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) Chronotropic effect: This term refers to changes in heart rate. Angiotensin II receptor antagonists like valsartan primarily affect blood pressure and vascular tone, rather than directly altering heart rate.
B) Diuresis: Diuresis involves increased urine production. Although some antihypertensives can have a diuretic effect, valsartan primarily works through mechanisms other than increasing urine output.
C) Vasodilation: Angiotensin II receptor antagonists such as valsartan work by blocking the action of angiotensin II, which leads to vasodilation. This reduction in vascular resistance helps to lower blood pressure and is the primary therapeutic effect of valsartan.
D) Sympatholytic action: This refers to the suppression of sympathetic nervous system activity. Valsartan does not primarily act through sympathetic nervous system modulation but rather through direct vasodilation by blocking angiotensin II receptors.

A. Determine if there is a decrease in serum potassium due to renal compromise B. Expect to find an increase in today's activated partial thromboplastin time (APTT) as compared to last quarter's due to bleeding. C. Look at last quarter's hemoglobin and hematocrit, expecting an increase today due to dehydration. D. Look for an increase in today's lactic dehydrogenase (LDH) compared to the previous one to assess for possible liver damage.

Correct Answer is D

Explanation

A. Determine if there is a decrease in serum potassium due to renal compromise: Acetaminophen is not commonly associated with significant renal impairment or changes in serum potassium levels, making this a less relevant consideration.
B. Expect to find an increase in today's activated partial thromboplastin time (APTT) as compared to last quarter's due to bleeding: Acetaminophen does not significantly affect APTT or bleeding risk, so changes in APTT would not be expected due to acetaminophen use.
C. Look at last quarter's hemoglobin and hematocrit, expecting an increase today due to dehydration: Acetaminophen is not known to cause changes in hemoglobin and hematocrit levels or dehydration-related increases in these values.
D. Look for an increase in today's lactic dehydrogenase (LDH) compared to the previous one to assess for possible liver damage: Acetaminophen overdose or chronic high use can lead to liver damage, which would be indicated by elevated LDH levels. Monitoring LDH is appropriate to assess for potential liver damage related to acetaminophen use.

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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

The nurse is administering the angiotensin II receptor antagonist valsartan. Which physiological response causes its therapeutic effect?

Correct Answer is C

Explanation

Correct Answer is D

Explanation

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