MEDICAL SURGE II MEDICATIONS 65 QUESTIONS
WITH CORRECT ANSWERS LATEST UPDATE
2024 A+ GUARANTEED
1. When administering alendronate (fosamax) to a patient, the nurse will first
a. Administer the ordered calcium carbonate.
b. Be sure the patient has recently eaten.
c. Assist the patient to sit up at the bedside.
d. Ask about any leg cramps or hot flashes.: answer: c
Rationale: to avoid esophageal erosions, the patient taking bisphosphonates should
be upright for at least 30 minutes after taking the medication. Fosamax should be
taken on an empty stomach, not after taking other medications or eating. Leg
cramps and hot flashes are not side effects of bisphosphonates.
2. Alendronate (foxamas). Class: bisphosphonates. Inhibit osteoclast-
mediated bone resorption, thereby increasing total bone mass.: because of
the risk of esophagitis, bisphosphonates must be administered in the morning,
before the client eats or drinks, with a full glass of water; the client must then
remain sitting or standing for at least 30 to 60 minutes, depending on the
medication.
3. Alendronate (foxamas) contraindicated: clients with
Esophageal disorders that can impede swallowing and for
Clients who can not sit or stand
4. Alendronate (foxamas)
Adverse effect: esophagitis, muscle pain and ocular problems, the client is
instructed to contact the hcp if adverse effects
Occur
5. Alendronate is prescribed for a client with osteoporosis and the nurse is
providing instruction on administration of the medication. Which
instruction should the nurse provide?
,1. Take the medication at bedtime
2. Take the medication in the morning with breakfast
3. Lie down for 30 minutes after taking the medication
4. Take the medication with a full glass of water after rising in
The morning:
4. Take the medication with a full glass of water after rising in the morning
Rational. Precaution need to be taken to avoid esophageal irri-
Tation. Do not eat or drink anything for 30 minutes following
Administration and should not lie down after taking the medication
6. Metformin (biguanides) (glucophage) glucophage xr (extended release):
dose: tablets: 500 mg, 850 mg, 1000 mg
Extended-release tablets (fortamet, glucophage xr, glumetza): 500 mg, 750 mg,
1000 mg
Po: (adults and children >17 yr): 500 mg twice daily; may ‘ by 500 mg at weekly
intervals up to 2000 mg/day. If doses >2000 mg/day are required, give in 3 divided
doses (not to exceed 2500 mg/day) or 850 mg once daily; may ‘ by 850 mg at 2-
wk intervals (in divided doses) up to 2550 mg/day in divided doses (up to 850 mg
3 times daily); extended-release tablets- 500-1000 mg once daily with evening
meal, may ‘ by 500 mg at weekly intervals up to 2000 mg once daily (glucophage
xr or glumetza) or 2500 mg once daily (fortamet). If 2000 mg once daily is
inadequate, 1000 mg twice daily may be used.
7. Actions of metformin: decrease glucose production by the liver
Augments glucose uptake by tissues, especially muscle
Improve glucose transport into the cells
8. Metformin side effects: diarrhea, lactic acidosis. Must be held 1-2
Days before iv contrast media given 48 hours after (lewis book)
Gi: abdominal bloating, diarrhea, nausea, vomiting, unpleasant metallic taste
, F and e: lactic acidosis
Misc: decreased vitamin b12 levels
Iggy. Diarrhea, nausea, flautulence, indigestion and abdominal
Pain. Page 1292
9. Metformin drug alert (lewis): - do not use in patients with
Kidney disease, liver diseases or heart failure. Lactic acidosis is a rare
complication of metformin accumulation
-iv contrast media that contain iodine pose a a risk of acute
Kidney injury, which could exacerbate metformin induce lactic acidosis
- To reduce risk of kidney injury, discontinue metformin a day or two before the
procedure
- May be resume 48 hours after the procedure , assuming kidney funtion is normal
- Do not use in people who drink excessive amounts of alcohol
- Take with food to minimize gi side effects
10. Metformin (assessment): patients who have been well controlled on
metformin who develop illness or laboratory abnormalities should be assessed for
ketoacidosis or lactic acidosis. Assess serum electrolytes, ketones, glucose, and,
if indicated, blood ph, lactate, pyruvate, and metformin levels. If either form of
acidosis is present, discontinue metformin immediately and treat acidosis.
Patients with severe renal impairment are at greatest risk for lactic acidosis.
Assess renal function before initiating and at least annually during therapy.
Monitor patients at risk for renal impairment (eg. Elderly) more frequently.
Discontinue metformin if renal impairment occurs.
Monitor serum folic acid and vitamin b12 every 1-2 yr in long-term therapy.
Metformin may interfere with absorption.
WITH CORRECT ANSWERS LATEST UPDATE
2024 A+ GUARANTEED
1. When administering alendronate (fosamax) to a patient, the nurse will first
a. Administer the ordered calcium carbonate.
b. Be sure the patient has recently eaten.
c. Assist the patient to sit up at the bedside.
d. Ask about any leg cramps or hot flashes.: answer: c
Rationale: to avoid esophageal erosions, the patient taking bisphosphonates should
be upright for at least 30 minutes after taking the medication. Fosamax should be
taken on an empty stomach, not after taking other medications or eating. Leg
cramps and hot flashes are not side effects of bisphosphonates.
2. Alendronate (foxamas). Class: bisphosphonates. Inhibit osteoclast-
mediated bone resorption, thereby increasing total bone mass.: because of
the risk of esophagitis, bisphosphonates must be administered in the morning,
before the client eats or drinks, with a full glass of water; the client must then
remain sitting or standing for at least 30 to 60 minutes, depending on the
medication.
3. Alendronate (foxamas) contraindicated: clients with
Esophageal disorders that can impede swallowing and for
Clients who can not sit or stand
4. Alendronate (foxamas)
Adverse effect: esophagitis, muscle pain and ocular problems, the client is
instructed to contact the hcp if adverse effects
Occur
5. Alendronate is prescribed for a client with osteoporosis and the nurse is
providing instruction on administration of the medication. Which
instruction should the nurse provide?
,1. Take the medication at bedtime
2. Take the medication in the morning with breakfast
3. Lie down for 30 minutes after taking the medication
4. Take the medication with a full glass of water after rising in
The morning:
4. Take the medication with a full glass of water after rising in the morning
Rational. Precaution need to be taken to avoid esophageal irri-
Tation. Do not eat or drink anything for 30 minutes following
Administration and should not lie down after taking the medication
6. Metformin (biguanides) (glucophage) glucophage xr (extended release):
dose: tablets: 500 mg, 850 mg, 1000 mg
Extended-release tablets (fortamet, glucophage xr, glumetza): 500 mg, 750 mg,
1000 mg
Po: (adults and children >17 yr): 500 mg twice daily; may ‘ by 500 mg at weekly
intervals up to 2000 mg/day. If doses >2000 mg/day are required, give in 3 divided
doses (not to exceed 2500 mg/day) or 850 mg once daily; may ‘ by 850 mg at 2-
wk intervals (in divided doses) up to 2550 mg/day in divided doses (up to 850 mg
3 times daily); extended-release tablets- 500-1000 mg once daily with evening
meal, may ‘ by 500 mg at weekly intervals up to 2000 mg once daily (glucophage
xr or glumetza) or 2500 mg once daily (fortamet). If 2000 mg once daily is
inadequate, 1000 mg twice daily may be used.
7. Actions of metformin: decrease glucose production by the liver
Augments glucose uptake by tissues, especially muscle
Improve glucose transport into the cells
8. Metformin side effects: diarrhea, lactic acidosis. Must be held 1-2
Days before iv contrast media given 48 hours after (lewis book)
Gi: abdominal bloating, diarrhea, nausea, vomiting, unpleasant metallic taste
, F and e: lactic acidosis
Misc: decreased vitamin b12 levels
Iggy. Diarrhea, nausea, flautulence, indigestion and abdominal
Pain. Page 1292
9. Metformin drug alert (lewis): - do not use in patients with
Kidney disease, liver diseases or heart failure. Lactic acidosis is a rare
complication of metformin accumulation
-iv contrast media that contain iodine pose a a risk of acute
Kidney injury, which could exacerbate metformin induce lactic acidosis
- To reduce risk of kidney injury, discontinue metformin a day or two before the
procedure
- May be resume 48 hours after the procedure , assuming kidney funtion is normal
- Do not use in people who drink excessive amounts of alcohol
- Take with food to minimize gi side effects
10. Metformin (assessment): patients who have been well controlled on
metformin who develop illness or laboratory abnormalities should be assessed for
ketoacidosis or lactic acidosis. Assess serum electrolytes, ketones, glucose, and,
if indicated, blood ph, lactate, pyruvate, and metformin levels. If either form of
acidosis is present, discontinue metformin immediately and treat acidosis.
Patients with severe renal impairment are at greatest risk for lactic acidosis.
Assess renal function before initiating and at least annually during therapy.
Monitor patients at risk for renal impairment (eg. Elderly) more frequently.
Discontinue metformin if renal impairment occurs.
Monitor serum folic acid and vitamin b12 every 1-2 yr in long-term therapy.
Metformin may interfere with absorption.
