The client receives alendronate (Fosamax) as treatment for osteoporosis. The nurse has completed medication education and evaluates learning has occurred when the client makes which statements?

Correct Answer: D

Rationale: In this scenario, option D, "I must take this with a full glass of water," is the correct statement that indicates successful learning about alendronate (Fosamax) medication. This is because alendronate should be taken with a full glass of water on an empty stomach to enhance absorption and reduce the risk of esophageal irritation. Option A, "I cannot lie down for at least 30 minutes after taking the medication," is incorrect because while it is vital to remain upright for 30 minutes after taking alendronate to prevent esophageal irritation, the statement implies a restriction that is not necessary. Option B, "Milk will help with the absorption of this medication," is incorrect because calcium-rich foods, including milk, can interfere with the absorption of alendronate. It is recommended to avoid consuming calcium-rich foods or supplements within 30 minutes of taking alendronate. Option C, "I should call my doctor if I experience heartburn," is also incorrect as occasional heartburn is a common side effect of alendronate and not necessarily a cause for immediate concern unless it persists or worsens. In an educational context, it is crucial for clients receiving alendronate to understand the correct administration instructions to ensure the medication's effectiveness and reduce the risk of side effects. By emphasizing the importance of taking alendronate with a full glass of water on an empty stomach, healthcare providers can help promote optimal outcomes in the treatment of osteoporosis.

Correct Answer: C

Rationale: In this scenario, option C is the correct answer because probenecid (Probalan) is not used to treat acute attacks of gout. Probenecid is a uricosuric agent that works by increasing the excretion of uric acid in the urine, thus preventing gout attacks rather than treating acute episodes. Option A is incorrect because probenecid (Probalan) is not administered intravenously; it is taken orally. Option B is incorrect because probenecid does not work immediately to relieve pain in acute gout attacks; it is more for long-term prevention. Option D is incorrect as there is a specific consideration to be made before responding to the patient's complaint. Educationally, it is important for nurses to understand the mechanism of action and appropriate use of medications like probenecid to effectively manage gout in patients. This case highlights the importance of differentiating between medications used for acute management versus prophylaxis in gout treatment.

Correct Answer: C

Rationale: In pharmacology, oral bioavailability is a crucial concept that refers to the percentage of a drug dose administered orally that reaches systemic circulation unchanged. The correct answer is option C: largely hydrophobic, yet soluble in aqueous solutions. This type of drug will have maximum oral bioavailability because it can easily dissolve in gastrointestinal fluids, allowing for efficient absorption across the gastrointestinal mucosa. The drug's hydrophobic nature facilitates its passage through the lipid-rich cell membranes in the intestines, leading to better absorption and increased bioavailability. Option A, drugs with high first-pass metabolism, have reduced oral bioavailability because they undergo extensive metabolism in the liver before reaching systemic circulation, lowering the amount of active drug available. Highly hydrophilic drugs (option B) face challenges in crossing lipid-rich cell membranes, resulting in poor absorption and reduced bioavailability. Chemically unstable drugs (option D) may undergo degradation in the harsh acidic environment of the stomach or during the absorption process, leading to reduced bioavailability. In an educational context, understanding factors influencing drug bioavailability is essential for healthcare professionals to optimize therapeutic outcomes. Knowledge of drug properties that enhance oral absorption can guide clinicians in selecting appropriate medications and dosing regimens for patients of different ages and health conditions. This knowledge also informs decisions regarding route of administration, drug formulations, and patient counseling on medication adherence.

Correct Answer: B

Rationale: In the elderly, levels of microsomal enzymes are decreased because the aging liver is less able to produce them; fat content is increased because of decreased lean body mass; the number of intact nephrons is decreased as the result of aging; and gastric pH is less acidic because of a gradual reduction of the production of hydrochloric acid. The other options are incorrect statements.

Correct Answer: A

Rationale: In pharmacology, β blockers are a class of medications commonly used to treat various cardiovascular conditions. The correct answer, option A, states that most β blockers have half-lives of 3-10 hours. This is accurate because β blockers are typically eliminated from the body relatively quickly, hence the need for multiple daily doses to maintain therapeutic levels. Option B, stating that β blockers have a small volume of distribution, is incorrect. In fact, β blockers have a relatively large volume of distribution due to their lipophilic nature, allowing them to distribute widely throughout the body. Option C, suggesting that β blockers have poor oral bioavailability, is also incorrect. Most β blockers have good oral bioavailability, meaning they are well absorbed when taken by mouth. Option D, claiming that β blockers are highly lipid soluble and cross the blood-brain barrier, is inaccurate. While some β blockers may have some degree of lipid solubility, most do not readily cross the blood-brain barrier due to their relatively large molecular size. In an educational context, understanding the pharmacokinetic properties of medications like β blockers is crucial for healthcare professionals to ensure safe and effective drug therapy. Knowing factors such as half-life, volume of distribution, bioavailability, and ability to cross physiological barriers can help in drug selection, dosing, and monitoring for optimal patient outcomes.