A patient who has been diagnosed with rheumatoid arthritis for 1 month and has generalized symptoms is taking high-dose NSAIDS and an oral glucocorticoid. The provider has prescribed methotrexate. The patient asks the nurse why methotrexate is necessary since pain and swelling have been well controlled with the other medications. The nurse will tell the patient that:

Choice A rationale: Methylphenidate is a central nervous system stimulant, and excessive caffeine intake can exacerbate its stimulant effects. Consuming an unlimited number of cola soft drinks, which typically contain caffeine, is not advisable. The patient should be educated to moderate caffeine intake to avoid potential interactions and side effects.
Choice B rationale: Methylphenidate can interact with caffeine, so avoiding chocolate, coffee, and tea is a valid recommendation to prevent excessive stimulant effects.
Choice C rationale: Decaffeinated coffee still contains a small amount of caffeine, and patients taking methylphenidate should be aware of this to manage their overall caffeine intake.
Choice D rationale: Taking methylphenidate after breakfast is a common recommendation to minimize appetite suppression and potential weight loss associated with the medication.

Choice A rationale: Stopping aspirin immediately may not be necessary and can increase the risk of rebound thrombosis. A gradual discontinuation is often recommended.
Choice B rationale: Stopping aspirin 3 days prior to surgery is a common recommendation to minimize the risk of bleeding during and after the surgical procedure.
Choice C rationale: Reducing the aspirin dosage may not be sufficient, and complete discontinuation is often advised before surgery.
Choice D rationale: Continuing aspirin as scheduled can increase the risk of bleeding during and after surgery. It is generally recommended to discontinue aspirin before elective surgical procedures.