a patient is starting on alendronate fosamax for osteoporosis what instructions should the nurse provide to ensure the effectiveness of the medication

ATI RN

Pathophysiology Practice Exam

1. A patient is starting on alendronate (Fosamax) for osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?

A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
B. Take the medication at bedtime to ensure absorption during sleep.
C. Take the medication with milk to enhance calcium absorption.
D. Take the medication with food to prevent gastrointestinal upset.

Correct answer: A

Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper absorption. Choice B is incorrect because taking alendronate at bedtime can increase the risk of esophageal irritation due to lying down. Choice C is incorrect as taking alendronate with milk can reduce its absorption. Choice D is incorrect because alendronate should be taken on an empty stomach to enhance its effectiveness.

2. A 20-year-old college student has presented to her campus medical clinic for a scheduled Pap smear. The clinician who will interpret the smear will examine cell samples for evidence of:

A. Changes in cell shape, size, and organization
B. Presence of unexpected cell types
C. Ischemic changes in cell sample
D. Abnormally high numbers of cells

Correct answer: A

Rationale: The correct answer is changes in cell shape, size, and organization (Choice A). Pap smears are performed to detect potential precancerous or cancerous conditions by examining the cells for any abnormalities in their shape, size, or organization. This helps in identifying early signs of cervical cancer. Choices B, C, and D are incorrect because Pap smears primarily focus on detecting cellular changes associated with cancer, not unexpected cell types, ischemic changes, or abnormally high numbers of cells.

3. Which of the following imbalances is found in clients with syndrome of inappropriate antidiuretic hormone (SIADH)?

A. Decreased insulin production
B. Decreased antidiuretic hormone (ADH) production
C. Increased secretion of antidiuretic hormone (ADH)
D. Increased production of insulin

Correct answer: C

Rationale: The correct answer is C: Increased secretion of antidiuretic hormone (ADH). Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by the excessive release of ADH, which leads to water retention and dilution of blood sodium levels. Choices A, B, and D are incorrect because SIADH is not associated with decreased insulin production, decreased ADH production, or increased production of insulin.

4. Which of the following are manifestations of Cushing syndrome?

A. Truncal obesity with thin extremities.
B. Enlargement of face, hands, and feet.
C. Cachexia.
D. Thick scalp hair.

Correct answer: A

Rationale: Truncal obesity with thin extremities is a classic manifestation of Cushing syndrome due to the redistribution of fat. Enlargement of face, hands, and feet is seen in conditions like acromegaly, not Cushing syndrome. Cachexia is a state of severe weight loss and muscle wasting, typically seen in conditions like cancer or advanced infections. Thick scalp hair is not typically associated with Cushing syndrome.

5. Which immunoglobulin is the first to appear in response to a new antigen?

A. IgA
B. IgG
C. IgE
D. IgM

Correct answer: D

Rationale: The correct answer is IgM. IgM is the first immunoglobulin to appear in response to a new antigen. It is produced initially during the primary immune response. IgA is mainly found in mucosal areas and secretions. IgG is produced in a secondary immune response and is the most abundant immunoglobulin in the bloodstream. IgE is involved in allergic reactions and parasitic infections, not the initial response to a new antigen.