A nurse is teaching a client who has rheumatoid arthritis about taking methotrexate. Which of the following information should the nurse include?
Take an antiemetic 1 hr following administration.
Take the medication with an NSAID.
Drink 2 to 3 L Of water per day.
Rinse mouth 2 times per day with an alcohol-based mouthwash.
The Correct Answer is C
Methotrexate causes hyperuricemia which may predispose to kidney stones. Adequate hydration help flush out the uric acid preventing stone formation
A-Although methotrexate can cause nausea and vomiting, this does not always happen, therefore, no need for the antiemetic before intake
B-Taking methotrexate with an NSAID increases risk of gastrointestinal irritation
D-Methotrexate cause stomatitis which may be aggravated by use of alcohol-based mouth wash
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Senna is a laxative that works to stimulate bowel movements by irritating the intestinal lining in clients with constipation. In cases of small bowel obstruction, this can increase the risk of perforation or exacerbate the obstruction in cases.
A. Zolpidem is a sleep medication and is unlikely to affect the bowel obstruction.
B. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause gastric irritation but is not contraindicated in small bowel obstruction.
C. Omeprazole is a proton pump inhibitor used to reduce stomach acid production and is safe to use in small bowel obstruction.
Correct Answer is B
Explanation
Prolonged oral corticosteroid use reduces the body’s secretion of endogenous steroids- cortisol as the body relies on the oral steroids. If abruptly stopped the body experiences severe adrenocortical insufficiency with symptoms such as fatigue, weakness, weight loss, nausea, vomiting, and low blood pressure. Tapering the dose allows the body to readjust and produce cortisol.
A, C, D- Are not effects of abrupt discontinuation of steroids
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