Nokea
Which instruction should be given to the client taking alendronate sodium (Fosamax)?
- A. Take the medication before arising.
- B. Force fluids while taking this medication.
- C. Remain upright for 30 minutes after taking this medication.
- D. Take the medication in conjunction with estrogen.
Correct Answer: C
Rationale: Alendronate sodium is a drug used to treat osteoporosis. The drug causes gastric reflux, so the client should remain upright for 30 minutes after taking it and take it with only water. Taking it before arising or with estrogen is incorrect, and forcing fluids is not necessary.
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An adult is being discharged from the emergency room with instructions to apply a cold pack to his sprained ankle. The client asks why it is necessary to use a cold pack. The nurse replies that the cold pack will do which of the following?
- A. Keep the sprain from becoming a fracture
- B. Prevent bruising and ecchymosis from occurring
- C. Keep the client from developing a fever
- D. Help reduce swelling and pain
Correct Answer: D
Rationale: Cold packs reduce swelling and pain by constricting blood vessels and numbing the area, aiding sprain recovery. They don't prevent fractures, bruising, or fever.
The nurse is teaching a client with a new diagnosis of osteoarthritis about celecoxib (Celebrex). Which of the following instructions should the nurse include?
- A. Take the medication with grapefruit juice
- B. Report any black, tarry stools
- C. Stop the medication if pain decreases
- D. Avoid regular joint exams
Correct Answer: B
Rationale: Black, tarry stools indicate gastroinTest inal bleeding, a serious celecoxib side effect. Options A, C, and D are incorrect: grapefruit juice is irrelevant, stopping the medication may not be advised, and exams are needed.
The nurse is caring for a client with a chest tube. On the second postoperative day, the chest tube accidentally disconnects from the drainage tube. The first action the nurse should take is
- A. reconnect the tube
- B. raise the collection chamber above the client's chest
- C. call the health care provider
- D. clamp the chest tube
Correct Answer: D
Rationale: Immediate steps should be taken to prevent air from entering the chest cavity. Lung collapse may occur if air enters the chest cavity. Clamping the tube close to the client's chest is the first action to take, followed by health care provider notification.
A 38-year-old woman, mother of two, has a mastectomy for breast cancer.
- A. Which client response one month after a mastectomy indicates a normal reaction to the surgery?
- B. I have been helping my family deal with their feelings about the surgery.'
- C. I have been having difficulty coping with the surgery and cry frequently.'
- D. I have been unable to leave the house or talk to my friends about the surgery.'
- E. I am doing just great since the surgery and have gone back to work at my job.'
Correct Answer: B
Rationale: Frequent crying and difficulty coping one month post-mastectomy reflect a normal grieving process for the loss of a body part. Helping family cope is premature, social withdrawal indicates abnormal adjustment, and immediate return to normal activities suggests denial, which is too early for integration.
Which of the following lab values might the nurse expect to see in a client with Addison's disease?
- A. WBC 10,000
- B. BUN 22
- C. $\mathrm{K}+3.5 \mathrm{mEq} / \mathrm{L}$
- D. $\mathrm{Na}+142 \mathrm{mEq} / \mathrm{L}$
Correct Answer: C
Rationale: Addison's disease causes hyperkalemia (elevated potassium, not 3.5 mEq/L, which is normal) and hyponatremia due to adrenal insufficiency.