A nurse is providing teaching to a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following information should the nurse provide?

Take the medication in the morning to prevent insomnia.

Drink 2 to 3 L of water per day while on the medication.

Expect to have a fever for the first days of therapy.

Administer the medication with an NSAID to enhance effectiveness.

Answer and Explanation

The Correct Answer is B

A. Methotrexate is not typically associated with insomnia, and the timing of administration should be according to the provider's instructions.
B. Drinking 2 to 3 L of water per day helps prevent kidney damage and reduces the risk of side effects such as methotrexate toxicity.
C. Fever is not a common expected side effect of methotrexate and should be reported to the provider.
D. Combining methotrexate with NSAIDs can increase the risk of toxicity; this should only be done under direct medical supervision.

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Correct Answer is A

Explanation

A. Propranolol is a beta-blocker used to control blood pressure and heart rate. However, the nurse has a hold order for propranolol if the apical pulse (heart rate) is less than 50 beats per minute. The nurse documented a heart rate of 42 bpm at 0815, which falls below the hold parameter for propranolol. Administering propranolol in this case could worsen the client's bradycardia (slow heart rate) and therefore requires an incident report.
B. Pantoprazole is a proton pump inhibitor and doesn't have a direct impact on heart rate within the usual therapeutic range.
C. Lovastatin is a cholesterol medication and wouldn't cause a significant drop in heart rate at this dosage.
D. While morphine can slow the heart rate, it's typically used for pain management and may be necessary for the client's comfort. However, the nurse should monitor the respiratory rate closely due to potential respiratory depression.
E. Cefuroxime is an antibiotic and wouldn't significantly affect heart rate.

A. Report of tinnitus B. Tremor C. Agitation D. Bradycardia E. Fever

Correct Answer is ["B","C","E"]

Explanation

A. Tinnitus is not commonly associated with acute cocaine toxicity.
B. Tremor is a common finding in acute cocaine toxicity due to increased sympathetic nervous system activity.
C. Agitation is common in acute cocaine toxicity as a result of CNS stimulation.
D. Bradycardia is not typically seen; tachycardia is more common.
E. Fever can occur as a symptom of acute cocaine toxicity.

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A nurse is providing teaching to a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following information should the nurse provide?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client. Exhibits The nurse reviews the medication administration record following the 0815 assessment findings. Which of the following administered medications would require an incident report?

Correct Answer is A

Explanation

A nurse is assessing a client who has acute cocaine toxicity. Which of the following findings should the nurse expect? (Select all that apply.)

Correct Answer is ["B","C","E"]

Explanation

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