Nokea
The nurse is providing patient teaching about the oral bisphosphonate alendronate (Fosamax). Which statement by the patient indicates a good understanding of when this drug should be taken?
- A. I will take it in the evening just before bedtime.
- B. I will take it in the morning with an 8-ounce glass of water.
- C. I will take it with the first bite of the morning meal.
- D. I will take it between meals on an empty stomach.
Correct Answer: B
Rationale: Alendronate must be taken in the morning with 6â??8 ounces of water, followed by staying upright for 30 minutes, to prevent esophageal irritation. Taking it with food or at other times is incorrect.
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The nurse is reviewing the use of uterine tocolytics, such as indomethacin (Indocin). Which statement best describes the indication for these drugs?
- A. Prevention of preterm labor in the 15th week of pregnancy
- B. Prevention of preterm labor in the 22nd week of pregnancy
- C. Stimulation of contractions in prolonged labor
- D. Stimulation of ovulation as part of infertility treatments
Correct Answer: B
Rationale: Tocolytics like indomethacin are used to prevent preterm labor between 20 and 37 weeks, such as at 22 weeks, by relaxing uterine smooth muscle. They do not stimulate contractions or ovulation.
A patient who is taking the bisphosphonate alendronate has been instructed to lie flat in bed for 2 days after having ophthalmic surgery. Which intervention is appropriate at this time?
- A. She will continue to take the alendronate with water.
- B. She cannot take the alendronate until she can sit up for 30 minutes.
- C. She can take the medication with breakfast.
- D. She will stop taking the medication 72 hours before her surgery.
Correct Answer: B
Rationale: Alendronate requires the patient to remain upright for 30 minutes post-dose to prevent esophageal damage. Lying flat post-surgery necessitates withholding the drug until the patient can sit up.
The nurse recognizes that use of estrogen drugs is contraindicated in which patient?
- A. A patient who has atrophic vaginitis
- B. A patient who has inoperable prostate cancer
- C. A woman who has just given birth and wants to prevent postpartum lactation
- D. A woman with a history of thrombophlebitis
Correct Answer: D
Rationale: Estrogen increases the risk of thromboembolism, making it contraindicated in patients with a history of thrombophlebitis. Atrophic vaginitis and inoperable prostate cancer are indications for estrogen therapy, and it is not used to prevent lactation.
The nurse is preparing to administer the contraceptive form of medroxyprogesterone. What route is appropriate?
- A. Subcutaneous
- B. Intramuscular
- C. Vaginal
- D. Transdermal
Correct Answer: B
Rationale: Medroxyprogesterone (Depo-Provera) as a contraceptive is administered intramuscularly for sustained release. Other routes are not appropriate for this formulation.
A patient wants to try an oral soy product to relieve perimenopausal symptoms. The nurse will assess the patient's medication history for which potential drug interaction?
- A. Thyroid replacement therapy
- B. Oral anticoagulant therapy
- C. Nonsteroidal anti-inflammatory drugs
- D. Beta blockers
Correct Answer: A
Rationale: Oral soy can interfere with thyroid hormone absorption, reducing its efficacy. It does not significantly interact with anticoagulants, NSAIDs, or beta blockers.