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 B
Explanation
The nurse should make the statement “The client has hypoxemia after 10 minutes on a rebreather mask.” first. This is because SBAR (Situation- Background-Assessment-Recommendation) is a communication tool that helps provide essential, concise information, usually during crucial situations. The first component of SBAR is Situation, which is a concise statement of the problem.
The nurse should state the most urgent and relevant problem first, which is the client’s hypoxemia.
Choice A is wrong because it is not a clear statement of the situation.
It is vague and does not provide specific information about the client’s condition or vital signs.
It also expresses the nurse’s feeling rather than an objective assessment.
Choice C is wrong because it is part of the Assessment component of SBAR, not the Situation.
It provides numerical data about the client’s blood gas analysis, but it does not state the problem or the reason for calling the healthcare provider.
Choice D is wrong because it is part of the Background component of SBAR, not the Situation.
It provides pertinent and brief information related to the situation, such as the client’s medical history and diagnosis, but it does not state the current problem or concern.
Normal ranges for blood gas analysis are:
- PaO2: 80-100 mmHg
- PaCO2: 35-45 mmHg
- HCO3: 22-26 mEq/L
Hypoxemia is defined as a low level of oxygen in the blood, usually below 60 mmHg.
Correct Answer is C
Explanation
Motrin is a brand name for ibuprofen, which is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs can cause renal toxicity, especially in older adults and patients with renal disease.
Therefore, the nurse should be most concerned about this medication and its potential adverse effects on the patient’s kidney function.
Choice A is wrong because digoxin is a cardiac glycoside that is used to treat heart failure and atrial fibrillation. Digoxin has a narrow therapeutic index and can cause toxicity if the dose is too high or if the patient has hypokalemia. However, digoxin does not directly affect the kidneys and can be safely used in patients with renal disease if the dose is adjusted according to the patient’s creatinine clearance.
Choice B is wrong because levothyroxine is a synthetic thyroid hormone that is used to treat hypothyroidism. Levothyroxine does not have any major interactions with the kidneys and can be used in patients with renal disease without dose adjustment.
Choice D is wrong because Tylenol is a brand name for acetaminophen, which is an analgesic and antipyretic drug. Acetaminophen does not have any anti-inflammatory effects and does not affect the kidneys at therapeutic doses. However, acetaminophen can cause hepatotoxicity if the dose exceeds 4 g per day or if the patient has liver disease or alcohol abuse.
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