The nurse is caring for a client who takes methotrexate for rheumatoid arthritis and receives a prescription for adalimumab. Which instructions should the nurse provide the client?
Avoid crowds and people who are sick.
Undergo annual eye examinations.
Obtain routine vaccinations as scheduled.
Have a chest x-ray prior to your first dose.
The Correct Answer is A
Choice A reason:
Avoiding crowds and people who are sick is crucial for clients taking methotrexate and adalimumab. Both medications suppress the immune system, increasing the risk of infections. Methotrexate is an immunosuppressant that can reduce the body’s ability to fight infections. Adalimumab, a TNF inhibitor, also lowers the immune response, making clients more susceptible to infections. Therefore, avoiding exposure to potential sources of infection is essential to prevent serious health complications.
Choice B reason:
While undergoing annual eye examinations is important for overall health, it is not directly related to the use of methotrexate and adalimumab. Methotrexate can cause ocular side effects, but these are relatively rare. Regular eye exams are a good practice but not the most critical instruction in this context.
Choice C reason:
Obtaining routine vaccinations is generally recommended for clients on immunosuppressive therapy. However, live vaccines should be avoided as they can cause infections in immunocompromised individuals. Non-live vaccines, such as the flu shot, are safe and should be administered according to the vaccination schedule. This instruction is important but secondary to avoiding exposure to infections.
Choice D reason:
Having a chest x-ray prior to the first dose of adalimumab is necessary to check for latent tuberculosis (TB). Adalimumab can reactivate latent TB, so screening is essential before starting the medication. However, this is a one-time requirement and not an ongoing instruction like avoiding crowds and sick people.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["37.5"]
Explanation
Step-by-Step Calculation
Step 1: Determine the total amount of magnesium sulfate in the IV bag.
- The IV bag contains 4 grams of magnesium sulfate.
Step 2: Convert grams to milligrams.
- 4 grams × 1000 mg/gram = 4000 mg
Result: The IV bag contains 4000 mg of magnesium sulfate.
Step 3: Determine the concentration of magnesium sulfate in the IV bag.
- Concentration = Total amount of magnesium sulfate ÷ Total volume of the IV bag
- Concentration = 4000 mg ÷ 500 mL
Result: The concentration is 8 mg/mL.
Step 4: Calculate the infusion rate.
- Infusion rate = Prescribed dose ÷ Concentration
- Infusion rate = 300 mg/hour ÷ 8 mg/mL
Result: The infusion rate is 37.5 mL/hour.
Correct Answer is C
Explanation
Choice A Reason:
Osteoarthritis is a common condition treated with NSAIDs like diclofenac. While it is important to monitor for potential side effects, osteoarthritis itself does not pose a significant concern in the context of diclofenac use. The medication is often prescribed to manage the pain and inflammation associated with osteoarthritis.
Choice B Reason:
Migraine headaches are also treated with NSAIDs, including diclofenac. While it is essential to monitor for side effects, migraines do not present a significant concern regarding the use of diclofenac. The medication can help alleviate the pain associated with migraines.
Choice C Reason:
Chronic alcoholism is of greatest concern when prescribing diclofenac. Alcohol can increase the risk of gastrointestinal bleeding and liver damage, both of which are potential side effects of NSAIDs. Combining alcohol with diclofenac can exacerbate these risks, making it crucial for the nurse to monitor the client closely and provide appropriate guidance.
Choice D Reason:
Type 2 diabetes mellitus requires careful management, but it is not the primary concern when prescribing diclofenac. While it is important to monitor for potential interactions and side effects, diabetes itself does not significantly increase the risks associated with diclofenac use compared to chronic alcoholism.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today