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 C
Explanation
This is because renal calculi can cause renal colic, which is a sudden and intense pain in the flank area that radiates to the groin or testicles.
The pain is caused by the stone obstructing the ureter and triggering spasms.
Choice A is wrong because a feeling of pressure in the bladder is more likely to indicate a lower urinary tract infection or an overactive bladder.
Choice B is wrong because a mild, burning pain when urinating is more likely to indicate a urinary tract infection or a urethral injury.
Choice D is wrong because a constant, dull, aching pain in the right upper quadrant is more likely to indicate a liver or gallbladder problem.
Normal ranges for urine pH are 4.5 to 8.0, and for specific gravity are 1.005 to 1.030.
Correct Answer is D
Explanation
“I feel uncomfortable praying with you, but I will find someone who won’t feel that way.” This statement by the nurse would best meet the client’s spiritual needs because it acknowledges the nurse’s own boundaries and feelings while also respecting the client’s request and finding a way to fulfill it.
Some possible explanations for why the other choices are wrong are:
Choice A is wrong because it does not address the client’s request to pray together and it assumes that the client wants a Bible without asking.
Choice B is wrong because it implies that the nurse does not want to pray with the client and that the client’s visitors would be more suitable for this task, which could make the client feel rejected or unsupported.
Choice C is wrong because it directly rejects the client’s request and discloses the nurse’s personal beliefs, which could create a sense of disconnection or conflict between the nurse and the client.
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