A nurse is assessing a client with a major burn injury.

Which of the following findings should the nurse prioritize?

Choice A rationale
Alendronate should be taken at least 30 minutes before the first food, beverage, or medication of the day with plain water only. This is because other beverages (including mineral water), food, and some medications are likely to reduce the absorption of alendronate.
Choice B rationale
Alendronate should not be taken with milk. This is because the calcium in the milk can bind to the alendronate, preventing it from being absorbed into the body and therefore making it less effective. This is why the patient’s statement indicates a need for further instruction.
Choice C rationale
After taking alendronate, the patient should not lie down and should remain fully upright (sitting, standing, or walking) for at least 30 minutes. This is to help alendronate reach the stomach more quickly and also to reduce the risk of irritation to the esophagus. Therefore, sitting up and reading the morning paper after taking alendronate is a correct practice.
Choice D rationale
Regular bone density tests are necessary while taking alendronate. This is to monitor the drug’s effectiveness in increasing bone mass and to adjust the treatment plan as necessary. Therefore, the patient’s statement is correct.

Choice A rationale
While pain management is important in burn care, the first action should be to stop the burning process. Administering IV morphine does not achieve this.
Choice B rationale
Applying ice to a burn can cause vasoconstriction and may increase tissue damage. It is not the first action to stop the burning process.
Choice C rationale
Applying a neutralizing agent is not the first action in chemical burn management. The priority is to remove the chemical from contact with the skin.
Choice D rationale
Removing the patient’s clothing is the first action in burn management. This prevents further contact of the chemical with the skin and stops the burning process.