Nursing Elites

1. A client has a new prescription for Methotrexate. Which of the following instructions should be included in the teaching?

• A. Avoid drinking alcohol while taking this medication.
• B. Take the medication with a high-fat meal.
• C. Expect increased hair growth.
• D. You should never stop taking the medication without consulting your healthcare provider.

Correct answer: A

Rationale: The correct instruction for a client taking Methotrexate is to avoid drinking alcohol. Methotrexate can cause liver toxicity, and alcohol consumption can increase this risk. It is important to emphasize the avoidance of alcohol while on this medication to prevent adverse effects and ensure treatment effectiveness. The other options are incorrect: Taking Methotrexate with a high-fat meal is not necessary as it can be taken with or without food. Increased hair growth is not an expected effect of Methotrexate; in fact, hair loss is a potential side effect. Stopping the medication without consulting a healthcare provider can be dangerous and may lead to worsening of symptoms or relapse, making option D incorrect.

2. A client has a new prescription for Efavirenz, an NNRTI. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime to prevent drowsiness.
• B. Take this medication with a glass of milk.
• C. Take this medication with a glass of juice.
• D. Take this medication at the same time every day.

Correct answer: A

Rationale: The correct instruction is to take Efavirenz at bedtime to prevent drowsiness and manage central nervous system side effects like dizziness and vivid dreams. While it is important to take the medication at the same time daily for consistent blood levels, the emphasis should be on bedtime to minimize the impact of these side effects. Choices B and C suggesting taking the medication with milk or juice are incorrect and not relevant to optimizing Efavirenz therapy.

3. A client has a new prescription for Nifedipine. Which of the following adverse effects should the nurse monitor?

• A. Hypertension
• B. Edema
• C. Hyperglycemia
• D. Bradycardia

Correct answer: B

Rationale: Nifedipine, a calcium channel blocker, can lead to peripheral edema as an adverse effect. The nurse should monitor the client for swelling in the lower extremities, as it indicates the onset of edema. Hypertension is typically treated with Nifedipine and is not an adverse effect of the medication. Hyperglycemia and bradycardia are not commonly associated with Nifedipine use. Therefore, the correct adverse effect to monitor for when a client is prescribed Nifedipine is edema.

4. A client has a new prescription for methotrexate to treat Rheumatoid Arthritis. The nurse should expect to monitor the client for which of the following adverse effects?

• A. Insomnia
• B. Hypertension
• C. Bone marrow suppression
• D. Constipation

Correct answer: C

Rationale: The correct answer is bone marrow suppression (Choice C). Methotrexate can lead to bone marrow suppression, resulting in adverse effects such as anemia, leukopenia, and thrombocytopenia. Monitoring for signs of decreased blood cell counts is essential to prevent complications and adjust treatment as needed. Choices A, B, and D are incorrect. Insomnia, hypertension, and constipation are not typically associated with methotrexate use in the treatment of Rheumatoid Arthritis.

5. A healthcare provider is caring for four clients who have Peptic Ulcer Disease. The healthcare provider should recognize Misoprostol is contraindicated for which of the following clients?

• A. A client who is pregnant
• B. A client who has osteoarthritis
• C. A client who has a kidney stone
• D. A client who has a urinary tract infection

Correct answer: A

Rationale: Misoprostol is contraindicated in pregnancy due to its potential to induce labor. It is used to prevent ulcers in patients taking nonsteroidal anti-inflammatory drugs and is not indicated for osteoarthritis, kidney stones, or urinary tract infections. Therefore, the correct answer is A. Misoprostol should not be used in pregnant individuals as it can cause uterine contractions and potentially harm the fetus. Choices B, C, and D are incorrect as Misoprostol is not contraindicated for clients with osteoarthritis, kidney stones, or urinary tract infections.

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