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?

Avoid crowds and people who are sick.

Undergo annual eye examinations.

Obtain routine vaccinations as scheduled.

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

Answer and Explanation

The Correct Answer is A

Choice A reason:

Avoiding crowds and people who are sick is crucial for clients taking methotrexate and adalimumab. Both medications suppress the immune system, increasing the risk of infections. Methotrexate is an immunosuppressant that can reduce the body’s ability to fight infections. Adalimumab, a TNF inhibitor, also lowers the immune response, making clients more susceptible to infections. Therefore, avoiding exposure to potential sources of infection is essential to prevent serious health complications.

Choice B reason:

While undergoing annual eye examinations is important for overall health, it is not directly related to the use of methotrexate and adalimumab. Methotrexate can cause ocular side effects, but these are relatively rare. Regular eye exams are a good practice but not the most critical instruction in this context.

Choice C reason:

Obtaining routine vaccinations is generally recommended for clients on immunosuppressive therapy. However, live vaccines should be avoided as they can cause infections in immunocompromised individuals. Non-live vaccines, such as the flu shot, are safe and should be administered according to the vaccination schedule. This instruction is important but secondary to avoiding exposure to infections.

Choice D reason:

Having a chest x-ray prior to the first dose of adalimumab is necessary to check for latent tuberculosis (TB). Adalimumab can reactivate latent TB, so screening is essential before starting the medication. However, this is a one-time requirement and not an ongoing instruction like avoiding crowds and sick people.

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Free Nursing Study Resources

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

Explanation

Choice A reason:

Lisinopril is an ACE inhibitor that is commonly prescribed for once-daily dosing. It is effective in managing hypertension and heart failure with a single daily dose, making it convenient for patients who may have difficulty remembering multiple doses12.

Choice B reason:

Quinapril can also be administered once daily. It is used to treat hypertension and heart failure, and its long half-life allows for effective blood pressure control with a single daily dose

Choice C reason:

Ramipril is another ACE inhibitor that can be given once daily. It is used for hypertension, heart failure, and to reduce the risk of cardiovascular events. Its pharmacokinetics support once-daily dosing, which helps improve patient adherence.

Choice D reason:

Captopril is typically not given once daily due to its shorter half-life. It usually requires multiple doses throughout the day to maintain effective blood pressure control.

Choice E reason:

Trandolapril is an ACE inhibitor that can be administered once daily. It is used for hypertension and heart failure, and its long duration of action supports once-daily dosing.

A. Take the medication an hour after antacids. B. Decrease cigarette use to a pack per day. C. Monitor for any signs of sexual dysfunction. D. Notify the healthcare provider of lethargy.

Correct Answer is B

Explanation

Choice A reason:

Taking cimetidine an hour after antacids is appropriate because antacids can interfere with the absorption of cimetidine. It is recommended to separate the intake of these medications by at least one hour to ensure proper absorption and effectiveness of cimetidine.

Choice B reason:

Decreasing cigarette use to a pack per day is not sufficient for a client with peptic ulcer disease. Smoking has been shown to exacerbate peptic ulcers and hinder their healing process. Complete cessation of smoking is strongly recommended to improve the healing of peptic ulcers and reduce the risk of recurrence.

Choice C reason:

Monitoring for signs of sexual dysfunction is important because cimetidine can cause side effects such as decreased libido and erectile dysfunction. Patients should be aware of these potential side effects and report any issues to their healthcare provider.

Choice D reason:

Notifying the healthcare provider of lethargy is crucial because lethargy can be a sign of a more serious underlying condition or an adverse reaction to the medication. Prompt reporting allows for timely intervention and management.

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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

The nurse notifies the healthcare provider (HCP) that the client is having trouble remembering to take his second dose of captopril. What angiotensin-converting enzyme (ACE) inhibitors can be given only once per day? Select all that apply.

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

Explanation

A client with peptic ulcer disease receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?

Correct Answer is B

Explanation

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