. A nurse is caring for a client who is taking alendronate to treat osteoporosis. The nurse should monitor for which of the following adverse effects?

Drowsiness

Dyskinesia

Musculoskeletal pain

Weight gain

Answer and Explanation

The Correct Answer is C

A. Drowsiness. Alendronate, a bisphosphonate used to treat osteoporosis, does not cause drowsiness. It primarily affects bone metabolism rather than the central nervous system. If a client experiences drowsiness, it is likely due to another cause rather than the medication itself.

B. Dyskinesia. Dyskinesia refers to involuntary movements often associated with neurological disorders or medications affecting dopamine, such as antipsychotics or Parkinson’s medications. Alendronate does not affect dopamine or the nervous system, making dyskinesia an unlikely adverse effect.

C. Musculoskeletal pain. A known side effect of alendronate is musculoskeletal pain, including bone, joint, and muscle discomfort. This occurs due to the medication’s effects on bone remodeling and turnover. While mild pain may resolve on its own, persistent or severe pain should be reported to the provider as it may require dose adjustment or discontinuation.

D. Weight gain. Alendronate does not cause weight gain. It primarily acts on bone tissue to inhibit osteoclast-mediated bone resorption, preventing further bone loss. Clients experiencing unexplained weight gain should be evaluated for other potential causes, such as metabolic conditions or lifestyle factors.

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Correct Answer is B

Explanation

A. Oatmeal. Oatmeal is a healthy carbohydrate and fiber source, but it is not a significant source of potassium, which is essential for clients taking furosemide. While beneficial for overall health, oatmeal will not help counteract potassium loss caused by diuretic therapy.

B. Baked potatoes. Baked potatoes are rich in potassium, which is frequently lost due to furosemide’s potassium-wasting effects. Furosemide is a loop diuretic that increases urine output and depletes electrolytes, particularly potassium, which can lead to hypokalemia (low potassium levels). To help maintain electrolyte balance, clients should consume potassium-rich foods like potatoes, bananas, oranges, and spinach.

C. Brown rice. Brown rice is a good source of fiber and complex carbohydrates, but it contains only small amounts of potassium. While it provides sustained energy, it does not significantly contribute to potassium replacement, making it less beneficial for clients on furosemide.

D. Eggs. Eggs are high in protein and essential nutrients but are not a significant source of potassium. While eggs are beneficial for overall health, they do not help replenish potassium lost due to diuretic therapy.

A. Cover the administration area with plastic wrap. B. Massage the ointment into the skin. C. Spread the ointment in a 10 cm2 (4in2) area. D. Apply the ointment in a thick layer.

Correct Answer is A

Explanation

A. Cover the administration area with plastic wrap. After applying nitroglycerin ointment, the area should be covered with plastic wrap or a transparent dressing to prevent evaporation and ensure proper absorption through the skin. This also helps prevent the medication from accidentally transferring to another person or clothing.

B. Massage the ointment into the skin. Nitroglycerin ointment should not be massaged into the skin, as this can cause rapid absorption and lead to hypotension and dizziness due to vasodilation. Instead, it should be applied as a thin, even layer and covered with a dressing.

C. Spread the ointment in a 10 cm² (4 in²) area. The correct application method involves measuring the exact prescribed amount (e.g., using the applicator paper) and applying it in a thin layer. The area of application may vary based on the dosage, but the focus should be on accurate measurement, not a specific area size.

D. Apply the ointment in a thick layer. A thick application is unnecessary and could increase absorption too quickly, leading to side effects such as headache, dizziness, and hypotension. Instead, a measured dose should be spread thinly and evenly onto clean, dry skin.

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