Nursing Elites

1. When educating a client about the use of risedronate to treat osteoporosis, which instruction should be included?

• A. Drink a full glass of water with each dose.
• B. Take the medication on an empty stomach.
• C. Remain upright for 30 minutes after taking the medication.
• D. Avoid lying down for at least 1 hour after taking the medication.

Correct answer: C

Rationale: The correct instruction for a client taking risedronate to treat osteoporosis is to remain upright for 30 minutes after taking the medication. This is important to prevent esophageal irritation, as risedronate can cause irritation if it remains in contact with the esophagus. By staying upright, the medication is more likely to reach the stomach quickly and reduce the risk of irritation to the esophagus. Choices A, B, and D are incorrect. Drinking a full glass of water is recommended, not milk, to help with swallowing the medication. Risedronate should be taken on an empty stomach, not with meals, to ensure proper absorption. Additionally, avoiding lying down for at least 1 hour after taking the medication helps prevent esophageal irritation.

2. The nurse is caring for a client receiving anticoagulant therapy. Which instruction should the nurse reinforce with the client to prevent bleeding complications?

• A. Use a soft-bristle toothbrush and electric razor.
• B. Increase your intake of vitamin K-rich foods.
• C. Take aspirin if you have a headache.
• D. Avoid using ice packs for injuries.

Correct answer: A

Rationale: The correct instruction to prevent bleeding complications in a client on anticoagulant therapy is to use a soft-bristle toothbrush and an electric razor. These implements help reduce the risk of bleeding by being gentle on the skin and reducing the chances of cuts or abrasions that could lead to bleeding in individuals on anticoagulants. Choice B is incorrect because increasing intake of vitamin K-rich foods can interfere with the action of anticoagulants. Choice C is incorrect as aspirin is a blood thinner and can increase the risk of bleeding when combined with anticoagulant therapy. Choice D is incorrect as ice packs can help reduce bleeding and swelling in injuries, but in a client on anticoagulant therapy, it is important to avoid potential trauma to the skin that could lead to bleeding.

3. A client with hypertension is prescribed a thiazide diuretic. What instruction should the nurse reinforce to the client?

• A. Take the medication in the morning.
• B. Increase potassium intake in the diet.
• C. Weigh yourself daily.
• D. Limit fluid intake to 2 liters per day.

Correct answer: C

Rationale: The correct answer is to weigh oneself daily. This instruction is important as daily weights help monitor fluid loss and are crucial for detecting early signs of fluid imbalance when taking a diuretic. Weighing daily allows for timely adjustments in treatment and helps prevent complications associated with fluid imbalance. Choice A is not directly related to the client's need for monitoring fluid balance. Choice B, although important for some diuretics, is not specific to thiazide diuretics. Choice D is not appropriate as limiting fluid intake without proper monitoring can lead to dehydration, especially when taking diuretics.

4. A client has a new prescription for atenolol. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Monitor heart rate daily.
• C. Avoid eating foods high in potassium.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct answer is to monitor heart rate daily. Atenolol is a beta-blocker that can lead to bradycardia, a condition characterized by a slow heart rate. Monitoring the heart rate daily is essential to detect any abnormal changes promptly, allowing for timely medical intervention if necessary. Choice A is incorrect because atenolol can be taken with or without food. Choice C is irrelevant as atenolol does not interact with potassium-rich foods. Choice D is incorrect as atenolol is usually taken in the morning to help manage blood pressure throughout the day.

5. What predisposing factor most likely contributed to the proximal end of the femur fracture in a 62-year-old woman who lives alone and tripped on a rug in her home?

• A. Failing eyesight leading to an unsafe environment
• B. Renal osteodystrophy from chronic kidney disease (CKD)
• C. Osteoporosis from declining hormone levels
• D. Cerebral vessel changes causing transient ischemic attacks

Correct answer: C

Rationale: The most likely predisposing factor contributing to the proximal end of the femur fracture in a 62-year-old woman is osteoporosis resulting from declining hormone levels. Osteoporosis weakens the bones, making them more susceptible to fractures, especially in older adults, particularly women. In this case, the fracture can be attributed to the bone density loss associated with osteoporosis, which is a common concern in postmenopausal women. Choices A, B, and D are less likely to have directly contributed to the femur fracture in this scenario. Failing eyesight may increase the risk of falls but does not directly weaken the bones. Renal osteodystrophy affects bone health but is less common in this age group. Cerebral vessel changes causing transient ischemic attacks are related to vascular issues, not bone strength.

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