A client receives a prescription for methotrexate. Which information provided by the client requires additional instruction by the nurse?

Obtain a platelet count weekly.

Take the medication during pregnancy.

Use folic acid to protect the liver.

Store the medication at room temperature.

Answer and Explanation

The Correct Answer is B

A. Obtain a platelet count weekly: Regular monitoring of platelet counts is important for clients on methotrexate due to the risk of bone marrow suppression and potential thrombocytopenia. This instruction is appropriate and necessary.
B. Take the medication during pregnancy: Methotrexate is contraindicated during pregnancy due to its teratogenic effects and potential to cause fetal harm. It is crucial for clients to avoid using methotrexate while pregnant or planning to become pregnant.
C. Use folic acid to protect the liver: While folic acid is often used to help reduce the side effects of methotrexate, particularly its gastrointestinal effects and potential for liver toxicity, it is not used to "protect the liver" per se. The correct approach is to use folic acid as directed by a healthcare provider, often to mitigate some of the side effects of methotrexate.
D. Store the medication at room temperature: Methotrexate should be stored according to the manufacturer's instructions, which usually involve keeping it at room temperature. This information is correct and does not require additional instruction.

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Correct Answer is C

Explanation

A. Diabetes mellitus: While diabetes mellitus is an important condition to consider for overall health, it is not directly related to the use of magnesium hydroxide and aluminum hydroxide, as these antacids primarily affect the gastrointestinal system and renal function.
B. Deep vein thrombosis: Deep vein thrombosis is related to blood clot formation and does not have a direct connection to the use of magnesium and aluminum hydroxide, which affect the gastrointestinal system and renal function.
C. Renal disease: Magnesium hydroxide and aluminum hydroxide can affect kidney function and cause complications in individuals with renal disease. Magnesium and aluminum are excreted through the kidneys, and impaired renal function can lead to an accumulation of these substances, causing potential toxicity.
D. Chronic bronchitis: Chronic bronchitis affects the respiratory system and is not directly impacted by the use of magnesium and aluminum hydroxide, which are primarily concerned with gastrointestinal and renal function.

A. Takes metformin hydrochloride for type 2 diabetes mellitus. B. Metal hip prosthesis was placed twenty years ago. C. Report of client's sobriety for the last five years. D. CT scan that was performed six months earlier.

Correct Answer is A

Explanation

A) Takes metformin hydrochloride for type 2 diabetes mellitus: Metformin can interact with the contrast dye used in CT scans, particularly in patients with impaired renal function. The contrast dye can affect kidney function, potentially leading to lactic acidosis in patients taking metformin. It is important to follow up on this history and possibly temporarily discontinue metformin and monitor kidney function before and after the procedure.

B) Metal hip prosthesis was placed twenty years ago: A metal hip prosthesis does not typically affect the CT scan with contrast, though it may affect the imaging technique or quality. This history usually does not require follow-up related to the contrast use.
C) Report of client's sobriety for the last five years: Sobriety does not directly impact the use of contrast dye in a CT scan. This information is relevant for overall health but not specifically for the use of contrast.
D) CT scan that was performed six months earlier: The timing of a previous CT scan is not a contraindication for a new scan with contrast. Follow-up on the history of a prior scan may be relevant for comparison but does not specifically impact the use of contrast dye.

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A client receives a prescription for methotrexate. Which information provided by the client requires additional instruction by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A male client tells the home health nurse that he has started taking magnesium hydroxide and aluminum hydroxide to treat occasional heartburn. It is most important for the nurse to review the client's medical history regarding the presence of which disorder?

Correct Answer is C

Explanation

A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client's history requires follow up by the nurse?

Correct Answer is A

Explanation

During an annual physical exam, an older adult tells the nurse of using goldenseal as an herbal supplement. Which additional history should the nurse gather from the client?

The nurse is caring for a client receiving regular insulin prescribed per a sliding scale. If a dose of regular insulin is administered at 0730, which additional nursing action is indicated for this client?

The healthcare provider prescribes the anticoagulant heparin for a client with a pulmonary embolism. Before initiating the medication, the nurse should ensure that which drug is readily available in case of heparin overdose?

A client with a history of angina reports the onset of chest pain. The nurse determines that the heart rate is 104 beats/minute and the blood pressure is 138/86 mm Hg. A transdermal nitroglycerin patch was applied 30 minutes ago to the right upper chest. Which action should the nurse take?

When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client's upper back and the client denies pain. Which action should the nurse take?