What instruction for oral administration of methotrexate should the nurse include when teaching a client diagnosed with rheumatoid arthritis?

Use an antiemetic one hour following administration.

Drink 2-3 liters of water per day.

Rinse mouth twice per day with an alcohol-based mouthwash.

Take the medication with an NSAID.

Answer and Explanation

The Correct Answer is D

Choice A Reason
Using an antiemetic one hour after administration of methotrexate is not a standard recommendation. Antiemetics are typically used to prevent nausea and vomiting associated with chemotherapy and are taken before or at the time of methotrexate administration, not afterward.

Choice B Reason
Drinking 2-3 liters of water per day is important for patients taking methotrexate to prevent kidney damage by ensuring adequate hydration and facilitating the excretion of the drug¹. Methotrexate can be nephrotoxic, and proper hydration helps to mitigate this risk.

Choice C Reason
Rinsing the mouth with an alcohol-based mouthwash is not recommended for patients taking methotrexate. Alcohol can cause drying and irritation, which might exacerbate any mouth sores caused by methotrexate. Instead, patients should use a gentle, non-alcoholic mouthwash to maintain oral hygiene.

Choice D Reason
Taking methotrexate with an NSAID is not advised without specific medical guidance. NSAIDs can increase the toxicity of methotrexate by displacing it from protein-binding sites and reducing its renal clearance, potentially leading to increased side effects.

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Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A Reason
The continuous nature of the mucosa refers to the uninterrupted lining of the urinary tract, which provides a barrier against pathogens. However, this characteristic is not a significant factor in the increased susceptibility of women to cystitis. Both men and women have a continuous mucosal lining, and it does not account for the gender difference in infection rates.

Choice B Reason
High estrogen levels can influence the tissues of the urinary tract and may affect susceptibility to infections. However, the role of estrogen in the development of cystitis is not as direct or significant as anatomical differences. Estrogen levels vary throughout a woman's life and do not consistently correlate with cystitis risk.

Choice C Reason
Urethral proximity to the rectum is the most significant anatomical factor contributing to a woman's increased susceptibility to cystitis¹⁴. Women have a shorter urethra than men, and its close proximity to the anus allows bacteria from the bowel area to more easily enter the urinary tract and cause infections.

Choice D Reason
Inadequate fluid intake can lead to less frequent urination, which is a risk factor for cystitis because it reduces the natural flushing of bacteria from the urinary tract. However, this is a modifiable risk factor and does not inherently explain the higher incidence of cystitis in women compared to men.

A. Bleeding at the arterial puncture site. B. Cardiac dysrhythmias related to catheter insertion. C. Electrolyte imbalances related to dye injection. D. Discomfort at the catheter insertion site.

Correct Answer is A

Explanation

Choice a reason:
Bleeding at the arterial puncture site is a primary concern post-cardiac angiogram, as it can lead to significant blood loss and hematoma formation. The nurse must frequently monitor the site for any signs of bleeding or hematoma, apply pressure if necessary, and report any abnormalities to the physician immediately.

Choice b reason:
Cardiac dysrhythmias may occur due to irritation of the heart muscle by the catheter during insertion. Monitoring the client's heart rhythm is essential to detect any new onset of arrhythmias, which could indicate complications from the procedure.

Choice c reason:
Electrolyte imbalances can result from the contrast dye used during a cardiac angiogram. The dye can affect kidney function, leading to changes in electrolyte levels. Monitoring electrolyte levels is important to prevent complications such as arrhythmias or fluid imbalances.

Choice d reason:
While discomfort at the catheter insertion site is expected, it is typically mild. However, the nurse should assess for discomfort as it may indicate other issues such as infection, bleeding, or a reaction to the procedure.

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What instruction for oral administration of methotrexate should the nurse include when teaching a client diagnosed with rheumatoid arthritis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When teaching a client about cystitis, the nurse explains that women are more prone to the infection than men. Which of the following best explains a woman's increased susceptibility?

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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