Methotrexate is prescribed for a client with rheumatoid arthritis (RA) who is also taking aspirin. Which is the best explanation for the nurse to provide as to why a second medication has been added?

Methotrexate slows the disease progression while aspirin controls the symptoms.

Methotrexate helps to reduce the side effects of the aspirin therapy.

Methotrexate enhances the effectiveness of the aspirin.

Methotrexate has less harmful side effects than aspirin.

Answer and Explanation

The Correct Answer is A

A.   Methotrexate is commonly used in the treatment of rheumatoid arthritis (RA) to slow the progression of the disease by suppressing the immune system's response that causes inflammation. Aspirin may be used concurrently to provide symptomatic relief from pain and inflammation associated with RA.
B.   While methotrexate may have side effects, its primary indication in RA treatment is to slow disease progression rather than to mitigate aspirin side effects.
C.   Methotrexate and aspirin typically work through different mechanisms of action and are not typically used together to enhance each other's effectiveness.
D.   Methotrexate and aspirin have different side effect profiles, but the primary reason for adding methotrexate is to slow the progression of RA rather than to replace aspirin due to side effects.

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Correct Answer is A

Explanation

A. Crohn's disease with colectomy. Peritoneal dialysis involves instilling dialysis fluid into the peritoneal cavity, and conditions that affect the integrity or function of the peritoneum, such as Crohn's disease with colectomy, can be contraindications due to the risk of infection or inadequate dialysis.

B. Latent hepatitis C is not a contraindication for peritoneal dialysis, although active hepatitis C infection may be a concern due to increased risk of peritonitis.

C. Type 2 diabetes mellitus is not a contraindication for peritoneal dialysis; in fact, it is a common cause of end-stage renal disease and may necessitate dialysis.

D. Nephrotic syndrome history is not a contraindication for peritoneal dialysis; in fact, peritoneal dialysis may be indicated in some cases of renal failure associated with nephrotic syndrome.

A. Increase IV fluids to 150 mL/hr B. Monitor for adverse reaction to antibiotics C. Repeat CD4+ T-cell count STAT D. Initiate airborne isolation E. Administer antiemetic

Correct Answer is ["A","B","E"]

Explanation

A. This intervention is likely to be ordered due to the patient's fever and elevated heart rate, which may suggest dehydration or the need for increased fluid intake to support hemodynamic stability and mitigate the effects of fever and potential dehydration from fever and nausea.

B. Given the diagnosis of Pneumocystis pneumonia, the patient will likely be on or start antibiotics specific to this infection, such as trimethoprim-sulfamethoxazole. Monitoring for adverse reactions is crucial, especially in a newly diagnosed HIV- positive patient who might be starting multiple new medications.
C. While it is important to monitor CD4 counts in HIV-positive patients to guide treatment decisions, repeating the CD4 count immediately might not be prioritized unless there are specific clinical changes that suggest a rapid decline in immune function. Given the recent test results showing a CD4 count of 443 cells/mm^3, immediate retesting might not be clinically justified unless guided by other symptoms or considerations not detailed here.
D. Pneumocystis pneumonia does not require airborne isolation as it is not typically contagious between people under normal circumstances. Instead, it arises as an opportunistic infection in individuals with weakened immune systems. Hence, this order would not be appropriate unless there were other infections suspected that require such precautions.
E. The patient reports severe nausea, which not only is distressing but can also prevent the patient from taking oral medications and maintain necessary nutrition. Administering an antiemetic can help manage this symptom effectively.

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Methotrexate is prescribed for a client with rheumatoid arthritis (RA) who is also taking aspirin. Which is the best explanation for the nurse to provide as to why a second medication has been added?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is diagnosed with chronic kidney disease and needs to begin dialysis. Which condition entered on the client's medical record should the nurse recognize as a contraindication for peritoneal dialysis?

Correct Answer is A

Explanation

Patient Data Exhibits What order(s) should the nurse anticipate being prescribed after an update is reported to the healthcare providers? Select all that apply.

Correct Answer is ["A","B","E"]

Explanation

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