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A client with osteoporosis has a new prescription for alendronate. Which of the following instructions should the nurse provide?
- A. Take the medication with a meal.
- B. Remain upright for at least 30 minutes after taking the medication.
- C. Take the medication with a glass of juice.
- D. Take the medication with milk or food.
Correct Answer: B
Rationale: The correct instruction for a client taking alendronate is to remain upright for at least 30 minutes after administration. This is essential to prevent esophageal irritation and ensure the medication reaches the stomach properly. Remaining upright reduces the risk of side effects such as esophagitis. Choices A, C, and D are incorrect as alendronate should not be taken with a meal, juice, milk, or food to optimize its absorption and effectiveness.
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A client with thrombophlebitis receiving heparin by continuous IV infusion asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?
- A. It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level.
- B. A pharmacist is the person to answer that question.
- C. Heparin does not dissolve clots. It stops new clots from forming.
- D. The oral medication you will take after this IV will dissolve the clot.
Correct Answer: C
Rationale: The correct response is C. Heparin does not dissolve clots; it prevents new clots from forming. Heparin works by inhibiting the formation of new clots and the extension of existing clots, rather than directly dissolving them. The client should be informed that the purpose of heparin therapy is to prevent the clot from getting larger and to reduce the risk of new clots forming. Choices A, B, and D are incorrect. Choice A talks about reaching a therapeutic blood level of heparin, which is not related to clot dissolution. Choice B deflects the question to a pharmacist without providing relevant information. Choice D inaccurately suggests that an oral medication will dissolve the clot, which is not the mechanism of action for heparin.
When a nurse assesses a client's IV catheter insertion site and notes a hematoma, which of the following actions should the nurse take? (Select all that apply.)
- A. Stop the infusion.
- B. Apply alcohol to the insertion site.
- C. Apply warm compresses to the insertion site.
- D. Elevate the client's arm.
Correct Answer: C
Rationale: When a nurse detects a hematoma at the IV catheter insertion site, applying warm compresses is beneficial as it can promote healing by enhancing circulation and reducing swelling. Elevating the client's arm helps in reducing edema, which can relieve pressure, pain, and further bleeding in the hematoma area. Stopping the infusion may be necessary in certain situations, but it is not a standard action for all hematoma cases. Applying alcohol to the insertion site is discouraged as it can cause irritation and may not aid in resolving the hematoma.
A client has a prescription for a Nitroglycerin transdermal patch. Which of the following instructions should be included by the healthcare provider?
- A. Apply the patch to a hairless area of the body.
- B. Remove the patch every 12 hours.
- C. Massage the patch after applying it.
- D. Place the patch over a hairless area of the body.
Correct Answer: D
Rationale: The correct instruction for a Nitroglycerin transdermal patch is to place it over a hairless area of the body. This is essential to ensure proper adhesion and consistent absorption of the medication. Hair can impede the patch's ability to stick to the skin and deliver the medication effectively. Therefore, choices A, B, and C are incorrect. Applying the patch to the same site every day (Choice A) may lead to skin irritation, removing the patch every 12 hours (Choice B) is not typically recommended for Nitroglycerin patches, and massaging the patch after applying it (Choice C) could alter its integrity and affect drug delivery.
When teaching a client with a prescription for Phenytoin, which of the following instructions should the nurse include?
- A. Expect the development of a mild rash.
- B. Take the medication on an empty stomach.
- C. Monitor for signs of gingival hyperplasia.
- D. Increase your intake of calcium.
Correct Answer: C
Rationale: Phenytoin is known to cause gingival hyperplasia, a condition characterized by overgrowth of gum tissue. The nurse should instruct the client to monitor for signs of gingival hyperplasia, such as swollen or bleeding gums. Good oral hygiene practices are essential to prevent or manage this side effect. Choices A, B, and D are incorrect. Phenytoin does not typically cause a mild rash, should be taken with food to reduce gastrointestinal upset, and does not warrant an increase in calcium intake.
A healthcare professional is about to administer Propranolol to a patient. The healthcare professional takes the patient's apical pulse and documents it as 58 bpm. How should the healthcare professional proceed?
- A. Administer the medication as prescribed
- B. Administer half of the normal dose
- C. Consider the extended-release form of the medication
- D. Withhold administration of the medication and notify the healthcare provider
Correct Answer: D
Rationale: When a patient's apical pulse is 58 bpm, it is below the normal range. Propranolol is a beta-blocker that can further lower the heart rate. Therefore, it is crucial to withhold the medication and notify the healthcare provider to evaluate the patient's condition. Administering Propranolol in this situation can exacerbate bradycardia, leading to serious complications. Choosing to administer the medication as prescribed (Choice A) can put the patient at risk. Administering half of the normal dose (Choice B) without healthcare provider guidance is not appropriate in this case. Considering the extended-release form of the medication (Choice C) does not address the immediate concern of bradycardia and is not the best course of action.