A nurse is teaching a client who has type 1 diabetes about insulin administration. Which of the following statements by the client indicates an understanding of the teaching?

Choice A reason: This is incorrect because alendronate is not safe during pregnancy, as it may harm the fetus or cause birth defects. The client should inform the provider if they are pregnant or planning to become pregnant before taking this medication.

Choice B reason: This is incorrect because the client should not lie down for at least 30 minutes after taking alendronate, as this may cause esophageal irritation, ulceration, or bleeding. The client should take alendronate with a full glass of water and swallow it whole, without chewing or crushing.

Choice C reason: This is incorrect because the client should not continue smoking while on alendronate, as smoking can worsen the bone loss and increase the risk of fractures. The client should quit smoking or reduce the amount of cigarettes they smoke.

Choice D reason: This is correct because the client should avoid alcohol with alendronate, as alcohol can also worsen the bone loss and increase the risk of fractures. Alcohol can also interact with alendronate and cause side effects, such as stomach upset, drowsiness, or liver damage.

Choice E reason: This is correct because the client should sit up for at least 30 minutes after taking alendronate, as this can prevent the medication from refluxing back into the esophagus and causing irritation, ulceration, or bleeding. The client should also avoid eating or drinking anything other than water for at least 30 minutes after taking alendronate, as this can reduce its absorption and effectiveness.

The correct answer is c. 2,525 mL.

Choice A reason:

1,350 mL is calculated by considering only the lactated Ringer’s IV intake. The calculation is as follows:

• Lactated Ringer’s IV at 150 mL/hr for 9 hr: 150 mL/hr × 9 hr = 1,350 mL. This option does not include the intake from cefazolin, packed RBCs, sodium chloride boluses, or famotidine.

Choice B reason:

1,600 mL is not a correct calculation based on the given intake. This value does not accurately sum up any combination of the provided intake components.

Choice C reason:

2,525 mL is the correct total intake. The detailed calculation is:

• Lactated Ringer’s IV at 150 mL/hr for 9 hr: 150 mL/hr × 9 hr = 1,350 mL.
• Cefazolin in 100 mL of 0.9% sodium chloride: 100 mL.
• Two units of packed RBCs: 275 mL + 250 mL = 525 mL.
• Two IV bolus infusions of 250 mL of 6.0% sodium chloride: 250 mL + 250 mL = 500 mL.
• Famotidine in 50 mL of 0.9% sodium chloride: 50 mL.

Adding these together: 1,350 mL + 100 mL + 525 mL + 500 mL + 50 mL = 2,525 mL.

Choice D reason:

2,100 mL is not a correct calculation based on the given intake. This value does not accurately sum up any combination of the provided intake components.