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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Free Nursing Study Resources

Correct Answer is ["133"]

Explanation

The nurse should program the infusion pump to deliver approximately 133 ml/hour.

Here's how we can calculate the rate:

Total volume of infusion (mL): 200 mL (dextrose 5% in water)

Infusion time (minutes): 90 minutes

We need to convert the infusion time to hours for the pump rate calculation:

Infusion time (hours) = 90 minutes / 60 minutes/hour

Infusion time (hours) = 1.5 hours

Now, calculate the flow rate (mL/hr):

Flow rate (mL/hr) = Total volume (mL) / Infusion time (hours)

Flow rate (mL/hr) = 200 mL / 1.5 hours

Flow rate (mL/hr) = 133.33 mL/hr (round to nearest whole number as requested)

Therefore, the nurse should program the pump to deliver 133 ml/hour.

A. Decreased blood urea nitrogen. B. Hearing has decreased. C. Reports of photophobia. D. White blood cell count of 6,000/mm3 (6 x 10/1)

Correct Answer is B

Explanation

A) Decreased blood urea nitrogen (BUN) is not a typical adverse effect of gentamicin. Gentamicin is primarily associated with nephrotoxicity (kidney damage), which would manifest as an increased BUN and serum creatinine rather than a decrease.

B) Hearing loss is a well-known adverse effect of gentamicin, particularly when the drug reaches high concentrations in the inner ear (ototoxicity). Gentamicin can cause irreversible damage to the cochlear and vestibular organs, leading to sensorineural hearing loss and balance disturbances.

C) Reports of photophobia are not typically associated with gentamicin. Photophobia (sensitivity to light) may occur with certain eye conditions or central nervous system disorders but is not a direct adverse effect of gentamicin.

D) A white blood cell count of 6,000/mm3 falls within the normal reference range, so it does not indicate an adverse effect of gentamicin. Gentamicin is not known to directly affect white blood cell count.

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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

Correct Answer is ["133"]

Explanation

A male client has been receiving the antibiotic gentamicin sulfate, IV piggyback every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin? Reference Range: White Blood Cell [5000 to 10,000/mm3 (5 to 10 x 10%)]

Correct Answer is B

Explanation

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