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A patient with osteoporosis is administered risedronate at 0700 and requests a glass of milk to take with the medication. What should the nurse’s response be?
- A. Advise the patient to only consume water with the medication.
- B. Delay the medication until the patient’s breakfast tray arrives.
- C. Consult with a pharmacist about administering the dose one hour post-meal.
- D. Assign an unlicensed assistive personnel to bring the patient a glass of low-fat milk.
Correct Answer: A
Rationale: This question is identical to Question 1. Risedronate requires plain water on an empty stomach (A) to ensure absorption. Milk (D) reduces efficacy. Delaying for breakfast (B) or post-meal dosing (C) violates guidelines. Note: Duplicate question; consider removing.
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A client with benign prostatic hyperplasia has been prescribed tamsulosin. What should the nurse do to monitor for an adverse reaction?
- A. Monitor the client’s blood pressure.
- B. Assess the client’s urine output.
- C. Perform a bladder scan.
- D. Obtain the client’s daily weights.
Correct Answer: A
Rationale: This question is identical to Question 29. Tamsulosin can cause hypotension (A), necessitating blood pressure monitoring. Urine output (B), bladder scans (C), and weights (D) don’t address adverse effects. Note: Duplicate question; consider removing.
The nurse is preparing to administer the anti-ulcer gastrointestinal agent sucralfate to a patient with peptic ulcer disease. What should be included in this patient’s care plan?
- A. Administer sucralfate once daily, preferably at bedtime.
- B. Give sucralfate on an empty stomach.
- C. Monitor for a secondary Candida infection.
- D. Monitor for electrolyte imbalances.
Correct Answer: B
Rationale: Sucralfate forms a protective barrier over ulcers and should be given on an empty stomach (B), 1 hour before meals or at bedtime, for optimal efficacy. Once-daily dosing (A) is incorrect; it’s typically 4 times daily. Candida infection (C) and electrolyte imbalances (D) are not associated with sucralfate.
After taking orlistat for one week, a female patient tells the home health nurse that she is experiencing increasingly frequent oily stools and gas. What action should the nurse take?
- A. Ask the patient to describe her dietary intake history for the last several days.
- B. Advise the patient to stop taking the drug and contact her healthcare provider.
- C. Instruct the patient to increase her intake of saturated fats over the next week.
- D. Obtain a stool specimen to evaluate for occult blood and fat content.
Correct Answer: A
Rationale: Orlistat inhibits fat absorption, causing oily stools and gas if dietary fat is high. Assessing dietary intake (A) identifies the cause. Stopping the drug (B) is premature. Increasing fats (C) worsens symptoms. Stool testing (D) is unnecessary for known side effects.
A client is receiving intravenous vancomycin, and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times would provide the best determination of these levels?
- A. One hour after completion of the IV dose and one hour before the next administration of the medication.
- B. Two hours after completion of the IV dose and two hours before the next administration of the medication.
- C. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication.
- D. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.
Correct Answer: A
Rationale: Vancomycin peak levels are drawn 1 hour post-infusion, and trough levels 1 hour pre-dose (A) for accurate therapeutic monitoring. Two-hour intervals (B) miss peak/trough. Mid-infusion (C) is too early for peak. Immediate post-dose (D) underestimates peak.
A client with atrial fibrillation has been prescribed dabigatran. What instruction should the nurse include in this client’s teaching plan?
- A. Eliminate spinach and other green vegetables from the diet.
- B. Avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
- C. Continue to obtain scheduled laboratory bleeding tests.
- D. Keep an antidote available in case of hemorrhage.
Correct Answer: B
Rationale: Dabigatran increases bleeding risk; avoiding NSAIDs (B) reduces this risk. Spinach (A) affects warfarin, not dabigatran. Routine bleeding tests (C) aren’t required for dabigatran. Antidotes (D) like idarucizumab are hospital-administered, not kept at home.