A nurse is providing discharge planning for a client who has just been diagnosed as being in the early stage of rheumatoid arthritis and starting methotrexate. What should the nurse include in the client's teaching?

Monitor for symptoms of anemia

Expect an increase in appetite while on the medication

Rotate the site of the patch application

Anticipate relief of symptoms in 1-2 weeks

Answer and Explanation

The Correct Answer is A

A. Monitoring for symptoms of anemia is essential as methotrexate can cause bone marrow suppression, leading to anemia. The nurse should instruct the client to report symptoms like fatigue, pallor, and shortness of breath.
B. Methotrexate is more likely to cause gastrointestinal side effects like nausea and loss of appetite rather than an increase in appetite.
C. Methotrexate is typically administered orally or by injection, not via a patch, so rotating the site of patch application is not relevant.
D. Relief of symptoms from methotrexate generally takes several weeks to months. It is important to set realistic expectations about the timeline for symptom improvement.

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Correct Answer is B

Explanation

B. In a disaster situation, prioritizing care for clients with life-threatening emergencies is crucial to ensure that those in the most critical condition receive immediate attention. This aligns with triage principles and ensures that limited resources are used effectively.
A. While addressing ADLs is important, it is secondary to addressing life-threatening emergencies in a disaster scenario.
C. Discharging stable clients can help increase bed availability but should be considered after addressing immediate life-threatening needs.
D. Stocking additional supplies is necessary but should follow after ensuring that life-threatening conditions are managed.

A. Dry the sclera with a cotton swab prior to medication administration. B. Administer the medications 5 minutes apart. C. Administer the medications by touching the tip of the dropper to the sclera of the eye. D. Hold pressure on the conjunctival sac for 2 minutes following application of drops.

Correct Answer is B

Explanation

A. Drying the sclera with a cotton swab prior to administering eye drops is not recommended and could introduce fibers or cause irritation. Proper eye drop administration does not require drying the sclera.
B. Administering the medications 5 minutes apart is correct because it allows each medication to be absorbed properly, preventing the second drop from washing out the first. This timing helps ensure that both medications are effective.
C. Touching the tip of the dropper to the sclera is incorrect and can introduce contaminants, leading to infection. Eye drops should be administered without the dropper touching the eye to maintain sterility.
D. Holding pressure on the conjunctival sac for 2 minutes is excessive. The recommended practice is to gently press on the nasolacrimal duct for 1-2 minutes after administration to prevent systemic absorption, especially with medications like timolol.

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A nurse is providing discharge planning for a client who has just been diagnosed as being in the early stage of rheumatoid arthritis and starting methotrexate. What should the nurse include in the client's teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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