A nurse is providing teaching to a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following information should the nurse provide?

Take the medication in the morning to prevent insomnia.

Drink 2 to 3 L of water per day while on the medication.

Expect to have a fever for the first days of therapy.

Administer the medication with an NSAID to enhance effectiveness.

Answer and Explanation

The Correct Answer is B

A. Methotrexate is not typically associated with insomnia, and the timing of administration should be according to the provider's instructions.
B. Drinking 2 to 3 L of water per day helps prevent kidney damage and reduces the risk of side effects such as methotrexate toxicity.
C. Fever is not a common expected side effect of methotrexate and should be reported to the provider.
D. Combining methotrexate with NSAIDs can increase the risk of toxicity; this should only be done under direct medical supervision.

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Correct Answer is D

Explanation

A. Notifying the provider is necessary but not the first action.
B. Applying a cold pack may help with swelling but is not the first action to take.
C. Removing the PICC line should only be done after assessing the situation and consulting with the provider.
D. Measuring the circumference of both upper arms is the first action to assess the extent of the swelling and compare it to the other arm, which will help determine the severity of the issue.

A. Are you fully insured? B. Is it possible that you are pregnant? C. Do you take any medications? D. What was your last meal? E. What happened before you fell? F. Do you live with anyone?

Correct Answer is ["A","B","D","F"]

Explanation

A. Peripheral IV in large vein
Vancomycin should be administered through a large-bore IV to minimize the risk of complications such as phlebitis and to ensure effective drug delivery. This is a key factor in safely administering the medication.
B. Dosage in safe range
Confirming that the dosage is within the safe range ensures that the medication is administered at an effective but non-toxic level. Proper dosing is essential for achieving therapeutic effects without causing harm.
C. No known allergies
Ensuring that the client has no known allergies to vancomycin is critical to prevent allergic reactions. This step is necessary for the safe administration of the antibiotic.
D. Potassium 4.4 mEq/L (4.4 mmol/L)
While normal potassium levels are important for overall health, they do not specifically indicate the safety of vancomycin administration. Other factors such as IV access and dosage are more directly related to the safety of vancomycin.
E. Used for prophylaxis
Vancomycin is used for endocarditis prophylaxis in this case, which aligns with the clinical guidelines for preventing infections. Understanding the purpose of the medication supports its appropriate use in the client’s care.
F. Blood urea nitrogen 17 mg/dL (6.07 mmol/L)
An elevated BUN level might indicate renal impairment, which could affect vancomycin metabolism. However, this level alone does not directly address the immediate safety of administering the antibiotic compared to other factors like IV access and dosage.

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A nurse is providing teaching to a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following information should the nurse provide?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is receiving total parenteral nutrition via a peripherally inserted central catheter (PICC). When assessing the client, the nurse notes swelling of the client's arm above the PICC insertion site. Which of the following actions should the nurse take first?

Correct Answer is D

Explanation

Exhibits The nurse collects blood from the client during peripheral IV line placement. What laboratory specimens would the nurse expect for the provider to order? Select all that apply.

Correct Answer is ["A","B","D","F"]

Explanation

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