A patient will be starting therapy with a corticosteroid. The nurse reviews the prescriber's orders and notes that an interaction may occur if the corticosteroid is taken with which of these drug classes?

Choice A reason: This is incorrect because lispro insulin is a rapid-acting insulin that does not need to be administered with another type of insulin. However, the patient may need a long-acting or intermediate-acting insulin to provide basal coverage throughout the day.

Choice B reason: This is incorrect because lispro insulin has a peak action of 30 to 90 min after the injection, which means that the patient is at the highest risk of hypoglycemia during this time. The nurse should assess for hypoglycemia more frequently than 4 hr after the injection.

Choice C reason: This is correct because lispro insulin has a fast onset of action of 15 to 30 min after the injection, which means that the patient should eat a meal within 15 min of the injection to prevent hypoglycemia.

Choice D reason: This is incorrect because polyuria is a sign of hyperglycemia, not hypoglycemia. The nurse should monitor for polyuria before the insulin injection, as it may indicate that the patient's blood glucose level is high.

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.