The nurse is providing discharge teaching to a patient with rheumatoid arthritis (RA) who has been prescribed methotrexate. Which patient statement indicates to the nurse a need for further teaching?

"I will take this medication as needed during flares of joint pain."

"I will avoid drinking alcohol while taking this medication."

"I will call my provider if I develop a sore throat or fever."

"I will use contraception while taking this medication."

Answer and Explanation

The Correct Answer is A

Choice A reason: Methotrexate is a disease-modifying antirheumatic drug (DMARD) that must be taken regularly as prescribed, not just during flares of joint pain. It helps to prevent disease progression and joint damage. This statement indicates a misunderstanding of the medication regimen and requires further teaching.

Choice B reason: Avoiding drinking alcohol while taking methotrexate is important because alcohol can increase the risk of liver damage, a potential side effect of methotrexate. This statement indicates proper understanding.

Choice C reason: Calling the provider if a sore throat or fever develops is important because methotrexate can suppress the immune system, increasing the risk of infections. This statement indicates proper understanding.

Choice D reason: Using contraception while taking methotrexate is crucial because methotrexate can cause birth defects. This statement indicates proper understanding.

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Correct Answer is C

Explanation

Choice A reason: Monitoring the patient's absolute neutrophil count (ANC) daily and stopping medication when the ANC is greater than 20,000 cells/uL is an essential aspect of using filgrastim safely. However, this is typically managed by the healthcare provider and not the primary action for the nurse to take for patient education. The nurse's role focuses more on educating the patient about potential side effects and self-care.

Choice B reason: Teaching the patient how to administer the medication via intramuscular is not relevant for filgrastim, as it is typically administered via subcutaneous injection. Proper administration technique is crucial for ensuring the medication's effectiveness, but this choice does not accurately reflect the standard administration method for filgrastim.

Choice C reason: Ensuring the patient understands the risk of bone pain and how to manage it is crucial for promoting safe and effective use of filgrastim. Bone pain is a common side effect of filgrastim due to the stimulation of bone marrow to produce more neutrophils. Educating the patient about this potential side effect and providing strategies for managing the pain, such as using over-the-counter pain relievers, helps improve patient comfort and adherence to the medication.

Choice D reason: Administering filgrastim as needed for symptoms of infection is not appropriate. Filgrastim is used to stimulate neutrophil production and prevent infection, rather than treating active infections. The medication should be administered according to the prescribed schedule, not based on the presence of infection symptoms.

A. Acute hemolytic B. Allergic C. Anaphylactic D. Circulatory overload

Correct Answer is B

Explanation

Choice A reason: Acute hemolytic reactions are severe and typically present with symptoms such as fever, chills, flank pain, hemoglobinuria, and shock. The patient's mild symptoms of itching and a localized rash do not match the severe presentation of an acute hemolytic reaction.

Choice B reason: Allergic reactions to blood transfusions are common and usually present with symptoms such as itching, hives, and localized rash. The patient's vital signs and physical assessment showing mild itching and a rash on the arms are consistent with an allergic reaction.

Choice C reason: Anaphylactic reactions are severe allergic reactions that involve respiratory distress, hypotension, and shock. The patient's mild symptoms do not indicate an anaphylactic reaction.

Choice D reason: Circulatory overload presents with symptoms such as dyspnea, orthopnea, hypertension, and pulmonary edema. The patient's symptoms of itching and a rash do not align with circulatory overload.

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The nurse is providing discharge teaching to a patient with rheumatoid arthritis (RA) who has been prescribed methotrexate. Which patient statement indicates to the nurse a need for further teaching?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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