Nursing Elites

1. Alendronate (Fosamax) is prescribed for a client with osteoporosis. The client taking this medication is instructed to:

• A. Take the medication at bedtime.
• B. Take the medication in the morning with breakfast.
• C. Lie down for 30 minutes after taking the medication.
• D. Take the medication with a full glass of water after rising in the morning.

Correct answer: D

Rationale: Alendronate (Fosamax) should be taken with a full glass of water after rising in the morning to prevent gastrointestinal side effects and increase absorption. Taking the medication with a full glass of water and in an upright position after waking up helps decrease the risk of esophageal irritation and enhances the drug's effectiveness by ensuring proper absorption in the gastrointestinal tract.

2. A client who has begun taking fosinopril (Monopril) is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. The nurse provides the best support to the client by:

• A. Telling the client not to take the medication with food
• B. Suggesting that the client taper the dose until taste returns to normal
• C. Informing the client that impaired taste is expected and generally disappears in 2 to 3 months
• D. Requesting that the health care provider (HCP) change the prescription to another brand of angiotensin-converting enzyme (ACE) inhibitor

Correct answer: C

Rationale: The correct answer is to inform the client that impaired taste is an expected side effect of ACE inhibitors like fosinopril, such as Monopril, and typically resolves within 2 to 3 months. It is essential for the nurse to offer reassurance and education to the client about this common side effect to alleviate distress and encourage compliance with the medication regimen.

3. A client is taking levothyroxine (Synthroid) for hypothyroidism. Which symptom would indicate to the nurse that the client is taking too much medication?

• A. Bradycardia
• B. Lethargy
• C. Tremors
• D. Constipation

Correct answer: C

Rationale: When a client is taking an excessive dose of levothyroxine (Synthroid), it can lead to symptoms of hyperthyroidism. Tremors are a common sign of excessive medication, along with tachycardia and insomnia. Bradycardia, lethargy, and constipation are typical symptoms of hypothyroidism, indicating that the client may require a higher dose of levothyroxine rather than too much.

4. A client who is taking hydrochlorothiazide (HydroDIURIL, HCTZ) has been started on triamterene (Dyrenium) as well. The client asks the nurse why both medications are required. The nurse formulates a response, based on the understanding that:

• A. Both are weak potassium-losing diuretics.
• B. The combination of these medications prevents renal toxicity.
• C. Hydrochlorothiazide is less expensive, so using a combination of diuretics is cost-effective.
• D. Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic.

Correct answer: D

Rationale: The combination of triamterene and hydrochlorothiazide is used because triamterene is a potassium-sparing diuretic, which helps retain potassium, while hydrochlorothiazide is a potassium-losing diuretic, which promotes potassium excretion. This combination helps balance potassium levels in the body, preventing imbalances that can occur when using potassium-losing diuretics alone.

5. Cycloserine (Seromycin) is added to the medication regimen for a client with tuberculosis. Which of the following would the nurse include in the client-teaching plan regarding this medication?

• A. To take the medication after meals
• B. To return to the clinic weekly for serum drug-level testing
• C. To call the health care provider (HCP) if a skin rash occurs
• D. To restrict alcohol intake with this medication

Correct answer: B

Rationale: Cycloserine requires weekly serum drug level determinations to monitor for neurotoxicity. The medication must be taken after meals, and the client should avoid alcohol. Additionally, the client should report any signs of skin rash or central nervous system toxicity to the healthcare provider.

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