The nurse provides teaching about methotrexate to a client with rheumatoid arthritis. It is most important to address which topic regarding this drug?

Choice A reason: Abdominal pain and rectal bleeding are not the primary signs of a bowel obstruction. Rectal bleeding could be indicative of other gastrointestinal issues such as hemorrhoids, diverticulosis, or colorectal cancer. While abdominal pain is a symptom of bowel obstruction, rectal bleeding is not typically associated with it.

Choice B reason: The primary symptoms of bowel obstruction include abdominal distention, pain, inability to have a bowel movement, and nausea/vomiting. When a bowel obstruction occurs, the normal movement of intestinal contents is blocked, leading to a buildup of contents and gas. This results in abdominal distention and pain. The blockage also prevents the passage of stool and gas, causing constipation or inability to have a bowel movement. Nausea and vomiting are common as the digestive system tries to expel the contents that cannot pass through the obstruction.

Choice C reason: Dehydration, back pain, and fever are not the hallmark symptoms of bowel obstruction. While dehydration can occur due to vomiting and reduced intake, back pain is not commonly associated with bowel obstruction. Fever may indicate an infection or other complications but is not a primary symptom of bowel obstruction.

Choice D reason: Diarrhea and excessive thirst are not typical signs of bowel obstruction. In fact, bowel obstruction usually leads to constipation or the inability to pass stool rather than diarrhea. Excessive thirst could be a sign of dehydration but is not specific to bowel obstruction.

Choice A reason: Nucleoside reverse transcriptase inhibitors (NRTIs) are one of the main classes of antiretroviral drugs used in the treatment of HIV. They work by inhibiting the reverse transcriptase enzyme, which is crucial for the replication of the virus. By blocking this enzyme, NRTIs help prevent the virus from multiplying and reduce the viral load in the body.

Choice B reason: RNA transfer inhibitors are not a recognized class of drugs used in the management of HIV. The main classes of antiretroviral drugs include NRTIs, non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors, fusion inhibitors, integrase inhibitors, and entry inhibitors, but RNA transfer inhibitors are not among them.

Choice C reason: Fusion inhibitors are a class of antiretroviral drugs that prevent HIV from entering the host cells. They work by blocking the fusion process between the viral envelope and the host cell membrane, thereby preventing the virus from injecting its genetic material into the host cell. Fusion inhibitors are used as part of combination therapy to manage HIV infection.

Choice D reason: Protease inhibitors are another essential class of antiretroviral drugs used to treat HIV. They work by inhibiting the protease enzyme, which is necessary for the virus to produce mature viral particles. By blocking this enzyme, protease inhibitors prevent the production of functional viral particles, thus reducing the viral load in the body.

Choice E reason: DNA polymerase inhibitors are not used in the management of HIV. They are typically used to treat other viral infections, such as herpesviruses. The management of HIV primarily involves drugs that target the enzymes specific to HIV replication, such as reverse transcriptase, protease, and integrase