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."
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Scattered petechiae on bilateral lower extremities are a common finding in patients with thrombocytopenia, indicating low platelet count and increased risk of bleeding. While this finding is concerning, it is not as immediate a threat as significant bleeding or bruising.
Choice B reason: Ecchymosis around the intravenous site suggests significant bleeding and bruising, which can be more urgent and requires immediate reporting. A platelet count of 10,000/mm³ is critically low, increasing the risk of spontaneous bleeding and haemorrhage. Immediate intervention is necessary to prevent further complications.
Correct Answer is B
Explanation
Choice A reason: Kussmaul breathing is a sign of metabolic acidosis, not metabolic alkalosis. It is characterized by deep, labored breathing as the body tries to expel excess carbon dioxide.
Choice B reason: Positive Chvostek sign is an indication of hypocalcemia, which can be associated with metabolic alkalosis. It is a facial muscle twitch that occurs when the facial nerve is tapped.
Choice C reason: Hematemesis, or vomiting blood, is not a clinical manifestation of metabolic alkalosis. It is more related to gastrointestinal bleeding.
Choice D reason: Distended jugular veins are more commonly associated with conditions such as heart failure and fluid overload, not specifically with metabolic alkalosis.
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