Choice A rationale

Risedronate is a type of medication known as a bisphosphonate, which is used to treat and prevent osteoporosis. It works by slowing bone loss to help maintain strong bones and reduce the risk of fractures. It’s important to take risedronate correctly to ensure it works effectively. One key instruction is that it should be taken with a full glass of plain water, at least 30 minutes before any food, beverage, or other medicines. This is because food and beverages can decrease the amount of risedronate absorbed by the body. Therefore, the nurse should instruct the client that it is necessary to take nothing but water with the medication.

Choice B rationale

Withholding the medication until the client’s breakfast tray is available on the unit would not be the best action. This is because risedronate needs to be taken as soon as you get out of bed in the morning and at least 30 minutes before any food, beverage, or other medicines. Waiting for the breakfast tray could delay the administration of the medication and potentially decrease its effectiveness.

Choice C rationale

Consulting with a pharmacist about scheduling the dose one hour after the client eats is not the best action. As mentioned earlier, risedronate should be taken at least 30 minutes before any food, beverage, or other medicines. Taking it after eating could decrease the amount of medication that is absorbed by the body, reducing its effectiveness.

Choice D rationale

Assigning an unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk is not the correct action. This is because risedronate should be taken with a full glass of plain water, not milk. In fact, taking risedronate with milk could decrease the amount of medication that is absorbed by the body.

Choice A rationale

Hypertension, or high blood pressure, is not typically a side effect of piperacillin-tazobactam. While it’s important to monitor a client’s blood pressure during any infusion, hypertension alone would not typically be a reason to stop the infusion of piperacillin-tazobactam.

Choice B rationale

A scratchy throat could be a sign of an allergic reaction to piperacillin-tazobactam. Allergic reactions to medications can range from mild to severe, and can include symptoms such as hives, difficulty breathing, and swelling in the face or throat. If a client reports a scratchy throat shortly after starting an infusion of piperacillin-tazobactam, it would be prudent for the nurse to stop the infusion and assess the client for other signs of an allergic reaction.

Choice C rationale

Bradycardia, or a slow heart rate, is not typically a side effect of piperacillin-tazobactam. While it’s important to monitor a client’s heart rate during any infusion, bradycardia alone would not typically be a reason to stop the infusion of piperacillin-tazobactam.

Choice D rationale

Pupillary constriction is not typically a side effect of piperacillin-tazobactam. While it’s important to monitor a client’s pupils during any infusion, pupillary constriction alone would not typically be a reason to stop the infusion of piperacillin-tazobactam.

Choice A rationale

Determining when the last dose was administered is an important step in managing a client’s pain. However, it should not be the first action taken when a client requests the largest possible dose of pain medication. The nurse first needs to assess the client’s current level of pain to determine the appropriate intervention.

Choice B rationale

Reviewing the history for past use of recreational drugs is an important part of a comprehensive pain assessment. However, it should not be the first action taken when a client requests the largest possible dose of pain medication. The nurse first needs to assess the client’s current level of pain to determine the appropriate intervention.

Choice C rationale

Asking the client to rate the current level of pain using a pain scale should be the first action the nurse takes when a client requests the largest possible dose of pain medication. Pain is subjective and can only be accurately assessed by the person experiencing it. Using a pain scale helps the nurse quantify the client’s pain and guide appropriate interventions.

Choice D rationale

Encouraging the client to use diversional thoughts to manage pain can be a helpful non- pharmacological pain management strategy. However, it should not be the first action taken when a client requests the largest possible dose of pain medication. The nurse first needs to assess the client’s current level of pain to determine the appropriate intervention.

Choice A rationale

Explaining that the client needs to allow for sleep time of at least two hours after taking zolpidem is not the best action. While it’s true that zolpidem should be taken right before going to sleep, the client’s plan to take a short afternoon nap may not provide enough time for the effects of the medication to wear off, which could lead to drowsiness and potential safety issues.

Choice B rationale

Advising the client to take the medication with the noon meal is not the best action. Zolpidem should be taken on an empty stomach right before going to sleep. Taking it with food or right after a meal may decrease its effectiveness.

Choice C rationale

Encouraging the client to wait until bedtime to take the medication is the best action. Zolpidem is a sedative-hypnotic medication used to treat insomnia. It works quickly to put you to sleep and should be taken right before going to bed. Taking it during the day could lead to drowsiness and potential safety issues.

Choice D rationale

Reminding the client to drink plenty of fluids when taking the medication is not the best action. While staying hydrated is generally good advice, it’s not specifically related to the use of zolpidem. The key instruction for zolpidem is to take it right before going to bed.

Choice A rationale

Diarrhea is a common side effect of many medications, including metoclopramide. However, it is not considered a serious adverse effect that would require immediate medical attention.

Choice B rationale

Unusual irritability can be a side effect of metoclopramide, but it is not the most serious adverse effect of this medication. It is important to monitor for changes in mood or behavior, but these changes do not typically require immediate medical intervention.

Choice C rationale

Nausea is actually one of the conditions that metoclopramide is used to treat. If a patient experiences nausea while taking this medication, it may indicate that the medication is not effectively managing the patient’s symptoms, but it is not considered a serious adverse effect.

Choice D rationale

Involuntary movements, also known as tardive dyskinesia, are a serious potential side effect of metoclopramide. This condition is characterized by repetitive, involuntary movements, most often affecting the lower face. Tardive dyskinesia can be irreversible, even after

discontinuation of the medication, and can be debilitating. Therefore, any signs of involuntary movements should be reported to a healthcare provider immediately.

Choice A rationale

Codeine is an opioid medication that can cause drowsiness and dizziness. This can increase the risk of falls, particularly in older adults or those with balance or mobility issues. Therefore, it is important to instruct the client to request assistance when ambulating to prevent falls.

Choice B rationale

While constipation is a common side effect of opioid medications like codeine, and a stool softener or laxative may be helpful in managing this side effect, it is not the highest priority nursing action. The risk of falls due to drowsiness or dizziness is a more immediate safety concern.

Choice C rationale

While it is important for the client to notify the nurse if the pain is not relieved, this is not the highest priority nursing action. The safety of the client is the primary concern, and preventing falls by providing assistance with ambulation is a more immediate need.

Choice D rationale

Advising the client that the medication should start to work in about 30 minutes is an important part of patient education, but it is not the highest priority nursing action. The safety of the client is the primary concern, and preventing falls by providing assistance with ambulation is a more immediate need.

Choice A rationale

While reducing salt intake is generally beneficial for clients with heart failure, replacing salt with a salt substitute is not recommended for clients taking spironolactone. Many salt

substitutes contain potassium, and spironolactone can cause high potassium levels in the blood.

Choice B rationale

Covering the skin before going outside is a general recommendation for sun protection, but it is not specifically related to the use of spironolactone.

Choice C rationale

Spironolactone is a potassium-sparing diuretic, which means it can cause the body to retain potassium. Therefore, clients taking this medication should be advised to limit their intake of high-potassium foods to prevent hyperkalemia, a potentially serious condition characterized by high levels of potassium in the blood.

Choice D rationale

While it is always important to monitor for signs of bruising, this is not the most critical instruction for a client taking spironolactone. The risk of hyperkalemia is a more immediate concern.

Choice A rationale

Erythromycin is an antibiotic that can potentially reduce the effectiveness of oral contraceptives. Therefore, patients who are taking both erythromycin and an oral contraceptive should be advised to use an additional form of contraception to prevent unintended pregnancy.

Choice B rationale

Immediately discontinuing the oral contraceptive is not necessary when taking erythromycin. Instead, the patient should be advised to use an additional form of contraception.

Choice C rationale

Ensuring a 12-hour gap between taking the medications is not a recommended strategy for managing the potential interaction between erythromycin and oral contraceptives. The patient should be advised to use an additional form of contraception.

Choice D rationale

Avoiding prolonged exposure to direct sunlight is a general recommendation for sun protection, but it is not specifically related to the use of erythromycin or oral contraceptives.

Choice A rationale

Tetracycline should not be consumed with milk or antacids. These substances contain calcium, which can bind to tetracycline in the stomach and reduce its absorption and effectiveness.

Choice B rationale

Tetracycline can make the skin more sensitive to sunlight, increasing the risk of sunburn. Patients should be advised to protect their skin from sunlight while taking this medication.

Choice C rationale

Taking tetracycline with orange juice is not recommended. Citrus fruits and juices contain calcium, which can bind to tetracycline in the stomach and reduce its absorption and effectiveness.

Choice D rationale

Returning to the clinic weekly for serum drug level checks is not typically necessary for patients taking tetracycline. While regular follow-up appointments may be needed to monitor the patient’s response to treatment, weekly serum drug level checks are not a standard part of tetracycline therapy.

Choice A rationale

Sucralfate is not typically administered once daily, preferably at bedtime. It is usually given multiple times a day.

Choice B rationale

Sucralfate should be given on an empty stomach, at least one hour before meals and at bedtime. This is because the absorption of sucralfate can be affected by the presence of food in the stomach.

Choice C rationale

While it’s important to monitor for infections when administering any medication, there’s no specific association between sucralfate and secondary Candida infections.

Choice D rationale

Sucralfate does not typically cause electrolyte imbalances. Its main function is to form a protective barrier over the ulcer, preventing further damage from acid and pepsin.