Which instruction should a nurse give to a client taking alendronate (Fosamax) for osteoporosis?

Chew the tablet well and report any difficulty swallowing.

Take the medication with six to eight ounces of milk.

Lie down for 15 to 30 minutes after taking the medication.

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

Answer and Explanation

The Correct Answer is D

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.

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Correct Answer is D

Explanation

The question asks how many milligrams of the medication will be in 1 mL of D5W. To find this, we need to know the concentration of the medication in the solution.

Concentration is the amount of medication per unit volume of solution. We can use this formula:

Concentration = Mass / Volume

We know that 250 mg of the medication is diluted in 500 mL of D5W. So we can plug these values into the formula:

Concentration = 250 mg / 500 mL Simplifying, we get:

Concentration = 0.5 mg / mL

This means that there are 0.5 mg of the medication in every 1 mL of D5W. So the answer is

To check our answer, we can use another formula:

Mass = Concentration x Volume

If we want to find the mass of the medication in 1 mL of D5W, we can multiply the concentration by the volume:

Mass = 0.5 mg / mL x 1 mL Simplifying, we get:

Mass = 0.5 mg

This matches our answer.

The other choices are wrong because they do not use the correct formula or values. Here is why:

Choice A is wrong because it uses the inverse of the concentration (1 / 0.5) instead of the concentration (0.5).

Choice B is wrong because it uses the mass of the medication (250 mg) instead of the concentration (0.5 mg / mL).

A. Slice of cheese pizza, french fries, and a glass of orange juice. B. Cheeseburger, potato chips, and a glass of soda. C. Chicken breast, green beans, and a glass of milk. D. Spaghetti and meatballs, a roll, and chocolate pudding.

Correct Answer is C

Explanation

Chicken breast, green beans, and a glass of milk. This is because chicken breast is a good source of protein, which is essential for wound healing. Green beans are rich in vitamin C, which helps with collagen synthesis and immune function. Milk is a good source of calcium and vitamin D, which are important for bone health and healing.

Choice A is wrong because cheese pizza and french fries are high in fat and sodium, which can increase inflammation and delay wound healing. Orange juice is high in sugar, which can also impair wound healing and increase the risk of infection.

Choice B is wrong because cheeseburger and potato chips are also high in fat and sodium, and have similar effects as choice A. Soda is also high in sugar and can cause dehydration, which can slow down wound healing.

Choice D is wrong because spaghetti and meatballs are high in refined carbohydrates, which can spike blood sugar levels and impair wound healing.

A roll is also a refined carbohydrate and does not provide much fiber or nutrients. Chocolate pudding is high in sugar and fat, and can also worsen wound healing.

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Which instruction should a nurse give to a client taking alendronate (Fosamax) for osteoporosis?

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