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A nurse is monitoring the laboratory values of a client who has rheumatoid arthritis and is taking methotrexate. Which of the following values should the nurse identify as an adverse effect of the medication?

Positive Rheumatoid factor

WBC count 2.000/mm3

Hemoglobin 14.8 g/dL

Erythrocyte sedimentation rate 24 mm/hr

Answer and Explanation

The Correct Answer is B

Choice A rationale:

A positive Rheumatoid factor is associated with rheumatoid arthritis and is not an adverse effect of methotrexate.

Choice B rationale:

A low WBC count (leukopenia) is an adverse effect of methotrexate and can increase the risk of infection.

Choice C rationale:

A hemoglobin level of 14.8 g/dL is within a normal range and is not an adverse effect of methotrexate.

Choice D rationale:

An erythrocyte sedimentation rate (ESR) of 24 mm/hr is within a normal range and is not an adverse effect of methotrexate.

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Correct Answer is C

Explanation

Choice A rationale:

Taking a hot bath to relieve muscle spasms might exacerbate symptoms in individuals with multiple sclerosis due to heat sensitivity.

Choice B rationale:

Participating in high-impact exercise daily can be challenging for individuals with multiple sclerosis, who may experience fatigue and mobility issues.

Choice C rationale:

Adequate hydration is essential for individuals with multiple sclerosis to maintain overall health and support neurological function.

Choice D rationale:

Restricting daily intake of dietary fiber is not recommended, as fiber can aid in maintaining bowel regularity for individuals with multiple sclerosis.

A. Place objects within reach on the client's right side. B. Encourage the client to repeat phonetic sounds. C. Pause to allow the client time to respond to questions. D. Frequently orient the client to time, place, and surroundings.

Correct Answer is A

Explanation

Choice A rationale:

Placing objects within the client's reach on the right side helps to compensate for the hemiparesis and facilitates the client's ability to independently access items.

Choice B rationale:

Encouraging the client to repeat phonetic sounds might be more appropriate for speech therapy and may not directly address hemiparesis.

Choice C rationale:

Pausing to allow the client time to respond to questions is a communication technique but does not address the physical effects of hemiparesis.

Choice D rationale:

Frequently orienting the client to time, place, and surroundings is important for cognitive support but does not specifically address hemiparesis.

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A nurse is monitoring the laboratory values of a client who has rheumatoid arthritis and is taking methotrexate. Which of the following values should the nurse identify as an adverse effect of the medication?

Nursing Test Bank

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