Practice A Pharmacology With Answer & Rationale Part 2

Practice A Pharmacology With Answer & Rationale 30. A nurse is teaching a group of unit nurses about medication reconciliation. Which of the following information should the nurse include in the teaching? A. The client's provider is required to complete medication reconciliation. B. Medication reconciliation at discharge is limited to the medication ordered at the time of discharge. C. A transition in care requires the nurse to conduct medication reconciliation. D. Medical reconciliation is limited to the name of the medications that the client is currently taking. A. The RN or a healthcare team member, such as the pharmacist, is required to complete medication reconciliation. B. Medication reconciliation at discharge includes medications ordered at the time of discharge, over-the-counter medications, vitamins, herbal supplements, nutritional supplements, and other medications the client is taking. C. The nurse should conduct medication reconciliation anytime the client is undergoing a change in care such as admission, transfer from one unit to another, or discharge. A complete listing of all prescribed and over-the-counter medications should be reviewed. D. The name of the current medication and new medication, over-the-counter medications, vitamins, herbal supplements, and nutritional supplements are included at the medication reconciliation. The indication, route, dosage size, and dosing interval are also required. 31. A nurse is caring for a 20-year-old female client who has a prescription for isotretinoin for severe nodulocystic acne vulgaris. Before the client can obtain a refill, the nurse should advise the client that which of the following tests is required? A. Serum calcium B. Pregnancy test C. 24-hr urine collection for protein D. Aspartate aminotransferase level A. The client does not need to have a laboratory test for serum calcium levels while taking isotretinoin. B. The nurse should instruct the client that isotretinoin has teratogenic effects; therefore, pregnancy must be ruled out before the client can obtain a refill. The client must provide two negative pregnancy tests for the initial prescription and one negative test before monthly refills. C. The client does not need to have a 24-hr urine test for protein levels when taking isotretinoin. D. The client should have a laboratory test for aspartate aminotransferase levels prior to starting isotretinoin, 1 month after starting the medication, and periodically thereafter. However, a laboratory test for aspartate aminotransferase is not required to renew a prescription for isotretinoin. 32. A nurse is caring for a pt who is receiving heparin therapy via continuous IV infusion to treat a pulmonary embolism. Which finding should the nurse identify as an adverse effect of the medication & report to the provider? A. Vomiting B. Blood in the urine C. Positive Chvostek's sign D. Ringing in the ears A. Vomiting is not an expected adverse effect of heparin therapy. The nurse should assess the client for other causes for vomiting. B. The nurse should report blood in the urine to the provider because this can be a manifestation of heparin toxicity. Other manifestations can include bruising, hematomas, hypotension, and tachycardia. C. A Chvostek's sign is seen in clients who have hypocalcemia or hypomagnesemia. D. Ringing in the ears is not an expected adverse effect of heparin therapy. Aminoglycosides, such as vancomycin, ations that cause ringing in the ears. 11 Practice A Pharmacology With Answer & Rationale 33. A nurse is planning care for a client who has hypertension and is to start taking metoprolol. Which of the following interventions should the nurse include in the plan of care? A. Weigh the client weekly. B. Determine apical pulse prior to administering. C. Administer the medication 30 min prior to breakfast. D. Monitor the client for jaundice. A. The nurse should weigh the client daily to monitor for the development of heart failure and weight gain. B. Life-threatening bradycardia is an adverse effect that might affect this client. Therefore, the nurse should assess the client's apical pulse prior to administering the medication. If the client's pulse rate is less than 60/min, the nurse should withhold the medication and notify the provider. C. The nurse should administer metoprolol following meals or at bedtime if orthostatic hypotension occurs. D. The nurse should monitor the client for adverse effects such as hypotension. However, jaundice is not associated with this medication. 34. A nurse is assessing a client 1 hr after administering morphine for pain. The nurse should identify which of the following findings as the best indication that the morphine has been effective? A. The client's vital signs are within normal limits. B. The client has not requested additional medication. C. The client is resting comfortably with eyes closed. D. The client rates pain as 3 on a scale from 0 to 10. A. Vital signs can be within normal limits for clients who have pain. B. Clients often do not request medicine even when they are experiencing pain. C. The client might rest with their eyes closed as a method to try to manage pain. However, this does not indicate that the pain is controlled. D. The client's description of the pain is the most accurate assessment of pain. 35. A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching. A. "I should take the medication with food." B. "I should take naproxen if I develop joint pain." C. "I should tell my provider if I develop a sore throat." D. "I should expect the medication to cause my urine to look orange." A. The client should take captopril on an empty stomach because food reduces absorption of the medication. The nurse should instruct the client to take the medication 1 hr before or 2 hr after a meal. B. Naproxen and other NSAIDs can interact with captopril, which can decrease the effect of the antihypertensive and increase the risk of kidney dysfunction. C. The client should report a sore throat to the provider because this can indicate neutropenia, a serious adverse effect of captopril. Neutropenia can be reversed if it is identified early and the medication is promptly discontinued. D. Captopril affects the urinary system by causing dysuria, urinary frequency, and changes in the normal amount of urine. However, captopril does not affect the color of the urine. 36. A nurse is planning care for a client who is receiving mannitol via continuous IV infusion. The nurse should monitor the client for which of the following adverse effects? 12 Practice A Pharmacology With Answer & Rationale A. Weight loss B. Increased intraocular pressure C. Auditory hallucinations D. Bibasilar crackles A. Mannitol is an osmotic diuretic used to promote diuresis, decrease intracranial pressure, and improve renal function. An expected therapeutic effect of mannitol is weight loss resulting from diuresis. B. An indication for the use of mannitol is increased intraocular pressure. Mannitol decreases the intraocular pressure by creating an osmotic gradient between the intraocular fluid and the plasma. C. Mannitol has several neurologic adverse effects, including increased intracranial pressure, seizures, confusion, and headaches. However, it does not cause auditory hallucinations. D. Mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema. Therefore, the nurse should recognize lung crackles as an indicator of a potential complication and stop the infusion. 37. A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect? A. Tachycardia B. Oliguria C. Xerostomia D. Miosis A. Neostigmine can cause bradycardia, rather than tachycardia, due to the excessive muscarinic stimulation. B. Neostigmine can cause urinary urgency, rather than decreased urinary output, due to the excessive muscarinic stimulation. C. Neostigmine can cause increased salivation, rather than dry mouth, due to the excessive muscarinic stimulation. D. Miosis, which is pupillary constriction, is a common adverse effect of neostigmine due to the excessive muscarinic stimulation that causes difficulty with visual accommodation. 38. A nurse is caring for a client who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medications? A. Vitamin K B. Acetylcysteine C. Benztropine D. Physostigmine A. Vitamin K is used to treat increased warfarin serum levels, indicated by elevated levels of PT/INR. B. Acetylcysteine is a specific antidote for acetaminophen toxicity. It can prevent severe injury when given orally or by IV infusion within 8 to 10 hr. C. Benztropine is an anticholinergic medication used to treat adverse effects of Parkinson's disease by reducing rigidity and tremors. D. Physostigmine is an effective antidote for antimuscarinic poisoning from medications such as atropine, scopolamine, some antihistamines, phenothiazines, and tricyclic antidepressants. It has no effect on acetaminophen toxicity. 13 Practice A Pharmacology With Answer & Rationale 39. A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to treat migraine headaches. Which of the following information should the nurse include in the instructions? A. "Take one tablet three times a day before meals." B. "Take one tablet at onset of migraine." C. "Take up to eight tablets as needed within a 24-hour period." D. "Take one tablet every 15 minutes until migraine subsides." A. Ergotamine, an alpha-adrenergic blocking medication, is not used prophylactically because this can result in ergotamine dependence. B. The client should take one tablet immediately after the onset of aura or headache. C. The client can take up to a maximum of three tablets in a 24-hr period. Excessive dosing can lead to ergotism, which can cause peripheral gangrene due to vasoconstriction and ischemia. D. The client can take one sublingual tablet every 30 min for a maximum of three tablets in a 24-hr period to manage a migraine. 40. A nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for IV calcium gluconate. The nurse should identify that which of the following medications can interact with calcium gluconate? A. Felodipine B. Guaifenesin C. Digoxin D. Regular insulin A. Calcium gluconate does not interact with felodipine. B. Calcium gluconate does not interact with guaifenesin. C. The nurse should identify that calcium gluconate can cause hypercalcemia, which increases the risk of digoxin toxicity. D. Calcium gluconate does not interact with insulin. 41. A nurse in an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering? A. Ondansetron B. Magnesium sulfate C. Flumazenil D. Protamine sulfate A. Ondansetron is an antiemetic that is used to treat nausea and vomiting. B. Magnesium sulfate is an electrolyte replacement that is used to treat clients who are at risk for seizure activity. C. The nurse should anticipate administering flumazenil, an antidote used to reverse benzodiazepines such as diazepam. D. Protamine sulfate is an antidote for heparin and is used to reverse an elevated aPTT caused by taking heparin. 42. A nurse is collecting a medication history from a client who has a new prescription for lithium. The nurse should identify that the client should discontinue which of the following over-the-counter medications? A. Aspirin B. Ibuprofen C. Ranitidine 14 Practice A Pharmacology With Answer & Rationale D. Bisacodyl A. Although most NSAIDs interact with lithium to increase lithium levels, aspirin does not interact with lithium. B. Most NSAIDs can significantly increase lithium levels. Therefore, the client should not take ibuprofen and lithium concurrently. C. There are no known medication interactions between ranitidine and lithium. D. There are no known medication interactions between bisacodyl and lithium. 43. A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan? (Select all that apply.) A. Report muscle pain to the provider. B. Avoid taking the medication with grapefruit juice. C. Take the medication in the early morning. D. Expect a flushing of the skin as a reaction to the medication. E. Expect therapy with this medication to be lifelong. A. Myopathy is an adverse effect of simvastatin that can lead to rhabdomyolysis. The nurse should instruct the client to report this to the provider. B. When taken with grapefruit juice, simvastatin increases the risk of muscle injury from elevations in creatine kinase. C. This medication is most effective when taken in the evening because cholesterol production generally increases overnight. D. The nurse should identify flushing of the skin as an adverse effect of the medication niacin, which can be used to decrease the client's triglyceride levels. E. If medication therapy is discontinued, cholesterol levels will return to their pretreatment range within several weeks to months. 44. A nurse is caring for the parent of a newborn. The parent asks the nurse when their newborn should receive the first diphtheria, tetanus, and pertussis vaccine (DTaP). The nurse should instruct the parent that their newborn should receive the immunization at which of the following ages? A. At birth B. 2 months C. 6 months D. 15 months A. According to the current recommended immunization schedule, only the hepatitis B vaccine is given at birth. B. The CDC recommends that newborns receive the first dose of the five-dose series of the DTaP immunization at 2 months of age. C. The CDC recommends that newborns receive the third dose of the five-dose series of the DTaP immunization at 6 months of age. D. The CDC recommends that newborns receive the fourth dose of the five-dose series of the DTaP immunization between 15 to 18 months of age. 15 Practice A Pharmacology With Answer & Rationale 45. A nurse is reviewing the medication list of a client who wants to begin taking oral contraceptives. The nurse should identify that which of the following client medications will interfere with the effectiveness of oral contraceptives? A. Carbamazepine B. Sumatriptan C. Atenolol D. Glipizide A. Carbamazepine causes an accelerated inactivation of oral contraceptives because of its action on hepatic medication-metabolizing enzymes. B. There is no medication interaction between oral contraceptives and sumatriptan, which is a medication to treat migraines. C. There is no medication interaction between oral contraceptives and atenolol, a beta blocker. D. There is no medication interaction between oral contraceptives and glipizide, an antidiabetic medication. 46. A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching? A. "Take beclomethasone to avoid an acute attack." B. "Use beclomethasone 5 minutes before using albuterol." C. "Limit your calcium and vitamin D intake when taking beclomethasone." D. "Rinse your mouth after inhaling the beclomethasone." A. The client should take albuterol, a short-acting beta2-adrenergic agonist, to avoid an acute asthma attack. B. The client should use the bronchodilator, albuterol, prior to taking beclomethasone, a glucocorticoid inhaler, to enhance its absorption. C. The client should increase the intake of calcium and vitamin D to minimize bone loss while taking beclomethasone, a glucocorticoid inhaler. D. The client should rinse their mouth after using beclomethasone, a glucocorticoid inhaler, to prevent oropharyngeal candidiasis and hoarseness. 47. A nurse is planning to teach about the use of a spacer to a child who has a new prescription for a fluticasone inhaler to treat chronic asthma. The nurse should include that the spacer decreases the risk for which of the following adverse effects of the medication? A. Oral candidiasis B. Headache C. Joint pain D. Adrenal suppression A. Dysphonia and oral candidiasis are adverse effects of inhaled corticosteroids. Using a spacer and rinsing the mouth after inhalation will minimize the amount of medication remaining in the oropharynx, preventing the development of these adverse effects. B. Fluticasone can cause neurologic adverse effects such as dizziness, fatigue, nervousness, and headaches. However, the use of a spacer will not decrease systemic adverse effects of fluticasone, such as headaches. C. Fluticasone can cause musculoskeletal adverse effects such as bone loss, muscle aches, and joint pain. However, the use of a spacer will not decrease systemic adverse effects of fluticasone, such as joint pain. 16 Practice A Pharmacology With Answer & Rationale D. Fluticasone is a glucocorticoid mediation that decreases bronchoconstriction. Inhaled glucocorticoids can cause adrenal suppression, although this occurs more often with oral glucocorticoids. The nurse should monitor the client for manifestations of adrenal suppression such as weakness, fatigue, hypotension, and hypoglycemia. However, the use of a spacer will not decrease systemic adverse effects of fluticasone, such as adrenal suppression. 48. A nurse in an emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer? A. Potassium iodide B. Glucagon C. Atropine D. Protamine A. Potassium iodide is a thyroid hormone antagonist used in the treatment of radioactive iodine exposure. B. Glucagon is an antihypoglycemic medication used in the treatment of low blood glucose levels. C. A cholinergic crisis is caused by an excess amount of cholinesterase inhibitor, such as neostigmine. The nurse should plan to administer atropine, an anticholinergic agent, to reverse cholinergic toxicity. D. Protamine is a heparin antagonist that is administered to reverse heparin toxicity evidenced by an aPTT greater than 70 seconds. 49. A nurse in an emergency department is caring for a client who has heroin toxicity. The client is unresponsive with pinpoint pupils and a respiratory rate of 6/min. Which of the following medication should the nurse plan to administer? A. Methadone B. Naloxone C. Diazepam D. Bupropion A. The nurse should administer methadone, an opioid agonist, to a client who has heroin toxicity to decrease manifestations of opioid withdrawal and suppress the euphoria the client feels when using heroin. However, the client should not receive methadone in an emergency. B. The nurse should administer naloxone, an opioid antagonist, to a client who has heroin toxicity to reverse the respiratory depressive effects of the heroin. However, the nurse should not administer naloxone too quickly because naloxone can cause hypertension, tachycardia, nausea, vomiting, and might cause the client to enter a state of opioid withdrawal. C. The nurse should administer diazepam, a benzodiazepine, to a client who has alcohol toxicity to decrease the manifestations of alcohol withdrawal and prevent withdrawal seizures. D. The nurse should administer bupropion, an atypical antidepressant, to a client who is trying to quit nicotine to decrease the manifestations of nicotine withdrawal and ease the client's cravings for nicotine. 50. A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for ranitidine. Which of the following instructions should the nurse include? A. "Take the medication on an empty stomach for full effectiveness." B. "You may discontinue this medication when stomach discomfort subsides." C. "Report yellowing of the skin." D. "Store the medication in the refrigerator." A. The client can take ranitidine with or without food because food does not affect the medication's effectiveness. B. For clients who have a gastric ulcer, ranitidine is prescribed to inhibit gastric secretion and must be taken for the full course of therapy to be effective. C. Ranitidine can be hepatotoxic and cause jaundice. The nurse should instruct the client to monitor for and report 17 Practice A Pharmacology With Answer & Rationale yellowing of the skin or eyes to the provider. D. The client should store ranitidine at room temperature. 51. A nurse is assessing a client who is postoperative following an outpatient endoscopy procedure using midazolam. The nurse should monitor for which of the following findings as an indication that the client is ready for discharge? A. The client's capnography has returned to baseline. B. The client can respond to their name when called. C. The client is passing flatus. D. The client is requesting oral intake. A. The nurse should identify that the client is ready for discharge when the capnography level indicates that gas exchange is adequate. B. The client is considered ready for discharge when the state of arousal is at the preprocedure level. C. The nurse should monitor for the passing of flatus for a client who received general anesthesia. D. A request for oral intake does not indicate the client is ready for discharge. The nurse should assess for a return of the gag reflex for a client who is postoperative following an endoscopy. 52. A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension, and dyspnea. Which of the following medication should the nurse administer first? A. Diphenhydramine B. Albuterol inhaler C. Epinephrine D. Prednisone A. The nurse should administer diphenhydramine, an antihistamine, as a second-line medication to decrease angioedema and urticaria following anaphylaxis. However, evidence-based practice indicates that administering another medication is the priority. B. The nurse should administer albuterol, a bronchodilator, for a client who has dyspnea from bronchospasms during anaphylaxis. However, evidence-based practice indicates that administering another medication is the priority. C. According to evidence-based practice, the nurse should administer epinephrine first to induce vasoconstriction and bronchodilation during anaphylaxis. D. The nurse should plan to administer prednisone, a glucocorticoid, for the urticaria following anaphylaxis and to prevent a delayed anaphylactic reaction from occurring. However, evidence-based practice indicates that administering another medication is the priority. 53. A nurse is caring for a client who is receiving filgrastim. Which of the following findings should the nurse document to indicate the effectiveness of the therapy? A. Increased neutrophil count B. Increased RBC count C. Decreased prothrombin time D. Decreased triglycerides A. Filgrastim stimulates the bone marrow to produce neutrophils. For clients receiving chemotherapy, the risk of infection is minimized. B. Filgrastim stimulates the bone marrow to produce neutrophils and has no effect on a client's RBC count. C. Prothrombin time measures the effectiveness of warfarin therapy. Filgrastim therapy does not cause a decrease 18 Practice A Pharmacology With Answer & Rationale in prothrombin time. D. Triglycerides are a form of lipids found in the blood stream. Increased levels are associated with an increased risk for heart disease. Decreased levels can occur in clients who have malnutrition or malabsorption disorders. Filgrastim is used to treat chemotherapy-induced neutropenia and has no effect on a client's triglyceride levels. 54. A nurse is caring for a client who is experiencing acute alcohol withdrawal. For which of the following client outcomes should the nurse administer chlordiazepoxide? A. Minimize diaphoresis B. Maintain abstinence C. Lessen craving D. Prevent delirium tremens A. The client should take clonidine or a beta-adrenergic blocker, such as atenolol, to minimize autonomic components, such as diaphoresis, during alcohol withdrawal. B. The client should take acamprosate to help maintain abstinence from alcohol by decreasing anxiety and other uncomfortable manifestations. C. The client should take propranolol to decrease cravings during alcohol withdrawal. D. The client should take chlordiazepoxide to prevent delirium tremens during acute alcohol withdrawal. 55. A nurse is reviewing the laboratory results of a client who is taking digoxin for heart failure. Which of the following results should the nurse report to the provider? A. Calcium level 9.2 mg/dL B. Magnesium level 1.6 mEq/L C. Digoxin level 1.1 ng/mL D. Potassium level 2.8 mEq/L A. A calcium level of 9.2 mg/dL is within the expected reference range of 9.0 to 10.5 mg/dL. The nurse should report a calcium level that is outside the expected reference range to the provider. B. A magnesium level of 1.6 mEq/L is within the expected reference range of 1.3 to 2.1 mEq/L. The nurse should report a magnesium level that is outside the expected reference range to the provider. C. A digoxin level of 1.1 ng/mL is within the expected reference range of 0.8 to 2 ng/mL. The nurse should report a digoxin level that is outside the expected reference range to the provider for a dosage adjustment. D. A potassium level of 2.8 mEq/L is below the expected reference range of 3.5 to 5 mEq/L. The nurse should notify the provider if a client has hypokalemia prior to administration of digoxin due to the increased risk of developing digoxin toxicity and cardiac dysrhythmias. 56. A nurse is providing discharge teaching about handling medication to a pt who is to continue taking oral transmucosal fentanyl raspberry-flavored lozenges on a stick. What information should RN include in the teaching? A. Chew on the medication stick to release the medication. B. Leave the medication stick in one location of the mouth until melted. C. Allow the medication 1 hr for analgesia effects to begin. D. Store unused medication sticks in a storage container. A. The nurse should instruct the client to place the fentanyl stick between their cheek and lower gum and actively suck it for increased absorption of the medication. B. Instruct the pt to periodically move the med. stick to a different location in the mouth for best absorption. C. The nurse should instruct the client to expect the medication's analgesia effects to begin within 10 to 15 min. D. The nurse should instruct the client to store unused, used, or partially used medication sticks in the safe storage container that comes in the kit when the medication is initially prescribed. 19 Practice A Pharmacology With Answer & Rationale 57. A nurse is assessing a client who is taking propylthiouracil for the treatment of Graves' disease. Which of the following findings should the nurse identify as an indication that the medication has been effective? A. Decrease in WBC count B. Decrease in amount of time sleeping C. Increase in appetite D. Increase in ability to focus A. Propylthiouracil is a thyroid hormone antagonist used in the treatment of hyperthyroidism, or thyroid storms. A decreased WBC count is an adverse effect of propylthiouracil, which can cause myelosuppression. Therefore, a decrease in WBC count indicates the medication has not been effective. B. Graves' disease, a form of hyperthyroidism, has neurologic manifestations, including insomnia. Therefore, a decrease in the amount of time sleeping indicates the medication has not been effective. C. Graves' disease can result in gastrointestinal manifestations such as increased appetite, weight loss, and increased gastrointestinal motility. Therefore, an increase in appetite indicates the med. has not been effective. D. A client who has Graves' disease can experience psychological manifestations such as difficulty focusing, restlessness, and manic-type behaviors. Propylthiouracil is a thyroid hormone antagonist that decreases the circulating T4 hormone, reducing the manifestations of hyperthyroidism. An increased ability to focus indicates that the medication has been effective. 58. A nurse is teaching a client who is to begin taking tamoxifen for the treatment of breast cancer. Which of the following adverse effects should the nurse include in the teaching? A. Hot flashes B. Urinary retention C. Constipation D. Bradycardia A. The estrogen receptor blocking action of tamoxifen commonly results in the adverse effect of hot flashes. B. Tamoxifen can cause genitourinary adverse effects such as vaginal discharge and uterine cancer. However, urinary retention is not an expected adverse effect of tamoxifen. C. Gastrointestinal adverse effects of tamoxifen include nausea and vomiting. However, constipation is not an expected adverse effect of tamoxifen. D. Tamoxifen is an antiestrogen medication that works by blocking estrogen receptors. Cardiovascular adverse effects of the medication include chest pain, flushing, and the development of thrombus. However, bradycardia is not an expected adverse effect of tamoxifen. 59. A nurse is preparing to administer ciprofloxacin 15 mg/kg PO every 12 hr to a child who weighs 44 lb. How many mg should the nurse administer per dose? (Round nearest whole number, leading zero if it applies. No trailing zero.) Answer: 300 mg Step 1: What is the unit of measurement the nurse should calculate? (Place the unit of measure being calculated on the left side of the equation.) Step 2: Determine the ratio that contains the same unit as the unit being calculated. (Place the ratio on the right side of the equation, ensuring that the unit in the numerator matches the unit being calculated.) Step 3: Place any remaining ratios that are relevant to the item on the right side of the equation, along with any needed conversion factors, to cancel out unwanted units of measurement. Step 4: Solve for X. Step 5: Round if necessary. 20 Practice A Pharmacology With Answer & Rationale Step 6: Determine whether the amount to administer makes sense. If the prescription reads 15 mg/kg every 12 hr and the child weighs 20 kg, it makes sense to give 300 mg/dose every 12 hr. 60. A nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching? A. "I will drink a glass of milk when I take the risedronate." B. "I will take the risedronate 15 minutes after my evening meal." C. "I should take an antacid with the risedronate to avoid nausea." D. "I should sit up for 30 minutes after taking the risedronate." A. The nurse should reinforce that risedronate should be taken with a full glass of water, rather than any other liquid. B. Although the delayed release form of the medication can be taken after eating, the immediate release form of the medication should be taken at least 30 min prior to consuming food or other liquids. Both forms of medication should be taken in the morning. C. The absorption of risedronate, a bisphosphonate, will be reduced if it is taken with antacids containing calcium, aluminum, or magnesium. The nurse should instruct the client to take the antacid 2 hr after taking risedronate. D. Sitting upright for at least 30 min after taking risedronate will reduce the adverse gastrointestinal effects of esophagitis and dyspepsia. Risedronate is contraindicated for a client who cannot sit or stand upright for this length of time. 21