Question

A nurse is reinforcing teaching with a client who has osteoporosis and a new prescription for alendronate. Which of the following adverse effects should the nurse include in the teaching? (Select all that apply.)

Answer 1

Correct Answers:

Blurred vision
Dysphagia
Jaw pain

Rationale :

Blurred vision

Blurred vision is a significant adverse effect associated with alendronate use, potentially indicating ocular inflammation or other vision disturbances.
Clients should be instructed to report visual changes promptly to the healthcare provider to prevent serious eye complications.
Early recognition and intervention can mitigate potential risks to the client's vision.

Dysphagia

Dysphagia, or difficulty swallowing, is a notable adverse effect of alendronate, resulting from irritation or inflammation of the esophagus.
Clients are advised to take the medication with a full glass of water and remain upright for at least 30 minutes afterward to reduce esophageal irritation.
Prompt reporting of swallowing difficulties is essential to prevent progression to more severe esophageal complications.

Jaw pain

Jaw pain is associated with alendronate use and can be indicative of osteonecrosis of the jaw, a rare but serious complication.
Clients should receive education about maintaining excellent oral hygiene and reporting any jaw discomfort or dental issues immediately.
Regular dental assessments are important during long-term alendronate therapy to prevent serious dental and oral health problems.

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Answer 2

Correct Answers:

Sublimize.
Morphine.
Fentanyl.
Dolophine.
Demerol.

Rationale :

Sublimaze (Fentanyl)

🟠Fentanyl (Sublimaze) is a potent synthetic opioid agonist commonly used for pain management, especially for severe pain and anesthesia.

🟠It binds strongly to opioid receptors in the central nervous system, providing profound analgesia.

🟠Clinicians must monitor for respiratory depression due to its potency.

Morphine

🟠Morphine is a well-known natural opioid agonist frequently utilized in clinical settings to relieve moderate to severe pain.

🟠It activates mu opioid receptors in the central nervous system, altering the perception and response to pain.

🟠Monitoring for adverse effects such as respiratory depression, sedation, constipation, and addiction potential is critical.

Fentanyl

🟠Fentanyl is specifically highlighted again for its strong analgesic properties and high affinity for opioid receptors.

🟠Due to its rapid onset and short duration, fentanyl is extensively used in anesthesia, pain management, and procedural sedation.

🟠Close monitoring is essential because of its high risk for respiratory depression, sedation, and potential for abuse.

Dolophine (Methadone)

🟠Dolophine (Methadone) is a synthetic opioid agonist commonly used in chronic pain management and opioid addiction treatment programs.

🟠Methadone has a prolonged half-life, offering sustained pain relief and reducing withdrawal symptoms in opioid-dependent clients.

🟠Regular cardiac monitoring is recommended due to the risk of QT prolongation associated with methadone.

Demerol (Meperidine)

🟠Demerol (Meperidine) is a synthetic opioid agonist indicated for moderate to severe acute pain management, including perioperative use.

🟠Meperidine acts primarily by stimulating opioid receptors to produce analgesia and sedation.

🟠Caution is advised due to the risk of CNS excitability, seizures (especially with prolonged use), and respiratory depression.

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Answer 3

Correct Answers:

25

Rationale :

✍️Step 1: Write down the formula

Flow rate (gtt/min)=Total volume (mL)×Drop factor (gtt/mL)/Time

Total volume = 100 mL

Drop factor = 15 gtt/mL

Time = 1 hour = 60 minutes

100 mL×15 gtt/mL/60 min

1500/60

25 gtt/min

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Answer 4

Correct Answers:

Celecoxib.

Rationale :

♦️ Celecoxib is classified as a second-generation NSAID, specifically a selective COX-2 inhibitor.

♦️ It selectively inhibits COX-2 enzyme responsible for pain and inflammation, significantly reducing the risk of gastrointestinal side effects associated with traditional NSAIDs.

♦️ Unlike first-generation NSAIDs (e.g., ibuprofen, aspirin), celecoxib does not inhibit COX-1, reducing the likelihood of gastric ulcers and bleeding.

♦️ Clinically, celecoxib is used to manage arthritis, acute pain, and dysmenorrhea, offering effective pain relief with improved gastrointestinal tolerability.

♦️ Nurses should educate patients to take celecoxib with food if stomach upset occurs and to report any cardiovascular symptoms, as COX-2 inhibitors carry a potential increased cardiovascular risk.

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Answer 5

Correct Answers:

Ibuprofen.

Rationale :

🔴 Ibuprofen is a common example of a non-opioid analgesic classified as a nonsteroidal anti-inflammatory drug (NSAID).

🔴 It works by inhibiting prostaglandin synthesis, specifically blocking COX enzymes, which reduces inflammation, pain, and fever.

🔴 Non-opioid analgesics like ibuprofen do not cause sedation, respiratory depression, or addiction potential, distinguishing them from opioids.

🔴 Ibuprofen is widely used to treat mild-to-moderate pain, headaches, dysmenorrhea, and arthritis.

🔴 Nurses should advise patients to take ibuprofen with food to minimize gastrointestinal irritation and monitor for signs of gastric upset or bleeding.

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Answer 6

Correct Answers:

Esophagitis.

Rationale :

⏺️Fosamax (Alendronate) is known to cause significant esophageal irritation, potentially resulting in esophagitis.

⏺️ The symptoms described (abdominal pain, nausea, and difficulty swallowing) are classic manifestations of esophagitis associated with bisphosphonate medications.

⏺️ This occurs when the client does not remain upright or takes the medication without sufficient water, causing the tablet to linger and irritate the esophageal lining.

⏺️ Nurses should educate clients to take Fosamax with a full glass of water, remain upright for at least 30 minutes after administration, and promptly report difficulty swallowing or abdominal discomfort.

⏺️ Early identification and intervention are crucial to preventing serious complications such as esophageal ulceration or perforation.

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Answer 7

Correct Answers:

Respiratory rate.

Rationale :

🟢Morphine, an opioid analgesic, has a known adverse effect of respiratory depression.

🟢 Obtaining a baseline respiratory rate is essential before administering morphine to ensure patient safety.

🟢 A respiratory rate below 12 breaths per minute typically necessitates withholding morphine and notifying the provider immediately.

🟢 Although morphine may affect other vital signs, respiratory status is the priority assessment due to the potential risk of life-threatening complications.

🟢 Vigilant monitoring of respiratory function helps prevent severe respiratory compromise and ensures prompt intervention if necessary.

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Answer 8

Correct Answers:

2

Rationale :

🔹 Step 1: Identify required dosage and available dosage

Ordered dose: 500 mg

Available dose: 250 mg/tablet

🔹 Step 2: Calculate the number of tablets needed

Number of tablets=Ordered Dose/Available Dose per tablet

🔹 Step 3: Substitute values and calculate

500 mg/250 mg/tablet

2 tablets

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Answer 9

Correct Answers:

The client may be at risk for hypocalcemia.

Rationale :

💎Clients taking calcium supplements are primarily at risk for developing hypercalcemia, especially if intake exceeds recommended guidelines.

💎 Hypercalcemia occurs when serum calcium levels rise above the normal range (approximately 8.5–10.5 mg/dL), potentially causing symptoms such as muscle weakness, confusion, lethargy, constipation, kidney stones, and cardiac arrhythmias.

💎 Nurses should prioritize monitoring serum calcium levels periodically for clients on long-term calcium supplementation to prevent adverse effects.

💎 Additionally, educating clients about the importance of maintaining recommended dosage levels and recognizing early signs of hypercalcemia is essential for safe calcium supplementation.

💎 Prompt identification of elevated calcium levels ensures timely interventions to prevent severe complications, such as cardiac disturbances or renal impairment.

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Answer 10

Correct Answers:

Gastrointestinal discomfort.

Rationale :

🟣 Non-opioid analgesics, such as NSAIDs (e.g., ibuprofen, aspirin), commonly cause gastrointestinal discomfort due to their inhibition of COX-1 enzymes, which decreases protective gastric mucosa.

🟣 This side effect may present as nausea, epigastric pain, dyspepsia, or gastric ulcers, especially with prolonged or high-dose use.

🟣 Patients should be advised to take NSAIDs with food or milk to minimize gastric irritation and reduce the risk of GI bleeding.

🟣 Unlike opioids, non-opioid analgesics do not typically cause respiratory depression, bradycardia, or significant weight changes.

🟣 Monitoring for GI symptoms is a key nursing responsibility when patients are on chronic NSAID therapy.

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Custom 3 -PNSG 1600 EXAM 2-2025 (Summer)

No.

1 :
A nurse is reinforcing teaching with a client who has osteoporosis and a new prescription for alendronate. Which of the following adverse effects should the nurse include in the teaching? (Select all that apply.)

2 :
Which of the following are examples of opioid agonists?

3 :
A nurse is preparing to administer dextrose 5% in water (D5W) 100 mL to infuse over 1 hr. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number.)

4 :
Which of the following is a second-generation nonsteroidal anti-inflammatory drug (NSAID)?

5 :
Which of the following is an example of a non-opioid analgesic?

6 :
A client who is taking Fosamax presents with symptoms of abdominal pain, nausea and difficulty swallowing. The nurse analyzes the cues and prioritizes a hypothesis. Which hypothesis should the nurse prioritize?

7 :
A nurse is collecting data on a client who has a prescription for morphine. The nurse should recognize that which of the following data is a priority to obtain before administering this medication?

8 :
A nurse is preparing to administer erythromycin stearate 500 mg PO. Available is erythromycin stearate 250 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

9 :
A client is taking calcium supplements. Which hypothesis should the nurse prioritize based on this information?

10 :
Which of the following is a potential side effect of non-opioid analgesics?

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Custom 3 -PNSG 1600 EXAM 2-2025 (Summer)

No.

1 : A nurse is reinforcing teaching with a client who has osteoporosis and a new prescription for alendronate. Which of the following adverse effects should the nurse include in the teaching? (Select all that apply.)

2 : Which of the following are examples of opioid agonists?

3 : A nurse is preparing to administer dextrose 5% in water (D5W) 100 mL to infuse over 1 hr. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number.)

4 : Which of the following is a second-generation nonsteroidal anti-inflammatory drug (NSAID)?

5 : Which of the following is an example of a non-opioid analgesic?

6 : A client who is taking Fosamax presents with symptoms of abdominal pain, nausea and difficulty swallowing. The nurse analyzes the cues and prioritizes a hypothesis. Which hypothesis should the nurse prioritize?

7 : A nurse is collecting data on a client who has a prescription for morphine. The nurse should recognize that which of the following data is a priority to obtain before administering this medication?

8 : A nurse is preparing to administer erythromycin stearate 500 mg PO. Available is erythromycin stearate 250 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

9 : A client is taking calcium supplements. Which hypothesis should the nurse prioritize based on this information?

10 : Which of the following is a potential side effect of non-opioid analgesics?

1 :
A nurse is reinforcing teaching with a client who has osteoporosis and a new prescription for alendronate. Which of the following adverse effects should the nurse include in the teaching? (Select all that apply.)

2 :
Which of the following are examples of opioid agonists?

3 :
A nurse is preparing to administer dextrose 5% in water (D5W) 100 mL to infuse over 1 hr. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number.)

4 :
Which of the following is a second-generation nonsteroidal anti-inflammatory drug (NSAID)?

5 :
Which of the following is an example of a non-opioid analgesic?

6 :
A client who is taking Fosamax presents with symptoms of abdominal pain, nausea and difficulty swallowing. The nurse analyzes the cues and prioritizes a hypothesis. Which hypothesis should the nurse prioritize?

7 :
A nurse is collecting data on a client who has a prescription for morphine. The nurse should recognize that which of the following data is a priority to obtain before administering this medication?

8 :
A nurse is preparing to administer erythromycin stearate 500 mg PO. Available is erythromycin stearate 250 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

9 :
A client is taking calcium supplements. Which hypothesis should the nurse prioritize based on this information?

10 :
Which of the following is a potential side effect of non-opioid analgesics?