A school nurse is providing care to an adolescent who reports they are having difficulty focusing and sitting still in class. Which of the following screening considerations should the nurse identify as important for diagnosing ADHD in the adolescent?

A. ADHD diagnosis requires that symptoms of inattention, hyperactivity, or impulsivity be present in more than one setting (e.g., home, school, social situations) and persist for at least six months, ensuring that behaviors are consistent and not situational. B. Good academic performance does not rule out ADHD; some adolescents may compensate for symptoms through intelligence, support, or coping strategies, so ADHD can still be present despite satisfactory grades. C. Focusing only on classroom behavior is insufficient, as ADHD symptoms must be evident across multiple settings to meet diagnostic criteria. D. While hyperactivity may decrease with age, it remains a relevant criterion for diagnosis. Symptoms may manifest as restlessness or difficulty engaging in quiet activities rather than overt hyperactivity.