IR and ER
-More potent than Ritalin
-High risk of adverse effects
Stimulant Medications: Amphetamine (Adzenys)
-available in orally disintegrating ER formula for children who cannot swallow pills
-Avoid prescribing when an MAOI has been used within 14 days
Stimulant Medications: Dextroamphetamine (Adderall)
-Available in IR and extended-release formulations
-Often dosed in morning (IR or XR) with an evening or evening prn (IR) dose if med effects diminish prior
to end of school, study or the workday
-Most abused & diverted prescription stimulant
Stimulant Medications: Lisdexamfetamine (Vyvanse)
-Biologically inactive until metabolized by the body (Prodrug)
-Less abuse & diversion potential than other stimulants
-Higher-cost medication
,Non-stimulant medication: Atomoxetine (Strattera)
-Noradrenergic (NRI)
-Initial drug of choice for adults with ADHD
-no abuse potential
-tolerated well when prescribed in BID dosing
-appropriate choice for comorbid substance abuse
-may augment the effects of antidepressants & antianxiety meds
-can be dosed at bedtime if fatigue is noted
-unlikely to worsen tics
Non-stimulant medication: Clonidine
-α 2 agonist
• May be taken as monotherapy or with stimulant medications
-enhances precortical function for better mental focus
-appetite neutral
-may help with sleep disturbances, administer at bedtime
-adverse effects:
• sedation, brain fog
-monitor of BP closely during initial titration, risk of hypotension
-tapered to avoid rebound hypertension post discontinuation
Non-stimulant medication: guanfacine
-α 2 agonist
• May be taken as monotherapy or with stimulant medications
-may also be used for children with tics, sleep disturbances, or aggression
-tolerability & convenience enhanced by once-daily oral controlled-release formulation
-adverse effects:
• sedation, headache, decreased appetite
-reduced side-effect profile comparable to clonidine
-bedtime administration to avoid daytime sedation
Non-stimulant medication: Bupropion (Wellbutrin)
-Norepinephrine Dopamine Reuptake Inhibitor
-off-label use for ADHD in adults
-appropriate for clients with concurrent depression or tobacco abuse
Attention-deficit/hyperactivity disorder (ADHD)
-one of the most common neuropsychiatric disorders
-approximately 9.4% of children in the U.S.
-more frequently males than females, ratio 2:1
-symptom burden mild to severe
-characterized by consistent pattern of inattention &/or hyperactivity & impulsivity that interferes with
functioning & development
,• affect development of proper cognitive, behavioral, emotional, social, & academic function
-hyperactivity and impulsivity ADHD subtype symptoms: excessive fidgeting or talking, feelings of
restlessness and impatience, frequent interruption, and difficultly playing quietly
-inattentive ADHD subtype symptoms: difficulty organizing tasks, maintaining a routine, and paying
attention to detail
• may not be distinguishable until eight or nine years of age
-primarily disrupts neuronal connections within the frontal lobe & prefrontal cortex
Without early identification and proper treatment, ADHD can cause disruptions in:
academic performance
family stress
difficulties in social relationships
accidental injuries
ADHD is associated with:
increased rates of depression & SUD
Symptoms of ADHD
-Selective Attention
• Lack of attention to detail
• Careless mistakes
• Not listening
• Losing things
• Diverting attention
• Forgetfulness
-Lack of Sustained Attention
• Poor problem solving
• Difficulty completing tasks
• Disorganization
• Difficulty sustaining mental effort
-Impulsivity
• Excessive talking
• Blurting things out
• Not waiting for one's turn
• Interrupting
-Hyperactivity
• Fidgeting
• Leaving one's seat
• Running, climbing
• Trouble playing quietly
, When is ADHD most often diagnosed
-preschool and elementary school
• inattentive features become more prominent
ADHD Lifespan Considerations: Symptoms Change with Age
-Young children with ADHD
• often have developmental delays
• may engage in behaviors less mature than peers
-Teens with ADHD at risk for:
• poor academic performance
• problems with driving
• difficulties with social situations
• risky sexual behavior
• substance abuse
->75% of children with ADHD experience symptoms in adulthood
-Adolescents & Adults with ADHD
• may struggle with executive function, attention, working memory
• problems with day-to-day functioning, performance at work, relationships
ADHD is a deficiency of neurotransmitters, mainly _________ & _________
dopamine and norepinephrine
ADHD diagnostic criteria
-A pattern of at least six symptoms of inattention and/or hyperactivity-impulsivity that interfere with
functioning or development.
-Symptoms persist for six months or longer.
-Symptoms interfere with social, academic, or occupational functioning.
-Symptoms are present in two or more settings
• for instance, home & school
Kelsey is a 7-year-old first-grader who is the youngest of four children. During parent-teacher
conferences, her teacher reported that she is polite, respectful, and gets along well with her peers.
She has a hard time keeping her desk neat and she frequently misplaces her supplies and loses library
books. She must often be told more than once to complete instructions. Her work is appropriate for
her grade level, but she often makes careless mistakes on her assignments. She struggles with math
and avoids doing arithmetic assignments. Her parents endorse that Kelsey's room is "sloppy" but do
not notice any of the other concerns in the home environment.
What is the most likely diagnosis for Kelsey?
ADHD predominantly inattentive presentation
ADHD predominantly hyperactive-impulsive
