a nurse is caring for a client who has been prescribed methotrexate to treat rheumatoid arthritis which of the following instructions should the nurse

ATI RN

ATI Pharmacology Test Bank

1. A client has been prescribed Methotrexate to treat Rheumatoid Arthritis. Which of the following instructions should the nurse provide?

A. Take this medication with food to prevent nausea.
B. Avoid alcohol while taking this medication.
C. Wear sunscreen when outdoors while taking this medication.
D. Take this medication on an empty stomach.

Correct answer: B

Rationale: Methotrexate is hepatotoxic, and avoiding alcohol is crucial to prevent liver damage. However, Option A (Take this medication with food to prevent nausea) could also be correct, as Methotrexate commonly causes nausea, and taking it with food can help alleviate this side effect. However, the most important instruction is to avoid alcohol due to the risk of liver toxicity.

2. Why has an ACE inhibitor been prescribed following an MI?

A. “This medication will lower your potassium level.”
B. “ACE inhibitors have been found to reduce mortality following MI.”
C. “ACE inhibitors are always prescribed with a beta blocker and calcium channel blocker following an MI.”
D. “This medication will treat your hypotension.”

Correct answer: B

Rationale: Following a myocardial infarction (MI), ACE inhibitors are commonly prescribed due to their proven benefit in reducing mortality and improving outcomes post-MI. These medications help by decreasing the workload of the heart, preventing remodeling of the heart chambers, and improving survival rates. While ACE inhibitors may have effects on potassium levels, the primary reason for their prescription post-MI is their mortality-reducing properties.

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

A. Hyperkalemia
B. Hypoglycemia
C. Hypocalcemia
D. Hyponatremia

Correct answer: A

Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia due to its mechanism of action. Hyperkalemia can cause muscle weakness and cardiac dysrhythmias. Therefore, the nurse should educate the client to monitor for signs and symptoms of hyperkalemia while taking Spironolactone.

4. A client has been prescribed Prednisone for asthma. Which of the following instructions should the nurse include in the teaching?

A. Take this medication with food to prevent nausea.
B. Take this medication at bedtime to reduce drowsiness.
C. Take this medication in the morning to reduce insomnia.
D. Avoid sudden changes in position.

Correct answer: C

Rationale: Prednisone is best taken in the morning to reduce the risk of insomnia, a common side effect of corticosteroids. Instructing the client to take the medication in the morning aligns with the goal of minimizing the impact of insomnia, which can disrupt sleep patterns and affect overall well-being. Choices A, B, and D are incorrect. Taking Prednisone with food does not primarily focus on preventing nausea; taking it at bedtime does not primarily reduce drowsiness, and avoiding sudden changes in position is not a specific instruction related to Prednisone use for asthma.

5. Which medication is used as a bronchodilator?

A. Warfarin
B. Lovastatin
C. Albuterol
D. Valproate

Correct answer: C

Rationale: Albuterol is the correct answer. It is a medication commonly used as a bronchodilator to treat conditions such as asthma. Albuterol works by relaxing the muscles in the airways, allowing better airflow and making breathing easier for individuals with respiratory conditions. Warfarin (Choice A) is an anticoagulant used to prevent blood clots, Lovastatin (Choice B) is a medication used to lower cholesterol levels, and Valproate (Choice D) is used to treat seizures and bipolar disorder. These medications are not bronchodilators and are used for different medical conditions.