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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Bulging fontanels are a sign of increased intracranial pressure, which is an abnormal finding in newborns. The nurse should assess for other signs of neurological impairment, such as lethargy, irritability, or seizures.
Choice B rationale:
Blue hands and feet, also known as acrocyanosis, are a normal finding in newborns who are 4 hr old. This is due to immature peripheral circulation and should resolve within 24 to 48 hr.
Choice C rationale:
Generalized petechiae are a sign of bleeding disorders, infection, or trauma, which are abnormal findings in newborns. The nurse should assess for other signs of bleeding, such as bruising, hematuria, or melena.
Choice D rationale:
Flaring of the nares is a sign of respiratory distress, which is an abnormal finding in newborns. The nurse should assess for other signs of respiratory distress, such as grunting, retractions, or cyanosis.
Correct Answer is C
Explanation
Choice A rationale:
Shaking the auto-injector is not recommended as it could disrupt the medication's effectiveness. Epinephrine auto-injectors contain two separate components that need to be mixed upon injection.
Choice B rationale:
Massaging the injection site after using the auto-injector can actually help disperse the medication and promote absorption and reduce pain and swelling.
Choice C rationale:
Injecting the medication into the top of the thigh is the correct administration site and technique for an epinephrine auto-injector. It's a large muscle area that allows for rapid absorption.
Choice D rationale:
Epinephrine auto-injectors should not be refrigerated, as extreme temperatures can affect their functionality. The client should store the device at room temperature away from light and heat sources.
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