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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

“I will discard unused pills after six months after replacing it with a new vial.” This statement indicates that the client understands that nitroglycerin tablets lose their potency over time and need to be replaced regularly.

Choice B is wrong because nitroglycerin can cause headaches as a side effect, but the client should not stop taking it if they have chest pain. They can use Tylenol for pain relief.

Choice C is wrong because nitroglycerin can cause hypotension and dizziness, so the client should avoid lying down or changing positions suddenly after taking it. They should sit or stand still until the chest pain subsides.

Choice D is wrong because a tingling feeling on the tongue is a normal sensation when taking sublingual nitroglycerin and does not indicate an adverse reaction. It also confirms that the tablet is potent and effective.

A. Place the arm across the client’s chest to support the wrist. B. Use a wrist restraint to decrease mobility in the arm. C. Apply an arm board to immobilize the wrist. D. Instruct client to limit use of that arm.

Correct Answer is C

Explanation

This is because immobilizing the wrist prevents kinking or dislodgement of the intravenous catheter and reduces the risk of complications such as infiltration, phlebitis, or infection.

Some additional information for the response are:

Choice A is wrong because placing the arm across the client’s chest may compromise venous return and increase the risk of thrombosis.

Choice B is wrong because using a wrist restraint may cause skin breakdown, nerve damage, or impaired circulation.

Choice D is wrong because instructing the client to limit use the of that arm may not be sufficient to prevent catheter movement or accidental removal.

Normal ranges for venous access depend on the type and location of the catheter, but some general values are: potassium (3 to 5 mEq/L), blood urea nitrogen (10 to 20 mg/dL), and central venous pressure (8 to 12 mmHg).

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Which instruction should a nurse give to a client taking alendronate (Fosamax) for osteoporosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which statement made by a client taking nitroglycerin as needed (prn) indicates understanding of the instructions for safe use of this drug?

Correct Answer is A

Explanation

A client with difficult venous access has an intravenous insertion site located at the bend of the wrist. Which action would be most appropriate for a nurse to take?

Correct Answer is C

Explanation

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