A patient with osteoporosis calls the nurse in the doctor s office to report that she has forgotten to take her weekly bisphosphonate (alendronate [Fosamax]) for 2 days past the weekly time. The nurse should advise the patient to:

Correct Answer: C

Rationale: Bisphosphonates like alendronate are taken weekly to slow bone loss in osteoporosis, with strict timing to maximize absorption and minimize side effects. Missing it by 2 days means taking it late could overlap with the next dose, risking irritation or reduced efficacy. Taking it now is tempting but disrupts the schedule. Two doses 3 days apart or doubling up now with a snack (which impairs absorption) violate dosing guidelines, potentially causing esophageal harm. Skipping this week and resuming next week maintains the regimen's consistency and safety, as the drug's long-acting nature means one missed dose won't drastically affect treatment, making it the best advice for adherence and health.

Correct Answer: A

Rationale: Synergists are muscles that assist the prime mover by stabilizing joints or reducing unwanted movements, enhancing the efficiency of the intended action. For example, when flexing the elbow, synergist muscles stabilize the wrist to focus the biceps' effort. Antagonist' muscles oppose the prime mover, not assist it. Intramuscular (IM) injection is a medical procedure, not a muscle type. The prime mover is the primary muscle responsible for the action, not an assistant. Synergists play a crucial supportive role in refining movement, making them the correct choice, as they align with the description of reducing unnecessary motion while complementing the prime mover's function.

Correct Answer: A

Rationale: Nodding yes involves flexion, extension, and hyperextension of the neck, with the skull pivoting at the atlanto-occipital joint (fulcrum). This is a first-class lever, where the fulcrum (joint) lies between the effort (neck muscles, like the splenius) and the load (head weight). Like a seesaw, the head rocks forward and back. Second-class levers (e.g., standing on tiptoes) have the load between fulcrum and effort, not applicable here. Third-class levers (e.g., biceps curl) place effort between fulcrum and load, unlike nodding. The first-class lever system matches the neck's motion, making it the correct answer, as it aligns with the anatomical mechanics of head movement at the fulcrum.

Correct Answer: A

Rationale: At the wrist, forearm muscles enable flexion (bending), extension (straightening), abduction (radial deviation), and adduction (ulnar deviation). At the interphalangeal joints of fingers, only flexion and extension occur, as abduction/adduction apply to spreading fingers at metacarpophalangeal joints, not interphalangeal ones. Thus, flexion, extension, abduction, and adduction describe wrist movements but not interphalangeal finger actions, making it the correct answer. Other options omit key wrist motions or include finger-relevant terms, missing the distinction required by the question, which hinges on joint-specific movement capabilities.

Correct Answer: B

Rationale: Speaking the tongue twister requires tongue mobility, handled by palatoglossus (elevates tongue), styloglossus (retracts), genioglossus (protrudes), and hyoglossus (depresses). Masseter and temporalis move the jaw, buccinator compresses cheeks, and platysma affects the neck less critical for tongue action. Risorius and zygomaticus muscles shape smiles, not speech. Mentalis and orbicularis oris move lips, secondary here. Tongue muscles are the correct answer, as they coordinate the rapid, precise movements needed for articulating this phrase, central to speech production.