A nurse in a provider's clinic is assessing a client who has cancer and a prescription for methotrexate PO. Which of the following actions should the nurse take when the client reports bleeding gums?

Check the value of the client's current platelet count.

Explain to the client that this is an expected adverse effect.

Instruct the client to use an electric toothbrush.

Have the client make an appointment to see the dentist.

Answer and Explanation

The Correct Answer is A

A. Methotrexate can lead to decreased DNA synthesis in the bone marrow leading to low platelets count.
B. It should be anticipated but should be addressed
C. Electric brush does not address the underlying issue
D. low platelets could lead to life-threatening bleeding and hence should be addressed immediately

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Correct Answer is ["A","B","C"]

Explanation

Methotrexate inhibits the synthesis of purines. Purines and pyrimidines are the building blocks of DNA synthesis in every cell in the body. It affects the production of white blood cells and hence lowers the immunity and hence the client is at a higher risk for infections

Avoiding infected persons and hand hygiene prevents infections. Alcohol should be avoided as it increases the risk of liver damage

E-it takes several weeks to months to produce its effects

A. Ask the provider to prescribe diphenhydramine as a precaution. B. Hold the medication until the provider makes rounds. C. Request that the surgeon prescribe a different antibiotic. D. Administer the medication.

Correct Answer is C

Explanation

Rationale- The client is at risk of a life-threatening anaphylaxis as cross reactivity occurs between cephalosporin and penicillin as they both contain a beta lactam ring. Cephalexin should be avoided completely
A. Diphenhydramine is used for mild reactions but not anaphylaxis
B. waiting for rounds delays the client’s medication and hence inappropriate

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A nurse in a provider's clinic is assessing a client who has cancer and a prescription for methotrexate PO. Which of the following actions should the nurse take when the client reports bleeding gums?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following instructions should the nurse include? (Select all that apply.)

Correct Answer is ["A","B","C"]

Explanation

Correct Answer is C

Explanation

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