a patient is starting on alendronate fosamax for the treatment of osteoporosis what instructions should the nurse provide to ensure the effectiveness

ATI RN

ATI Pathophysiology

1. A patient is starting on alendronate (Fosamax) for the treatment of osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?

A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
B. Take the medication with milk to enhance calcium absorption.
C. Take the medication at bedtime to ensure absorption during sleep.
D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication with milk (choice B) is not recommended as it may interfere with alendronate absorption. Taking it at bedtime (choice C) is not necessary and may increase the risk of esophageal irritation. Taking the medication with food (choice D) can reduce its absorption and effectiveness.

2. During a home visit to a family of three: a mother, father, and their child, the mother tells the community nurse that the father (who is not present) had hit the child on several occasions when he was drinking. The mother further explains that she has talked her husband into going to Alcoholics Anonymous and asks the nurse not to interfere so her husband won’t get angry and refuse treatment. Which of the following is the best response of the nurse?

A. The nurse agrees not to interfere if the husband attends an Alcoholics Anonymous meeting that evening.
B. The nurse commends the mother’s efforts and agrees to let her handle things.
C. The nurse commends the mother’s efforts and also contacts protective services.
D. The nurse confronts the mother’s failure to protect the child.

Correct answer: C

Rationale: In this situation, the best response for the nurse is to commend the mother's efforts in seeking help for her husband by encouraging him to attend Alcoholics Anonymous. However, it is crucial for the nurse to also contact protective services to ensure the safety and well-being of the child. Option A is incorrect as it is not appropriate to condition non-interference on the husband attending a meeting that evening. Option B is incorrect because solely letting the mother handle things might put the child at risk. Option D is incorrect as it does not address the immediate need to ensure the child's safety through involving protective services.

3. When educating a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?

A. Oral contraceptives are 100% effective when taken correctly.
B. Oral contraceptives are effective immediately after starting.
C. Oral contraceptives are less effective if taken with antibiotics.
D. Oral contraceptives are less effective if taken with food.

Correct answer: C

Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics as they may interfere with the contraceptive's efficacy, potentially leading to decreased effectiveness. Therefore, patients should be advised to use additional contraception methods if they are also taking antibiotics. Choice A is incorrect because while oral contraceptives are highly effective, they are not 100% foolproof. Choice B is incorrect as oral contraceptives may take some time to reach their full effectiveness after starting. Choice D is incorrect since taking oral contraceptives with food does not necessarily impact their effectiveness.

4. Muscular dystrophy is a result of an abnormality of the muscle protein:

A. glycoprotein
B. dystrophin
C. troponin
D. actinomyosin

Correct answer: dystrophin

Rationale: Muscular dystrophy is primarily caused by mutations in the gene that provides instructions for making the protein dystrophin. Dystrophin plays a crucial role in maintaining the structure of muscle fibers. Glycoprotein is a general term for proteins with sugar molecules attached, not specifically related to muscular dystrophy. Troponin is a protein involved in muscle contraction regulation, and actinomyosin is not a specific muscle protein but a complex formed during muscle contraction. Therefore, the correct answer is dystrophin.

5. A hemoglobin electrophoresis is done to evaluate for sickle cell disease. The report reveals the person has HbAS, which means the person:

A. is normal with no sickle cell disease.
B. is a sickle cell carrier.
C. has sickle cell anemia.
D. has thalassemia.

Correct answer: B

Rationale: HbAS indicates sickle cell trait, not full-blown sickle cell anemia. Choice A is incorrect because HbAS indicates the presence of the sickle cell trait. Choice C is incorrect as sickle cell anemia is characterized by HbSS, not HbAS. Choice D is incorrect as thalassemia is a different type of hemoglobin disorder not indicated by HbAS.