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 D

Explanation

A) Sensitivity to the sun can develop: St. John's wo’t can increase photosensitivity, making the skin more prone to sunburn. Therefore, clients should be advised to use sunscreen and protective clothing when exposed to sunlight.

B) Hard candy can be used for a dry mouth: Dry mouth is a common side effect of St. John's wo’t. Suggesting the use of hard candy can help alleviate the discomfort associated with dry mouth by stimulating saliva production.

C) Insomnia may occur while taking the medication: St. John's wo’t may cause insomnia or exacerbate existing sleep disturbances. Clients should be informed about this potential side effect so they can monitor their sleep patterns and seek appropriate management if needed.

D) Another form of contraception is not needed: This statement requires further instruction. St. John's wo’t can decrease the effectiveness of hormonal contraceptives, including birth control pills, patches, and rings. Therefore, clients using hormonal contraceptives should be advised to use additional or alternative methods of contraception to prevent unintended pregnancy.

A. Acetaminophen. B. Prednisone. C. Captopril. D. Omeprazole.

Correct Answer is A

Explanation

A) Acetaminophen is metabolized by the liver, and jaundice can indicate liver dysfunction or impairment. Therefore, the nurse should notify the healthcare provider about the scheduled acetaminophen to ensure appropriate monitoring of liver function and to consider alternative pain management options.

B) Prednisone is a corticosteroid that primarily affects the immune system and inflammation and is not directly metabolized by the liver. While prednisone can have side effects related to liver function, such as hepatotoxicity, jaundice is not a common manifestation.

C) Captopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension and heart failure. While it can affect renal function, jaundice is not a typical side effect of captopril.

D) Omeprazole is a proton pump inhibitor (PPI) used to reduce gastric acid production and treat conditions such as gastroesophageal reflux disease (GERD). It is primarily metabolized in the liver, but jaundice is not a common side effect associated with its use.

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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

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Explanation

Correct Answer is A

Explanation

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