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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. The float nurse may not be familiar with discharge planning specific to long-term care facilities.
B. A nurse from the PACU is highly experienced with postoperative care and monitoring of clients with chest tubes, making this the most appropriate assignment.
C. Teaching about insulin self-administration requires specific education techniques which the float nurse might not be most familiar with.
D. Teaching for cardiac rehabilitation involves specialized knowledge that might be outside the float nurse’s expertise.
Correct Answer is ["C","D"]
Explanation
A. While low back pain can be concerning, it's not an immediate priority compared to the vital sign changes. However, the nurse should document the pain and ask about its characteristics.
B. Brown-colored urine can sometimes indicate dehydration or certain medical conditions, requiring follow-up.
C. A significant drop in blood pressure (74/50 mmHg) indicates hypotension and requires immediate attention.
D. An increase in respiratory rate (28 breaths/min) suggests the client may be experiencing respiratory distress and needs evaluation.
E. The client’s oxygen saturation is 95% on room air which is normal.
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