A female client with osteoporosis has been taking a weekly dose of oral risedronate for several weeks. The client calls the clinic nurse to report increasing “heartburn.” How should the nurse respond?

Ask the client to describe how she takes the medication.

Suggest use of an antacid two hours after the medication.

Remind the client to take the medication with plenty of water.

Advise the client to go to the nearest emergency department.

Answer and Explanation

The Correct Answer is A

A) Asking the client to describe how she takes the medication is the most appropriate initial response by the nurse. “Heartburn” reported after taking risedronate raises concerns about potential esophageal irritation or gastroesophageal reflux disease (GERD) exacerbation. Understanding the client’s administration technique (e.g., whether she takes the medication with a full glass of water and remains upright for at least 30 minutes afterward) can help identify potential causes of the reported symptoms.

B) While suggesting the use of an antacid two hours after the medication may provide symptomatic relief, it does not address the underlying issue of potential esophageal irritation or GERD exacerbation related to risedronate administration. Moreover, if the client’s symptoms are due to esophageal irritation, using an antacid may mask the symptoms without addressing the cause.

C) Reminding the client to take the medication with plenty of water is a standard recommendation for bisphosphonate administration to minimize the risk of esophageal irritation and ensure proper drug absorption. However, since the client is already experiencing “heartburn,” further assessment of the client’s medication administration technique is warranted before providing this reminder.

D) Advising the client to go to the nearest emergency department is not appropriate at this stage, as the reported symptom of “heartburn” does not suggest an immediate life-threatening emergency. However, if the client experiences severe chest pain, difficulty swallowing, or signs of a severe allergic reaction (e.g., swelling of the face or throat, difficulty breathing), emergency medical attention would be necessary.

Therefore, the nurse should first assess the client’s medication administration technique to determine if improper administration may be contributing to the reported symptoms. Based on this assessment, appropriate interventions can be provided to address potential esophageal irritation or GERD exacerbation.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is ["100"]

Explanation

Since the client weighs 90 kg, let’s first convert their weight to pounds to determine the appropriate cefazolin dosage:

Conversion factor: 1 kg = 2.205 pounds

Client weight (pounds) = 90 kg x 2.205 pounds/kg = 198.45 pounds (rounded to two decimals)

Now, comparing the client’s weight (198.45 pounds) to the weight threshold (265.5 pounds):

Client weight is less than the threshold (198.45 pounds < 265.5 pounds).

Therefore, the appropriate dosage is:

Cefazolin 2 grams/100 mL 0.9% normal saline over 1 hour.

The pump rate is determined by the total volume of the IV fluid and the infusion time.

We are not given the specific bag size, but typically these come in 100 mL or 500 mL volumes.

Assuming a 100 mL bag (which aligns with the concentration provided):

Total volume of IV bag: 100 mL

Infusion time: 1 hour

Calculation:

Pump rate (mL/hr) = Total volume (mL) / Infusion time (hr)

Pump rate (mL/hr) = 100 mL / 1 hour = 100 mL/hr

Therefore, the nurse should program the pump to deliver 100 mL/hr.

A. Decreased blood urea nitrogen. B. Hearing has decreased. C. Reports of photophobia. D. White blood cell count of 6,000/mm3 (6 x 10/1)

Correct Answer is B

Explanation

A) Decreased blood urea nitrogen (BUN) is not a typical adverse effect of gentamicin. Gentamicin is primarily associated with nephrotoxicity (kidney damage), which would manifest as an increased BUN and serum creatinine rather than a decrease.

B) Hearing loss is a well-known adverse effect of gentamicin, particularly when the drug reaches high concentrations in the inner ear (ototoxicity). Gentamicin can cause irreversible damage to the cochlear and vestibular organs, leading to sensorineural hearing loss and balance disturbances.

C) Reports of photophobia are not typically associated with gentamicin. Photophobia (sensitivity to light) may occur with certain eye conditions or central nervous system disorders but is not a direct adverse effect of gentamicin.

D) A white blood cell count of 6,000/mm3 falls within the normal reference range, so it does not indicate an adverse effect of gentamicin. Gentamicin is not known to directly affect white blood cell count.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A female client with osteoporosis has been taking a weekly dose of oral risedronate for several weeks. The client calls the clinic nurse to report increasing “heartburn.” How should the nurse respond?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["100"]

Explanation

A male client has been receiving the antibiotic gentamicin sulfate, IV piggyback every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin? Reference Range: White Blood Cell [5000 to 10,000/mm3 (5 to 10 x 10%)]

Correct Answer is B

Explanation

Which instruction should the nurse include when teaching a client about self-administration of a bulk-forming laxative?

A client who is receiving pregabalin for fibromyalgia reports experiencing tremors in the hands. Which action should the nurse implement?

A client with a history of smoking cigarettes for many years arrives to the clinic and expresses a desire to stop smoking. The client receives a prescription for bupropion to reduce nicotine cravings. Which information should the nurse include in the discharge teaching?

Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium?

A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?

The nurse is reviewing the client’s laboratory results. Based on a client’s serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement?

A client with a history of angina reports the onset of chest pain. The nurse determines that the heart rate is 104 beats/minute and the blood pressure is 138/86 mm Hg. A transdermal nitroglycerin patch was applied 30 minutes ago to the right upper chest. Which action should the nurse take?