Which instruction should a nurse give to a client taking alendronate (Fosamax) for osteoporosis?
Chew the tablet well and report any difficulty swallowing.
Take the medication with six to eight ounces of milk.
Lie down for 15 to 30 minutes after taking the medication.
Take this medication at least 30 minutes before ingesting any food or medication.
The Correct Answer is D
Take this medication at least 30 minutes before ingesting any food or medication.
This is because alendronate (Fosamax) is a bisphosphonate that works by inhibiting the breakdown and reabsorption of bone. However, it has a very low bioavailability, which means that only a small amount of the drug is absorbed into the bloodstream when taken orally. Therefore, taking it with food or other medications can interfere with its absorption and reduce its effectiveness.
The other choices are wrong because:
A. Chew the tablet well and report any difficulty swallowing. This is wrong because alendronate tablets should not be chewed or crushed, but swallowed whole with a full glass of plain water. Chewing or crushing the tablets can increase the risk of irritation or damage to the esophagus (the tube that connects the mouth to the stomach). Difficulty swallowing is a possible side effect of alendronate and should be reported to the doctor, but it is not an instruction for taking the medication.
B. Take the medication with six to eight ounces of milk. This is wrong because milk contains calcium, which can bind to alendronate and prevent its absorption. Alendronate should not be taken with any beverages other than plain water.
C. Lie down for 15 to 30 minutes after taking the medication. This is wrong because lying down after taking alendronate can increase the risk of esophageal irritation or
ulceration. Alendronate should be taken in the morning, at least 30 minutes before eating or drinking anything, and the person should remain upright (sitting or standing) for at least 30 minutes after taking it.
Normal ranges for bone density are expressed as T-scores, which compare a person’s bone density to that of a healthy young adult of the same sex. A T-score of -1.0 or above is normal, a T-score between -1.0 and -2.5 indicates low bone density (osteopenia), and a T-score of -2.5 or below indicates osteoporosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
“Since I am taking Clozaril, I will need to have bloodwork performed weekly for six months.” This indicates that the client understands that Clozaril (clozapine) is an antipsychotic medication that can affect the immune system and cause a serious blood disorder called agranulocytosis. The client needs to have regular blood tests to monitor the white blood cell count and prevent infections.
Choice B is wrong because Clozaril can cause urinary retention, not decreased urination. The client should be advised to report any difficulty or pain when urinating.
Choice C is wrong because Clozaril is not a PRN medication. It should be taken regularly as prescribed by the doctor to maintain a therapeutic level and prevent relapse of psychotic symptoms.
Choice D is wrong because Clozaril is not available over the counter or in a generic form. It is a controlled substance that requires a special program and a certified pharmacy to dispense it.
Correct Answer is B
Explanation
.“I need to receive 3 doses of hepatitis B vaccination to assure protection.” This statement indicates that the person understands that hepatitis B is a serious infection that can be prevented by vaccination.
Hepatitis B vaccine is given as a series of 3 shots over a period of 6 months.
Choice A is wrong because hepatitis A is not usually transmitted through unprotected sex, but through ingestion of contaminated food or water or direct contact with an infected person.
Hepatitis A can also be prevented by vaccination.
Choice C is wrong because hepatitis C can be transmitted through IV drug use, as well as blood transfusions, organ transplants, needlestick injuries, and sharing personal items such as razors or toothbrushes with an infected person.
Hepatitis C can cause chronic liver disease and there is no vaccine for it.
Choice D is wrong because there is a vaccine for hepatitis A, which can provide lifelong protection against the infection.
Hepatitis A usually does not require treatment and most people recover completely within a few weeks. There is no specific medication to cure hepatitis
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