The nurse is preparing to administer alendronate to a patient with osteoporosis. Which of the following actions will the nurse implement initially?
- A. Ensure the patient has recently eaten.
- B. Ask about any leg cramps or hot flashes.
- C. Assist the patient to sit up at the bedside.
- D. Administer the prescribed calcium carbonate.
Correct Answer: C
Rationale: To avoid esophageal erosions, the patient taking bisphosphonates should be upright for at least 30 minutes after taking the medication. Fosamax should be taken on an empty stomach, not after taking other medications or eating. Leg cramps and hot flashes are not adverse effects of bisphosphonates.
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The nurse is caring for a patient who has acute osteomyelitis and is receiving tobramycin 80 mg IV twice daily. Which of the following actions should the nurse take before administering the gentamicin?
- A. Ask the patient about any nausea.
- B. Obtain the patient's oral temperature.
- C. Change the prescribed wet-to-dry dressing.
- D. Review the patient's blood urea nitrogen (BUN) and creatinine levels.
Correct Answer: D
Rationale: Gentamicin is nephrotoxic and can cause renal failure. Monitoring the patient's temperature before gentamicin administration is not necessary. Nausea is not a common adverse effect of IV gentamicin. There is no need to change the dressing before gentamicin administration.
Which of the following menu choices by a patient with osteoporosis indicates that the nurse's teaching about appropriate diet has been effective?
- A. Pancakes with syrup and bacon
- B. Whole wheat toast and fruit jelly
- C. Two-egg omelet and a half grapefruit
- D. Oatmeal with skim milk and fruit yogurt
Correct Answer: D
Rationale: Skim milk and yogurt are high in calcium. The other choices do not contain any high calcium foods.
The nurse is teaching a patient with persistent back pain, whose work involves lifting, about proper body mechanics. Which of the following patient statements indicates that the teaching has been effective?
- A. I plan to start doing exercises to strengthen the muscles of my back.
- B. I will try to sleep with my hips and knees extended to prevent back strain.
- C. I can tell my boss that I need to change to a job where I can work at a desk.
- D. I will keep my back straight when I need to lift anything higher than my waist.
Correct Answer: A
Rationale: Exercises can help to strengthen the muscles that support the back. Flexion of the hips and knees places less strain on the back. Modifications in the way the patient lifts boxes is needed as well as reminding that sitting for prolonged periods can aggravate back pain. The patient should not lift above the level of the elbows.
The nurse is teaching a patient with a bunion how to prevent further deformity. Which of the following patient statements indicates that more teaching is required?
- A. I will throw away my high heel shoes.
- B. I will use the bunion pad to relieve the pain.
- C. I will need to wear open sandals at all times.
- D. I will take ibuprofen when I need it.
Correct Answer: C
Rationale: The patient can wear shoes that have a wide forefoot. The other patient statements indicate that the teaching has been effective.
Which of the following assessment findings should alert the nurse to the presence of osteoporosis in an older adult patient?
- A. Measurable loss of height
- B. Presence of bowed legs
- C. Aversion to dairy products
- D. Statements about frequent falls
Correct Answer: A
Rationale: Osteoporosis occurring in the vertebrae produces a gradual loss of height. Bowed legs are associated with osteomalacia. Low intake of dairy products is a risk factor for osteoporosis, but it does not indicate that osteoporosis is present. Frequent falls increase the risk for fractures but are not an indicator of osteoporosis.
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