A nurse is providing teaching to a client who has osteoporosis and a new prescription for alendronate. Which of the following adverse effects should the nurse instruct the client to report to the provider? (Select all that apply.)

The correct answers are C (Jaw pain) and E (Esophageal erosion). Jaw pain is associated with a rare but serious side effect called osteonecrosis of the jaw, which can occur with bisphosphonate medications like alendronate. This requires immediate medical attention. Esophageal erosion is another significant adverse effect of alendronate due to its potential to cause irritation and damage to the esophagus. It is crucial for the client to report these symptoms promptly to prevent complications. Choices A, B, and D (Drowsiness, Tachycardia, Dizziness) are not typically associated with alendronate and are less concerning in this context, so they do not require immediate reporting.