一位病人因骨質疏鬆症被處方使用阿崙膦酸鈉（Alendronate）。護理師應提供哪項指導以確保給藥安全？
A client is prescribed alendronate for osteoporosis. Which instruction should the nurse provide to ensure safe administration?
- ALie down for 30 minutes after taking the medication to rest服用藥物後躺下休息 30 分鐘
- BCrush the tablet if it is too difficult to swallow若難以吞服，將錠劑磨碎
- CTake the medication with a glass of milk to increase calcium absorption與一杯牛奶同服以增加鈣吸收
- DTake the medication on an empty stomach with a full glass of water✓ 正解空腹時以一杯滿水服用藥物
Alendronate 是一種雙磷酸鹽類（Bisphosphonate）藥物，其給藥方式對療效與安全性至關重要。該藥物吸收極差，且對食道具有強烈刺激性。正確用法是：早晨起床後，在進食任何食物或飲料前（空腹），以一整杯白開水（Full glass of plain water）送服。服用後必須維持「上半身直立（坐著或站著）」至少 30 分鐘，以利用重力防止藥物反流導致食道炎或潰瘍。C 選項錯誤，牛奶會干擾吸收；A 選項躺下是禁忌；B 選項不可磨碎。這題考查護理師對藥物特殊給藥規範（藥物動力學與副作用預防）的衛教能力。
Alendronate is a bisphosphonate, and the manner of administration is critical to both efficacy and safety. The drug has very poor absorption and is strongly irritating to the esophagus. Correct usage is: upon awakening in the morning, before any food or beverage (on an empty stomach), with a full glass of plain water. After taking the medication, the client must remain upright (sitting or standing) for at least 30 minutes to use gravity to prevent reflux that could cause esophagitis or ulceration. Option C is incorrect because milk interferes with absorption; option A (lying down) is contraindicated; option B (crushing) is not allowed. This item assesses the nurse's ability to teach the special administration requirements of a drug (its pharmacokinetics and side-effect prevention).
美國 NCLEX 針對雙磷酸鹽類的「直立 30 分鐘」與「白開水」是經典考點。台灣臨床上，許多長輩會習慣配茶或配牛奶服藥，護理師在衛教時需特別強調「只能配水」以及「不可回籠覺」的重要性。