A nurse is teaching a newly licensed nurse about administering sodium polystyrene sulfonate to a client. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

A. A client who is transported to radiology: Transporting a client to radiology is a temporary transfer for diagnostic purposes, not a change in level of care or medication responsibility. Medication reconciliation is not required in this situation.

B. A client who has a consultation for physical therapy: A physical therapy consultation does not involve medication administration or changes, so medication reconciliation is unnecessary in this case.

C. A client who has a referral for social services: Social services referrals address psychosocial or discharge needs, not medication management. Therefore, medication reconciliation is not performed at this point.

D. A client who is transferred to a step-down unit: Medication reconciliation must be completed during any transition of care, including transfers between units. This process ensures continuity, prevents omissions or duplications, and identifies potential medication errors.

A. Handle in an area with controlled ventilation: Controlled ventilation is generally required for aerosolized or powdered hazardous medications, not for standard oral methotrexate tablets. This level of control is unnecessary for oral administration.

B. Wear an N95 mask: Respiratory protection is not required when administering oral methotrexate, as the risk of inhalation is minimal. Masks are reserved for procedures generating airborne particles of hazardous drugs.

C. Don a protective gown: A protective gown is recommended if there is a risk of the medication contacting skin or clothing, such as with injectable or crushed hazardous drugs. Oral tablets taken by the client do not pose this risk.

D. Apply gloves: Gloves should be worn when handling oral methotrexate tablets to prevent skin contact with the cytotoxic drug. Methotrexate is teratogenic and can be absorbed through the skin, making gloves an essential safety measure.