A female client with osteoporosis has been taking a weekly dose of oral risedronate for several weeks. The client calls the clinic nurse to report increasing “heartburn.” How should the nurse respond?

Ask the client to describe how she takes the medication.

Suggest use of an antacid two hours after the medication.

Remind the client to take the medication with plenty of water.

Advise the client to go to the nearest emergency department.

Answer and Explanation

The Correct Answer is A

A) Asking the client to describe how she takes the medication is the most appropriate initial response by the nurse. “Heartburn” reported after taking risedronate raises concerns about potential esophageal irritation or gastroesophageal reflux disease (GERD) exacerbation. Understanding the client’s administration technique (e.g., whether she takes the medication with a full glass of water and remains upright for at least 30 minutes afterward) can help identify potential causes of the reported symptoms.

B) While suggesting the use of an antacid two hours after the medication may provide symptomatic relief, it does not address the underlying issue of potential esophageal irritation or GERD exacerbation related to risedronate administration. Moreover, if the client’s symptoms are due to esophageal irritation, using an antacid may mask the symptoms without addressing the cause.

C) Reminding the client to take the medication with plenty of water is a standard recommendation for bisphosphonate administration to minimize the risk of esophageal irritation and ensure proper drug absorption. However, since the client is already experiencing “heartburn,” further assessment of the client’s medication administration technique is warranted before providing this reminder.

D) Advising the client to go to the nearest emergency department is not appropriate at this stage, as the reported symptom of “heartburn” does not suggest an immediate life-threatening emergency. However, if the client experiences severe chest pain, difficulty swallowing, or signs of a severe allergic reaction (e.g., swelling of the face or throat, difficulty breathing), emergency medical attention would be necessary.

Therefore, the nurse should first assess the client’s medication administration technique to determine if improper administration may be contributing to the reported symptoms. Based on this assessment, appropriate interventions can be provided to address potential esophageal irritation or GERD exacerbation.

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Correct Answer is B

Explanation

Recommend use of an over-the-counter antipyretic: While treating fever with an antipyretic like acetaminophen or ibuprofen may provide symptomatic relief, the priority in this scenario is to assess for other adverse effects of the medication. Fever can be a sign of an allergic reaction or other adverse effects to the antibiotic. Therefore, it is important to first assess for other symptoms before recommending symptomatic treatment.

B) Determine if other adverse effects have developed: This is the correct answer. The onset of a low-grade fever after starting a new medication, such as amoxicillin, warrants further assessment for other adverse effects. The nurse should inquire about other symptoms the client may be experiencing, such as rash, itching, swelling, difficulty breathing, or gastrointestinal disturbances, which could indicate an allergic reaction or other adverse effects.

C) Ask if the medication has been kept refrigerated: While it is important to ensure proper storage of medications, such as amoxicillin, which may require refrigeration, the onset of a low-grade fever is not typically related to medication storage. Therefore, this action would not address the client’s current symptoms and concerns.

D) Instruct the client to increase oral fluid intake: While maintaining adequate hydration is important for overall health and may help manage symptoms of illness, such as fever, the priority in this scenario is to assess for other adverse effects of the medication. Therefore, increasing oral fluid intake alone would not address the potential adverse effects of amoxicillin.

A. Obtain transportation to the emergency department. B. Increase Intake of fluids and high protein foods. C. Stop taking the medication Immediately. D. Avoid hazardous activities until symptoms subside.

Correct Answer is D

Explanation

A) Obtaining transportation to the emergency department may be unnecessary at this time. The client's sy’ptoms of fatigue and dizziness are likely side effects of the new medication, baclofen, and not indicative of a medical emergency. It's es’ential to assess the severity of symptoms and provide appropriate guidance before considering emergency care.

B) Increasing intake of fluids and high-protein foods may be beneficial for overall health but is not directly related to addressing the side effects of baclofen. While adequate hydration and nutrition are essential, this recommendation may not specifically address the client's sy’ptoms of fatigue and dizziness.

C) Stopping the medication immediately without consulting a healthcare provider is not advisable. Abruptly discontinuing baclofen can lead to withdrawal symptoms and a potential worsening of muscle spasticity. It's cr’cial for the client to discuss any concerns or side effects with their healthcare provider before making any changes to their medication regimen.

D) Advising the client to avoid hazardous activities until symptoms subside is the most appropriate action. Baclofen, as a muscle relaxant, can cause dizziness and fatigue, which may impair the client's ab’lity to safely engage in activities such as driving or operating machinery. By avoiding hazardous activities, the client can reduce the risk of injury or accidents while experiencing these side effects.

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A female client with osteoporosis has been taking a weekly dose of oral risedronate for several weeks. The client calls the clinic nurse to report increasing “heartburn.” How should the nurse respond?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Six days after starting a prescription of an oral amoxicillin solution, a client calls the clinic to report the onset of a low grade fever. Which action should the nurse Implement?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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