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","C","D"]
Explanation
Choice A rationale:
Asking the client to explain what she is hearing may not be helpful, as the client's perception of the hallucinations may not match reality.
Choice B rationale:
Conveying empathy is important to establish a therapeutic relationship and provide emotional support.
Choice C rationale:
Encouraging the client to listen to music through headphones can help distract from auditory hallucinations.
Choice D rationale:
Speaking simply and clearly when communicating helps the client understand and process information more effectively.
Choice E rationale:
Using therapeutic touch might not be appropriate for all clients and should be based on the client's preferences and comfort level.
Correct Answer is A
Explanation
Choice A rationale:
Avoiding temperature extremes can help prevent triggering a sickle cell crisis. Cold temperatures can cause blood vessels to constrict, leading to poor blood flow and increased risk of cell sickling.
Choice B rationale:
Engaging in high-impact exercise might not be recommended, as vigorous exercise can increase the risk of dehydration and oxygen deprivation, potentially triggering a crisis.
Choice C rationale:
Staying well-hydrated by drinking fluids is important, but temperature regulation is a key factor in preventing sickle cell crises.
Choice D rationale:
Receiving the influenza vaccine is recommended for individuals with sickle cell disease to reduce the risk of infections that could trigger a crisis. This statement is incorrect; the client should receive the influenza vaccine unless contraindicated.
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