Nokea
The client with postmenopausal osteoporosis is prescribed the bisphosphonate alendronate (Fosamax). Which discharge instruction should the nurse discuss with the client?
- A. The medication must be taken with the breakfast meal only.
- B. Remain upright for at least 30 minutes after taking medication.
- C. The tablet should be chewed thoroughly before swallowing.
- D. Stress the importance of having monthly hormone levels.
Correct Answer: B
Rationale: Alendronate requires upright posture for 30 minutes post-dose to prevent esophageal irritation, per FDA guidelines. Meal timing, chewing, or hormone levels are incorrect.
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The male client is self-medicating with the H-2 antagonist cimetidine (Tagamet). Which complication can occur while taking this medication?
- A. Melena.
- B. Gynecomastia.
- C. Pyrosis.
- D. Eructation.
Correct Answer: B
Rationale: Cimetidine can cause gynecomastia due to antiandrogen effects, especially in males. Melena, pyrosis, or eructation are unrelated.
A nurse who has been named in a lawsuit can use which of these factors for the best protection in a court of law?
- A. Clinical specialty certification in the associated area of practice
- B. Documentation on the specific client record with a focus on the nursing process
- C. Yearly evaluations and proficiency reports prepared by nurse's manager
- D. Verification of provider's orders for the plan of care with identification of outcomes
Correct Answer: B
Rationale: Documentation is the key to protect nurses when a lawsuit is filed. The thorough documentation should include all steps of the nursing process - assessment, analysis, plan, intervention, evaluation.
A 17-year-old client has been recently diagnosed as having diabetes mellitus Type 1. Insulin is prescribed. The client asks why insulin can't be taken by mouth. What is the best answer for the nurse to give?
- A. Insulin is irritating to the stomach.
- B. Oral insulin is too rapidly absorbed.
- C. Gastric juices destroy insulin.
- D. You can take it by mouth when the acute phase is over.
Correct Answer: C
Rationale: Insulin is a protein destroyed by gastric enzymes, requiring injection for effective delivery.
The elderly client is in a long-term care facility. If the client does not have a daily bowel movement in the morning, he requests a cathartic, bisacodyl (Dulcolax). Which action is most important for the nurse to take?
- A. Ensure the client gets a cathartic daily.
- B. Discuss the complications of a daily cathartic.
- C. Encourage the client to increase fiber in the diet.
- D. Refuse to administer the medication to the client.
Correct Answer: B
Rationale: Daily cathartics risk dependence and electrolyte imbalance; discussing complications educates and promotes safer alternatives like fiber.
The client with type 2 diabetes is diagnosed with gout and prescribed allopurinol (Zyloprim). Which instruction should the nurse discuss when teaching about this medication?
- A. The client will probably develop a red rash on the body.
- B. The client should drink two (2) to three (3) liters of water a day.
- C. The client should take this medication on an empty stomach.
- D. The client will need to increase oral diabetic medications.
Correct Answer: B
Rationale: Allopurinol increases uric acid excretion, risking kidney stones; 2–3 L water daily prevents this. Rash is possible but not probable, stomach timing is flexible, and diabetes meds are unaffected.