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A client with osteoporosis is prescribed alendronate. The practical nurse (PN) should reinforce which instruction regarding the administration of this medication?
- A. Take the medication with a full glass of water before breakfast.
- B. Take the medication immediately after a meal.
- C. Lie down for 30 minutes after taking the medication.
- D. Crush the medication and mix it with food.
Correct Answer: A
Rationale: The correct instruction for administering alendronate is to take the medication with a full glass of water before breakfast. This timing is crucial to ensure proper absorption in the body and reduce the risk of esophageal irritation. Taking it immediately after a meal or lying down for 30 minutes after may affect absorption and increase the risk of adverse effects. It should not be crushed or mixed with food to maintain its effectiveness.
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A client has a prescription for heparin 1,000 units IV STAT. Several pre-filled syringes of low molecular weight heparin are available in the client's medication drawer. Which action should the nurse implement?
- A. Dilute the available heparin in 250ml of normal saline solution prior to IV administration
- B. Advise the pharmacy on the need to deliver a vial of heparin to the nursing unit immediately
- C. Calculate and administer the equivalent dose of the available low molecular weight heparin
- D. Request a prescription to change the route of administration and use the available heparin
Correct Answer: B
Rationale: In this scenario, the nurse should contact the pharmacy to obtain the correct heparin formulation as the prescription calls for heparin 1,000 units IV STAT. Low molecular weight heparin is not the same as unfractionated heparin, and therefore, the nurse should not administer the available low molecular weight heparin without first obtaining the correct medication. Diluting the available heparin, calculating an equivalent dose, or changing the route of administration would not address the discrepancy between the prescribed heparin and the available low molecular weight heparin.
A client with severe rheumatoid arthritis is prescribed adalimumab. The nurse should monitor for which potential adverse effect?
- A. Increased risk of infection
- B. Bone marrow suppression
- C. Hair loss
- D. Hyperglycemia
Correct Answer: A
Rationale: The correct answer is A: Increased risk of infection. Adalimumab is known to increase the risk of infection due to its immunosuppressive effects. Patients on adalimumab should be closely monitored for signs and symptoms of infection, such as fever, chills, and malaise, and should promptly report any such symptoms to their healthcare provider for further evaluation and management. Monitoring for infection is crucial to prevent serious complications in patients receiving adalimumab therapy.
A client who is in the rehabilitation facility with newly diagnosed Parkinson's disease (PD) has levodopa-carbidopa prescribed. During the care planning session for this client, the nurse discusses which aspects with the other members of the health care team? (Select all that apply.)
- A. Ask the dietician to avoid increasing the amounts of foods high in Vitamin B6.
- B. Lessening of tremors
- C. Remind others on the team that this medication will not relieve all symptoms of PD.
- D. Ask the evening shift nurses to give the last dose earlier in the day if the client has insomnia.
Correct Answer: D
Rationale: Levodopa-carbidopa is a medication commonly used in the treatment of Parkinson's disease (PD). It can cause side effects such as hypotension with sudden position changes. To assist the client in managing this side effect, the physical therapy assistant can help avoid sudden position changes. Additionally, if insomnia occurs, adjusting the timing of the last dose earlier in the day can be beneficial. It is important to note that drowsiness can also be a side effect of the medication and should be reported to the nurse. Foods high in Vitamin B6 can interfere with the absorption of levodopa-carbidopa; hence, it is advisable to avoid increasing the consumption of such foods. Lastly, it is crucial to remind the team that while this medication helps alleviate symptoms like tremors, it may not relieve all symptoms of PD comprehensively.
A client with a diagnosis of schizophrenia is prescribed lurasidone. The nurse should monitor the client for which potential side effect?
- A. Weight gain
- B. Dry mouth
- C. Nausea
- D. Headache
Correct Answer: A
Rationale: The correct answer is A: Weight gain. When a client is prescribed lurasidone, monitoring for weight gain is essential as lurasidone can cause this side effect. Patients on lurasidone should have their weight monitored regularly to detect any changes that may occur. Options B, C, and D are not typically associated with lurasidone use, making them less likely to be a direct side effect of this medication.
A client who received a prescription for cyclosporine ophthalmic emulsion for dry eyes asks the practical nurse (PN) if it is safe to continue using artificial tears. What information should the PN provide?
- A. Avoid using artificial tears because they decrease the efficacy of cyclosporine.
- B. Discontinue the use of both products if transient blurring occurs after administration.
- C. Allow a 15-minute interval between the administration of cyclosporine and artificial tears.
- D. Discontinue the use of cyclosporine and artificial tears when tear production reaches a normal level.
Correct Answer: C
Rationale: The correct answer is to allow a 15-minute interval between the administration of cyclosporine and artificial tears. Cyclosporine, an ophthalmic emulsion that increases tear production, can be used in conjunction with artificial tears as long as the products are administered 15 minutes apart. This interval helps to prevent any potential interactions between the two products and ensures optimal effectiveness of cyclosporine for treating dry eyes.