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.
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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Related Questions
Correct Answer is D
Explanation
A. Sickle cell anemia typically presents with hemolytic crises and sickle-shaped red blood cells, not necessarily heavy menstrual bleeding.
B. Folic acid deficiency anemia can cause macrocytic anemia but is less likely to cause heavy menstrual bleeding as the primary symptom.
C. Pernicious anemia is due to vitamin B12 deficiency and typically presents with neurological symptoms along with anemia, not necessarily heavy menstrual bleeding.
D. Iron-deficiency anemia commonly presents with weakness, fatigue, and heavy menstrual bleeding due to inadequate iron for red blood cell production.
Correct Answer is A
Explanation
A. Determining what the client already knows about managing diabetes is the initial step in assessing the client's current knowledge and understanding. This helps the nurse tailor the teaching plan to the client's needs and avoid redundancy.
B. Providing access to a video about diabetes may be part of the teaching plan but should come after assessing the client's baseline knowledge.
C. Establishing short-term, realistic goals is important but should follow the assessment of the client's current knowledge and understanding.
D. Evaluating the effectiveness of the client's admission teaching plan is important but should occur after the initial assessment and implementation of a personalized teaching plan.
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