Nursing Elites

1. A nurse is teaching a client who has a new prescription for alendronate. Which of the following instructions should the nurse include in the teaching?

• A. Take this medication at bedtime.
• B. Take this medication with food.
• C. Remain upright for at least 30 minutes after taking this medication.
• D. Avoid taking this medication with calcium-rich foods.

Correct answer: C

Rationale: The correct answer is C: 'Remain upright for at least 30 minutes after taking this medication.' This instruction is crucial when taking alendronate as it reduces the risk of esophagitis by preventing the medication from irritating the esophagus. Choice A is incorrect because alendronate should be taken in the morning, not at bedtime, to enhance absorption. Choice B is incorrect as alendronate should be taken on an empty stomach, preferably in the morning, with a full glass of water. Choice D is incorrect as there are no specific restrictions on taking alendronate with calcium-rich foods.

2. A nurse is providing teaching to a client who has a new diagnosis of osteoporosis and is prescribed alendronate. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Take this medication with a full glass of water after meals.
• C. Take this medication on an empty stomach with a full glass of water.
• D. You can take this medication at any time of day.

Correct answer: C

Rationale: Correct Answer: C. Alendronate should be taken on an empty stomach with a full glass of water to ensure proper absorption. Choice A is incorrect because alendronate should not be taken with food. Choice B is incorrect because alendronate should be taken on an empty stomach, not after meals. Choice D is incorrect because alendronate should be taken at a specific time following the instructions given.

3. A nurse is teaching a client who has a new prescription for fluoxetine. Which of the following statements should the nurse include?

• A. "You should expect to feel an improvement in your symptoms within 1 week."
• B. "You may experience weight gain while taking this medication."
• C. "You should take this medication in the morning to prevent insomnia."
• D. "You should stop taking this medication if you experience dry mouth."

Correct answer: B

Rationale: The correct statement the nurse should include is that the client may experience weight gain while taking fluoxetine. Weight gain is a common side effect of fluoxetine, and patients should be informed about this potential issue. Stating that the client should expect improvement in symptoms within 1 week (Choice A) is incorrect as fluoxetine may take a few weeks to have a noticeable effect. Taking the medication in the morning to prevent insomnia (Choice C) is not necessary since fluoxetine can be taken at any time of the day. Instructing the client to stop taking the medication if experiencing dry mouth (Choice D) is misleading, as dry mouth is a common but usually not serious side effect of fluoxetine.

4. A nurse is caring for a client who has an indwelling urinary catheter. Which of the following interventions should the nurse implement to prevent catheter-associated infections?

• A. Change the catheter every 24 hours
• B. Ensure the drainage bag is positioned above the bladder
• C. Perform routine irrigation of the catheter
• D. Empty the drainage bag every 4 hours

Correct answer: B

Rationale: The correct answer is to ensure the drainage bag is positioned above the bladder. This positioning prevents urine reflux into the bladder, reducing the risk of catheter-associated infections. Changing the catheter too frequently (Choice A) can actually increase the risk of infection by introducing pathogens. Performing routine catheter irrigation (Choice C) is no longer recommended as it can increase the risk of infection by introducing bacteria. Emptying the drainage bag every 4 hours (Choice D) is a standard practice to prevent urinary stasis but is not directly related to preventing catheter-associated infections.

5. A nurse is assessing a client who is postoperative following a hip arthroplasty. Which of the following findings is the priority for the nurse to report?

• A. Heart rate of 90/min
• B. Blood pressure of 118/76 mm Hg
• C. Warmth and redness in the calf
• D. Pink-tinged urine

Correct answer: C

Rationale: The correct answer is C, warmth and redness in the calf. These symptoms may indicate a deep vein thrombosis (DVT), a serious complication following hip arthroplasty that requires immediate attention. A heart rate of 90/min and blood pressure of 118/76 mm Hg are within normal ranges for a postoperative client and do not indicate an urgent issue. Pink-tinged urine may suggest blood in the urine, which should be monitored but is not as critical as the potential DVT.

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