A client has been recently started on phenelzine, a monoamine oxidase inhibitor (MAOI) for depression.
Which statement indicates that the client requires further educational reinforcement about the medication?

Take this medication at least 30 minutes before ingesting any food or medication.

This is because alendronate (Fosamax) is a bisphosphonate that works by inhibiting the breakdown and reabsorption of bone. However, it has a very low bioavailability, which means that only a small amount of the drug is absorbed into the bloodstream when taken orally. Therefore, taking it with food or other medications can interfere with its absorption and reduce its effectiveness.

The other choices are wrong because:

A. Chew the tablet well and report any difficulty swallowing. This is wrong because alendronate tablets should not be chewed or crushed, but swallowed whole with a full glass of plain water. Chewing or crushing the tablets can increase the risk of irritation or damage to the esophagus (the tube that connects the mouth to the stomach). Difficulty swallowing is a possible side effect of alendronate and should be reported to the doctor, but it is not an instruction for taking the medication.

B. Take the medication with six to eight ounces of milk. This is wrong because milk contains calcium, which can bind to alendronate and prevent its absorption. Alendronate should not be taken with any beverages other than plain water.

C. Lie down for 15 to 30 minutes after taking the medication. This is wrong because lying down after taking alendronate can increase the risk of esophageal irritation or

ulceration. Alendronate should be taken in the morning, at least 30 minutes before eating or drinking anything, and the person should remain upright (sitting or standing) for at least 30 minutes after taking it.

Normal ranges for bone density are expressed as T-scores, which compare a person’s bone density to that of a healthy young adult of the same sex. A T-score of -1.0 or above is normal, a T-score between -1.0 and -2.5 indicates low bone density (osteopenia), and a T-score of -2.5 or below indicates osteoporosis.

This is because furosemide is a diuretic that makes you pee more and lose water and electrolytes such as potassium and sodium.

Therefore, you should avoid foods that are high in sodium or potassium, such as bananas, oranges, cranberries, and bagels with cream cheese.

You should also drink plenty of fluids to prevent dehydration.

Choice A is wrong because oatmeal with a banana, milk, and orange juice contains too much potassium, which can cause irregular heartbeat or muscle weakness when taking furosemide.

Choice B is wrong because blueberry muffins, cranberry juice, and herbal tea contain too much sodium and sugar, which can raise your blood pressure and worsen your heart failure.

Choice D is wrong because a bagel with low-fat cream cheese and decaffeinated coffee contains too much sodium and caffeine, which can cause fluid retention and increase your heart rate.

Normal ranges for potassium are 3.5 to 5.0 mmol/L and for sodium are 135 to 145 mmol/L.

You should monitor your electrolyte levels regularly when taking furosemide.