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 D

Explanation

A) Hypertension: Phenytoin is primarily used to manage seizures, and hypertension is not a common side effect associated with its use. While monitoring blood pressure is important for overall health, it is not specifically indicated for detecting common side effects of phenytoin.
B) Peripheral edema: Peripheral edema is not a typical side effect of phenytoin. Common side effects are usually related to oral health and skin changes rather than fluid retention or swelling in the extremities.
C) Hematuria: Hematuria, or blood in the urine, is not commonly associated with phenytoin use. This side effect is more relevant to other medications or conditions, and while monitoring for overall health changes is important, it is not a primary concern with phenytoin.
D) Gingival hyperplasia: Phenytoin is well-known for causing gingival hyperplasia, which is the overgrowth of gum tissue. This is a common and notable side effect of long-term phenytoin use, making it important for the nurse to assess for this symptom in clients receiving the medication.

A. Hematocrit 42% (0.42 volume fraction). B. Positive guaiac of stool. C. Gastric pH 2. D. Hemoglobin 13 g/dl. (8.07 mmol/l)

Correct Answer is B

Explanation

A. Hematocrit 42% (0.42 volume fraction): This value is within the normal range for hematocrit (42% to 52%). Therefore, it does not indicate an immediate concern.
B. Positive guaiac of stool: A positive guaiac test for occult blood in the stool indicates gastrointestinal bleeding. Given the client's history of self-treating with ibuprofen (a nonsteroidal anti-inflammatory drug, NSAID) and his symptoms of fatigue and dizziness, this finding suggests possible gastrointestinal bleeding due to NSAID-induced ulcers or bleeding. This requires immediate reporting to the healthcare provider for further evaluation and intervention.
C. Gastric pH 2: While the gastric pH is on the acidic side, it is within the normal range for gastric acid (1.5 to 3.5). This finding does not necessarily indicate an acute problem by itself.
D. Hemoglobin 13 g/dL (8.07 mmol/L): Although this hemoglobin level is slightly below the normal range for males (14 to 18 g/dL), it is not as critical as a positive guaiac test for stool blood. It might be worth monitoring, but it is not as urgent as addressing potential gastrointestinal bleeding.

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

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Naxlex Comprehensive Predictor Exams

To detect common untoward effects of phenytoin, the nurse should assess a client with a seizure disorder for which sign or symptom?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

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