A patient with osteoporosis is prescribed the bisphosphonate alendronate (Fosamax). What should the nurse include when teaching the patient about this medication? Select all that apply.

Correct Answer: A

Rationale: A. Take the medication as directed with clear water only: Alendronate should be taken with a full glass of plain water on an empty stomach in the morning at least 30 minutes before consuming any food, drink, or other medications. Avoid taking it with any other liquids besides plain water, as other beverages can interfere with the absorption of the drug.

Correct Answer: C

Rationale: In disseminated intravascular coagulation (DIC), the client is experiencing joint pain due to the formation of microthrombi which can lead to ischemia and inflammation within the joints. Heat application is appropriate as it can help improve circulation, reduce pain, and promote relaxation of the joints. Heat helps to increase blood flow to the affected area, which can aid in reducing pain and stiffness in the joints. Additionally, heat can also help to soothe the inflamed tissues and promote comfort for the client. Splints, cool compresses, and ice are not appropriate interventions for joint pain in DIC and may not provide the same level of relief as heat therapy.

Correct Answer: B

Rationale: HELLP syndrome is a serious complication of pregnancy characterized by Hemolysis (H), Elevated Liver enzymes (EL), and a Low Platelet count (LP). Therefore, the correct laboratory finding consistent with the diagnosis of HELLP syndrome is hemolysis. This can be indicated by an elevated lactate dehydrogenase (LDH) level, low haptoglobin, elevated bilirubin, and the presence of schistocytes on a blood smear. The other options (A, C, and D) do not align with the classic presentation of HELLP syndrome.

Correct Answer: A

Rationale: A. Take the medication as directed with clear water only: Alendronate should be taken with a full glass of plain water on an empty stomach in the morning at least 30 minutes before consuming any food, drink, or other medications. Avoid taking it with any other liquids besides plain water, as other beverages can interfere with the absorption of the drug.

Correct Answer: B

Rationale: When addressing a client's non-adherence to treatment, a nonjudgmental approach is most effective. This involves showing empathy, understanding, and support without criticizing or condemning the client. By adopting a nonjudgmental attitude, the nurse can create a safe environment for open communication and collaboration to explore the reasons behind the client's non-adherence. This approach helps build trust and rapport, which are essential for promoting positive behavior change and improving treatment adherence. In contrast, being indifferent, demanding, or confrontational can lead to defensiveness, resistance, and further non-adherence in the client.

Correct Answer: D

Rationale: In older adults, particularly those over 65 years of age, atypical symptoms of a myocardial infarction may occur. Abdominal pain is considered an atypical age-related warning sign because older adults may present with subtle or nonspecific symptoms, such as discomfort or pain in the abdomen, rather than the classic chest pain associated with a heart attack. This atypical presentation can lead to delays in seeking medical attention and diagnosis, which can have serious consequences for the client. Therefore, it is important for the nurse to educate older clients about the possibility of experiencing atypical symptoms, such as abdominal pain, in the context of a myocardial infarction.

Correct Answer: B

Rationale: Congenital defects are categorized according to the pathophysiology and hemodynamics of the defect. This means that defects are grouped based on the underlying mechanisms that lead to the defect and how these abnormalities impact the flow of blood or other bodily functions. This classification allows healthcare providers to better understand the nature of the defect and tailor treatment plans accordingly. It helps in determining the best course of action, whether it be medical management, surgical intervention, or monitoring for potential complications. By categorizing congenital defects in this way, healthcare providers can provide more targeted and effective care for affected individuals.

Correct Answer: A

Rationale: The first action that the nurse should take when caring for a patient experiencing diarrhea is to ask the patient to describe the number and character of daily stools. This assessment is crucial in determining the severity and possible cause of the diarrhea. By understanding the frequency and consistency of the stools, the nurse can evaluate if the diarrhea is due to an infection, a reaction to medications, dietary factors, or other underlying health issues. Based on this assessment, appropriate interventions can then be implemented, which may include further diagnostic tests, fluid replacement therapy, dietary modifications, or medication administration. It is essential to gather this information first before considering other interventions such as abstaining from oral intake or using over-the-counter antidiarrheal medications.

Correct Answer: D

Rationale: The nurse should ask the patient if she completed the antibiotic prescribed for the first urinary tract infection because it is important to determine if the initial infection was fully treated. If the antibiotic course was not completed as prescribed, it could lead to a recurrence of the infection due to incomplete eradication of the bacteria. Additionally, incomplete treatment can lead to antibiotic resistance, making it harder to treat future infections. Understanding if the patient followed through with the prescribed treatment is crucial in assessing the current situation and planning appropriate interventions.