Nokea
A patient is taking alendronate (Fosamax) for osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?
- A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
- B. Take the medication at bedtime to ensure absorption during sleep.
- C. Take the medication with milk to enhance calcium absorption.
- D. Take the medication with food to prevent nausea.
Correct Answer: A
Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication at bedtime (choice B) is not recommended as it can lead to esophageal irritation when lying down. Taking the medication with milk (choice C) is incorrect as it may interfere with the absorption of alendronate. Taking the medication with food (choice D) is not recommended as it may reduce the effectiveness of the medication.
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Staff at the care facility note that a woman has started complaining of back pain in recent weeks and occasionally groans in pain. She has many comorbidities that require several prescription medications. The nurse knows that which factor is likely to complicate the clinician's assessment and treatment of the client's pain?
- A. Her advanced age may influence the expression and perception of pain.
- B. Her polypharmacy may complicate the pain management process.
- C. Her underlying conditions may mask or exacerbate the pain.
- D. Her cognitive function may decline, making pain assessment difficult.
Correct Answer: B
Rationale: Polypharmacy, or the use of multiple medications, can complicate pain management due to drug interactions and side effects. While advanced age can influence pain perception, it is not the most likely factor to complicate assessment and treatment in this scenario. Underlying conditions may affect pain perception but do not directly complicate the management process. Cognitive decline can hinder pain assessment, but in this case, the focus is on factors directly impacting the treatment process, making option B the most appropriate choice.
Why is a beta-blocker prescribed to a client with a history of myocardial infarction?
- A. To reduce myocardial oxygen demand.
- B. To increase cardiac output.
- C. To prevent arrhythmias.
- D. To prevent the development of angina.
Correct Answer: A
Rationale: The primary reason for administering a beta-blocker to a client with a history of myocardial infarction is to reduce myocardial oxygen demand. By reducing myocardial oxygen demand, beta-blockers help decrease the workload on the heart, making it easier for the heart to function effectively. This is crucial for clients with a history of myocardial infarction to prevent further damage to the heart. Choice B is incorrect because beta-blockers do not aim to increase cardiac output; instead, they help improve cardiac function by reducing workload. Choice C is incorrect because while beta-blockers can help prevent certain arrhythmias, the primary reason for their use in this case is to reduce myocardial oxygen demand. Choice D is incorrect as preventing angina is not the primary purpose of administering beta-blockers to a client with a history of myocardial infarction.
A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What key contraindication should the nurse review with the patient?
- A. Use of nitrates
- B. History of hypertension
- C. Use of antihypertensive medications
- D. Use of antihypertensive medications
Correct Answer: A
Rationale: The correct answer is A: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, so their combined use can lead to a dangerous drop in blood pressure. Choices B, C, and D are incorrect because while a history of hypertension or use of antihypertensive medications may influence treatment decisions, they are not the key contraindication specifically related to sildenafil use.
During childhood, the thymus decreases in size, and this is referred to as ______ atrophy.
- A. Physiologic
- B. Pathologic
- C. Disuse
- D. Neurogenic
Correct Answer: A
Rationale: The correct answer is A, 'Physiologic.' Physiologic atrophy is a normal part of development, like the reduction in thymus size during childhood. Pathologic atrophy (choice B) refers to tissue wasting due to disease, not a normal process like the reduction in thymus size. Disuse atrophy (choice C) results from a lack of physical activity or stimulation, which is not the case with thymus size reduction. Neurogenic atrophy (choice D) is caused by damage to or diseases of the nerves supplying the muscles, not related to the thymus size reduction seen in childhood.
Which statement best conveys an aspect of the role of cerebrospinal fluid (CSF)?
- A. CSF provides immune protection to the brain and spinal cord by serving as a physical barrier.
- B. CSF cushions the brain and spinal cord, protecting them from injury.
- C. CSF plays a limited role in the exchange of nutrients and waste products between the blood and brain.
- D. CSF functions primarily as a medium for the transmission of nerve impulses.
Correct Answer: B
Rationale: The correct answer is B. Cerebrospinal fluid primarily cushions the brain and spinal cord, protecting them from injury. Choice A is incorrect because while CSF contributes to the brain's immune environment, its main role is not providing immune protection as a physical barrier. Choice C is incorrect because CSF has a significant role in the exchange of nutrients and waste products, rather than a limited one. Choice D is incorrect as CSF is not primarily a medium for nerve impulse transmission, but rather serves as a protective and supportive fluid.