1. Alendronate (Fosamax) is ordered for a patient with osteoporosis.

Which information
should the nurse teach the patient about the medication?
A. Acts as a selective estrogen receptor modulator
B. Reduces risk of invasive breast cancer
C. May be obtained as a nasal spray
D. Inhibits bone resorption

Rationale: Alendronate (Fosamax), a bisphosphonate, is a potent inhibitor of bone resorption

that preserves bone mass and increases bone density. Raloxifene (Evista) is an example of a
selective estrogen receptor modulator that is used to treat osteoporosis, and which also
reduces the risk of invasive breast cancer. Calcitonin (Miacalcin) is dispensed as a nasal spray.

2. How long does a patient taking bisphosphonates need to stay upright after administration?
A. 10 minutes
B. 20 minutes
C. 30 minutes
D. 120 minutes

Rationale: Bisphosphonates are administered on arising in the morning with a full glass of
water on an empty stomach, and the patient must stay upright for 30 to 60 minutes.

3. When caring for a client with hypocalcemia, the nurse should assess for:
A. A decreased level of consciousness
B. Tetany
C. Bradycardia
D. Respiratory Depression

Rationale: The most common complication of hypocalcemia is overstimulation of the nerves

and muscles. Tetany, which can progress to convulsions, indicated that the patient's condition
is worsening. Answer A is incorrect because a decreased level of consciousness is not associated
with hypocalcemia. Tachycardia, not bradycardia, is associated with hypocalcemia, making
answer C incorrect. Answer D is incorrect because respiratory depression is not directly related
to hypocalcemia.

4. The patient who is taking alendronate (Fosamax) is at high risk for developing which
disorder?
A. Cardiovascular disease
B. Breast cancer
C. Inflammation of the esophagus
D. Stroke

Rationale: Esophagitis and esophageal ulcers have been reported with use of all of the
bisphosphonates. The other answer selections apply to hormone replacement therapy.