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 A

Explanation

Choice A reason: The patient being increasingly drowsy and hard to arouse is an urgent finding that should be reported immediately. This condition may indicate intracranial bleeding or other severe complications related to extremely low platelet count (10,000/mm³) in idiopathic thrombocytopenic purpura (ITP). Immediate medical intervention is required to prevent further deterioration.

Choice B reason: Red, raised purpura on the patient's feet and hands is a concerning finding indicative of significant thrombocytopenia, but it is not as immediately life-threatening as decreased consciousness. It should still be monitored and managed, but the priority is the patient's level of consciousness.

A. Take the iron with dairy products to enhance absorption. B. Always take iron supplements with meals. C. Iron will cause the stools to darken in color. D. Limit foods high in fiber due to the risk for diarrhea. E. Include vitamin C-rich foods or drinks with your iron supplement.

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

Explanation

Choice A reason: Taking iron with dairy products to enhance absorption is incorrect. Calcium in dairy products can interfere with the absorption of iron. It is recommended to take iron supplements with water or vitamin C-rich foods to enhance absorption.

Choice B reason: Always taking iron supplements with meals is not necessary and can reduce absorption. Iron is best absorbed on an empty stomach, although taking it with food can help reduce gastrointestinal side effects. The timing should be individualized based on the patient's tolerance.

Choice C reason: Iron will cause the stools to darken in color, which is a common and harmless side effect of iron supplements. Patients should be informed about this to prevent unnecessary concern.

Choice D reason: Limiting foods high in fiber due to the risk of diarrhea is not necessary. High-fiber foods are generally beneficial for overall health and can help prevent constipation, which is a more common side effect of iron supplements.

Choice E reason: Including vitamin C-rich foods or drinks with your iron supplement is recommended. Vitamin C enhances the absorption of non-heme iron from supplements and plant-based sources, improving the efficacy of the treatment.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with idiopathic thrombocytopenic purpura (ITP) whose platelet count is 10,000/mm³. What assessment finding will the nurse report to the provider immediately?

Correct Answer is A

Explanation

The nurse is providing discharge education to a patient with iron deficiency anemia. The patient has been prescribed to take an oral iron supplement. What will the nurse include in the teaching for this patient? (Select All That Apply)

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

Explanation

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