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?

Undergo annual eye examinations.

Have a chest x-ray prior to your first dose.

Avoid crowds and people who are sick.

Obtain routine vaccinations as scheduled.

Answer and Explanation

The Correct Answer is C

A) Undergo annual eye examinations:
While methotrexate and adalimumab can both have potential ocular side effects, such as blurred vision or eye pain, the need for annual eye examinations is more commonly associated with methotrexate therapy. Methotrexate can cause ocular toxicity, including retinopathy and optic neuropathy, which necessitates regular monitoring by an ophthalmologist. However, adalimumab is not typically associated with annual eye examinations, so this instruction is not directly relevant to the addition of adalimumab to the client’s regimen.

B) Have a chest x-ray prior to your first dose:
A chest x-ray is not routinely required before initiating adalimumab therapy. While screening for tuberculosis (TB) may be necessary in clients starting adalimumab due to its immunosuppressive effects, a chest x-ray is not always indicated for this purpose. Instead, TB screening usually involves a thorough history, physical examination, and possibly tuberculin skin testing or interferon-gamma release assays. Therefore, this instruction is not specifically related to the addition of adalimumab to the client’s treatment regimen.

C) Avoid crowds and people who are sick:
Adalimumab is a biologic disease-modifying antirheumatic drug (DMARD) that suppresses the immune system’s inflammatory response by targeting tumor necrosis factor-alpha (TNF-alpha). As a result, clients taking adalimumab are at increased risk of infections, including bacterial, viral, and fungal infections. Therefore, instructing the client to avoid crowds and individuals who are sick helps reduce the risk of exposure to infectious pathogens and minimize the likelihood of developing infections while on adalimumab therapy.

D) Obtain routine vaccinations as scheduled:
While maintaining up-to-date vaccinations is important for overall health and immunity, clients receiving biologic DMARDs like adalimumab may have a reduced response to vaccines due to immunosuppression. Therefore, it is generally recommended to administer necessary vaccinations before starting adalimumab therapy whenever possible. However, the decision to administer vaccines should be individualized, and certain live vaccines may be contraindicated while receiving adalimumab. Nonetheless, this instruction is not directly related to the addition of adalimumab to the client’s medication regimen.

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Free Nursing Study Resources

Correct Answer is ["1.7"]

Explanation

To find out how many mL the nurse should administer:

We can set up a proportion to solve for the unknown.

Given:

The prescription is for 1,000,000 units of penicillin G.

The available medication is 1,200,000 units/2 mL.

We can set up the proportion as follows:

1,000,000units/ xmL = 1,200,000units/2mL

Solving for x gives us the volume in mL that the nurse should administer.

Cross-multiplying and solving for x:

X = 1,000,000units×2mL/1,200,000units

After performing the calculation, we find that x equals 1.67 mL.

So, the nurse should administer 1.7 mL (rounded to the nearest tenth) of the medication.

A. The viral load can be decreased to an undetectable level. B. HIV infection is not cured by the antiretroviral regimen. C. The medications can decrease acquired AIDS related complications. D. Antiretroviral medication prevents the transmission of the virus.

Correct Answer is D

Explanation

Answer: D. Antiretroviral medication prevents the transmission of the virus.

Rationale:

A. The viral load can be decreased to an undetectable level:
This statement reflects an accurate understanding of antiretroviral therapy. Effective treatment can reduce the viral load to undetectable levels, which is a key goal of HIV treatment, allowing individuals to live healthier lives and reducing the risk of transmitting the virus to others.

B. HIV infection is not cured by the antiretroviral regimen:
This statement is also accurate. Antiretroviral therapy (ART) effectively manages HIV infection but does not cure it. Patients need to remain on medication for life to control the virus and maintain their health.

C. The medications can decrease acquired AIDS-related complications:
This statement is correct as well. Antiretroviral medications can help manage HIV and prevent the progression to AIDS, thereby reducing the likelihood of complications associated with AIDS, such as opportunistic infections.

D. Antiretroviral medication prevents the transmission of the virus:
This statement requires additional instruction because, while effective antiretroviral therapy can significantly reduce the risk of transmission, it does not entirely prevent it. Patients with an undetectable viral load have a greatly reduced risk of transmitting HIV to sexual partners (often summarized as "U=U" or "Undetectable = Untransmittable"), but it is crucial to understand that there is still a small risk involved. Therefore, additional education is necessary to clarify the need for continued safe practices, such as using condoms, even when on effective therapy.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client receives a prescription for penicillin G 1,000,000 units intramuscular (IM) daily. The medication is available in 1,200,000 units/2 mL syringe. How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

Correct Answer is ["1.7"]

Explanation

The nurse is teaching a client who has been diagnosed with HIV about the antiretroviral medication regimen. Which statement provided by the client requires additional instruction by the nurse?

Correct Answer is D

Explanation

Rationale:

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