Page 1474 - Saunders Comprehensive Review For NCLEX-RN

Options 1, 2, and 4 are incorrect.
Test-Taking Strategy: Note the strategic word, best. Note the suffix -sone and recall
that medication names that end with these letters are corticosteroids. Remember that
a daily dose of a corticosteroid should be administered in the morning.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Endocrine Medications: Corticosteroids
Health Problem: N/A
Priority Concepts: Client Education; Hormonal Regulation
Reference: Hodgson, Kizior (2018), pp. 967-968.

527. Answer: 3, 4

Rationale: Alendronate is a bisphosphonate used in hyperparathyroidism to
inhibit bone loss and normalize serum calcium levels. Esophagitis is an adverse
effect of primary concern in clients taking alendronate. For this reason the client is
instructed to take alendronate first thing in the morning with a full glass of water on
an empty stomach, not to eat or drink anything else for at least 30 minutes after
taking the medication, and to remain sitting upright for at least 30 minutes after
taking it.
Test-Taking Strategy: Focus on the subject, the correct method to take
alendronate. Recall that the primary concern with alendronate is esophagitis.
Eliminate options 1 and 2, since taking with food and taking at bedtime will each
place the client at increased risk of reflux. Eliminate option 5 because alendronate
should be taken first thing in the morning on an empty stomach.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Evaluation
Content Area: Pharmacology: Endocrine Medications: Bisphosphonates and
Calcium Regulators
Health Problem: Adult Health: Endocrine: Parathyroid Disorders
Priority Concepts: Client Education; Safety
Reference: Lewis et al. (2017), p. 1513.

528. Answer: 2

Rationale: Prednisone may decrease the effect of oral hypoglycemics, insulin,
diuretics, and potassium supplements. Option 1, a beta blocker, and option 3, a
monoamine oxidase inhibitor, have their own intrinsic hypoglycemic activity.
Option 4 decreases urinary excretion of sulfonylurea agents, causing increased levels
of the oral agents, which can lead to hypoglycemia.
Test-Taking Strategy: Focus on the subject, an increase in the blood glucose level.
Recalling that prednisone is a corticosteroid and that corticosteroids decrease the
effects of hypoglycemics will direct you to the correct option.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity

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