A client has a new prescription for alendronate to treat osteoporosis. Which of the following instructions should be included?

Correct Answer: B

Rationale: In pharmacology, it is crucial to understand the administration instructions for each medication to ensure optimal effectiveness and minimize adverse effects. For alendronate, the correct instruction is to take the medication first thing in the morning on an empty stomach. This is because alendronate is a bisphosphonate drug used to treat osteoporosis, and it is best absorbed in an acidic environment on an empty stomach. Taking it with food, a full glass of milk, or with meals can decrease its absorption and efficacy. Educationally, this question highlights the importance of understanding medication administration guidelines to achieve desired therapeutic outcomes. Teaching students about the specific instructions for each medication helps them provide safe and effective patient care. Emphasizing the rationale behind the correct answer reinforces the pharmacological principles involved in drug absorption and bioavailability, which are essential for nursing practice. By contrasting the incorrect options, students learn to critically think about the implications of incorrect medication administration and its impact on patient outcomes.

Correct Answer: A

Rationale: Mesna, an uroprotectant agent, is administered with nitrogen mustard chemotherapy drugs like Cyclophosphamide to prevent hemorrhagic cystitis, a common adverse effect. Mesna works by binding to and inactivating the toxic metabolites of Cyclophosphamide in the bladder, thereby reducing the risk of bladder toxicity.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B) An older adult client with prostatitis. When administering antimicrobial therapy, it is essential to monitor for antibiotic toxicity, especially in older adults due to age-related changes in drug metabolism and excretion. Prostatitis typically requires longer antibiotic courses, increasing the risk of toxicity. Option A) An adolescent client with a sinus infection is less likely to experience antibiotic toxicity compared to the older adult with prostatitis. Sinus infections generally respond well to antibiotics without prolonged therapy. Option C) A client who is postpartum with mastitis may require antibiotics but is not as prone to toxicity compared to the older adult with prostatitis. The focus here would be more on monitoring infection resolution and lactation support. Option D) A middle-aged client with a urinary tract infection may need antibiotics, but the risk of toxicity is lower compared to the older adult with prostatitis. Monitoring for treatment effectiveness and potential side effects would be important in this case. Educationally, understanding patient-specific factors such as age, diagnosis, and treatment duration is crucial in determining the risk of antibiotic toxicity. Monitoring for adverse effects and adjusting therapy as needed is a key component of providing safe and effective pharmacological care.

Correct Answer: B

Rationale: In pharmacology, understanding the timing of peak serum levels of medications like gentamicin is crucial for effective dosing and monitoring of drug levels. In this scenario, when gentamicin is administered via IV infusion for 1 hour at 0900, the peak serum level is typically expected around 1030. The correct answer is B) 1030 because peak levels of gentamicin are usually measured 30 minutes after completion of a 1-hour IV infusion. This timing allows for the drug to reach its maximum concentration in the bloodstream, providing valuable information on its pharmacokinetics and efficacy. Option A) 1000 is too early for a peak level as it does not allow enough time for the drug to distribute and reach its peak concentration. Option C) 1100 and Option D) 1130 are both too late for peak levels as the drug would have already peaked and started to decline by these times. Educationally, this question highlights the importance of understanding drug pharmacokinetics, infusion timing, and peak levels in clinical practice. It reinforces the need for precise timing when monitoring drug levels to ensure optimal therapeutic outcomes and avoid potential toxicity.

Correct Answer: C

Rationale: The correct answer is fever. Amphotericin B is known to cause adverse effects such as fever, chills, and nausea during infusion. Monitoring for fever is essential as it can indicate an adverse reaction. To manage these effects, pretreatment with diphenhydramine and acetaminophen can be administered.