What instruction should the nurse give regarding the administration of alendronate to a patient with osteoporosis?

Correct Answer: C

Rationale: The correct answer is C: Take the medication with a full glass of water. Alendronate should be taken with a full glass of water on an empty stomach in the morning to enhance absorption. Option A is incorrect because taking alendronate with milk decreases its absorption. Option B is incorrect as lying down after taking alendronate can lead to esophageal irritation. Option D is incorrect because taking the medication before bedtime can cause esophageal irritation as well due to the risk of reflux when lying down.

Correct Answer: B

Rationale: The correct answer is B: Relieve bronchospasm. Tiotropium is an anticholinergic medication that acts by relaxing the muscles around the airways, thereby helping to relieve bronchospasm in patients with COPD. This results in improved airflow and reduced shortness of breath. A: Reduce mucus production - This is incorrect as tiotropium does not directly affect mucus production but rather focuses on bronchospasm relief. C: Suppress cough - Tiotropium may help with cough associated with COPD by improving airflow, but its primary purpose is not to suppress cough. D: Thin respiratory secretions - Tiotropium does not have a direct effect on thinning respiratory secretions; its main action is bronchodilation to relieve bronchospasm in COPD.

Correct Answer: C

Rationale: Rationale: 1. Enoxaparin is a low molecular weight heparin that primarily affects the intrinsic pathway of coagulation. 2. INR is used to monitor the effectiveness of anticoagulants affecting the intrinsic pathway. 3. Monitoring INR helps ensure the patient is within the therapeutic range to prevent clotting without excessive bleeding. 4. PT and PTT primarily evaluate the extrinsic and intrinsic pathways, respectively, not specific to enoxaparin. 5. Platelet count is not directly related to monitoring the effectiveness of enoxaparin in treating DVT.

Correct Answer: D

Rationale: The correct answer is D: Suicidal thoughts. When a patient with depression is prescribed fluoxetine, there is a risk of increased suicidal thoughts, especially in the initial weeks of treatment. This is important for the nurse to monitor because it can lead to serious consequences. Weight gain (A) is a common side effect of fluoxetine but not as critical to monitor as suicidal thoughts. Bradycardia (B) and dry mouth (C) are not common side effects of fluoxetine and are less relevant to monitor in this scenario. Monitoring for suicidal thoughts is crucial for patient safety.

Correct Answer: C

Rationale: Step-by-step rationale for choice C: 1. Metformin can cause gastrointestinal side effects. 2. Taking it with meals helps reduce stomach upset. 3. It also helps in better absorption and effectiveness. 4. Therefore, the nurse should instruct the patient to take metformin with meals. Summary of other choices: A: Taking on an empty stomach can worsen gastrointestinal side effects. B: Metformin doesn't typically cause hypoglycemia. D: Increasing simple carbohydrates can counteract the effects of metformin.