A 51-year-old woman will be taking selective estrogen receptor modulators (SERMs) as part of treatment for postmenopausal osteoporosis. The nurse reviews potential contraindications, including which condition?

Choice A reason: This is incorrect because alendronate is not safe during pregnancy, as it may harm the fetus or cause birth defects. The client should inform the provider if they are pregnant or planning to become pregnant before taking this medication.

Choice B reason: This is incorrect because the client should not lie down for at least 30 minutes after taking alendronate, as this may cause esophageal irritation, ulceration, or bleeding. The client should take alendronate with a full glass of water and swallow it whole, without chewing or crushing.

Choice C reason: This is incorrect because the client should not continue smoking while on alendronate, as smoking can worsen the bone loss and increase the risk of fractures. The client should quit smoking or reduce the amount of cigarettes they smoke.

Choice D reason: This is correct because the client should avoid alcohol with alendronate, as alcohol can also worsen the bone loss and increase the risk of fractures. Alcohol can also interact with alendronate and cause side effects, such as stomach upset, drowsiness, or liver damage.

Choice E reason: This is correct because the client should sit up for at least 30 minutes after taking alendronate, as this can prevent the medication from refluxing back into the esophagus and causing irritation, ulceration, or bleeding. The client should also avoid eating or drinking anything other than water for at least 30 minutes after taking alendronate, as this can reduce its absorption and effectiveness.

Choice A reason: The client waits 10 min between inhalations is not the correct answer. This is not a recommended practice for using an albuterol inhaler. The client should wait at least 1 min between inhalations to allow the medication to reach the lungs and avoid overdose.

Choice B reason: The client takes a quick inhalation while releasing the medication from the inhaler is the correct answer. This is the correct way to use an albuterol inhaler. The client should breathe in quickly and deeply while pressing down on the inhaler to release the medication. This ensures that the medication is delivered to the airways and not the mouth or throat.

Choice C reason: The client exhales as the medication is released from the inhaler is not the correct answer. This is not a recommended practice for using an albuterol inhaler. The client should exhale before using the inhaler, not during or after. Exhaling while using the inhaler can cause the medication to be wasted or to irritate the mouth or throat.

Choice D reason: The client holds his breath for 10 seconds after inhaling the medication is not the correct answer. This is not a recommended practice for using an albuterol inhaler. The client should hold his breath for only a few seconds after inhaling the medication, not 10 seconds. Holding the breath for too long can cause dizziness, headache, or chest discomfort.