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. When does regular insulin typically peak?

A. 30 minutes to 2 ½ hours
B. 1 to 3 hours
C. 6 to 14 hours
D. 1 to 5 hours

Correct answer: D

Rationale: Regular insulin usually peaks around 1 to 5 hours after administration. This peak time frame is important to consider when managing blood glucose levels and timing meals to coincide with insulin activity. Choice A, '30 minutes to 2 ½ hours,' is incorrect because regular insulin typically peaks later. Choice B, '1 to 3 hours,' is not the most accurate as the peak for regular insulin can extend beyond 3 hours. Choice C, '6 to 14 hours,' is incorrect as this timeframe is more indicative of long-acting insulins, not regular insulin.

3. A client has a prescription for Levothyroxine. Which of the following instructions should the nurse include?

A. Take this medication on an empty stomach.
B. Take this medication with food.
C. Take this medication at bedtime.
D. Take this medication with antacids.

Correct answer: A

Rationale: Levothyroxine should be taken on an empty stomach to increase absorption and efficacy. Taking it with food or antacids can interfere with its absorption, leading to reduced effectiveness of the medication.

4. A client has a new prescription for Digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?

A. Contact provider if heart rate is less than 60/min.
B. Check pulse rate for 30 seconds and multiply the result by 2.
C. Increase intake of sodium.
D. Take with food if nausea occurs.

Correct answer: A

Rationale: The correct instruction for a client prescribed Digoxin for heart failure is to contact the provider if the heart rate is less than 60/min. Digoxin can affect heart rate, and a heart rate below 60/min may indicate toxicity, requiring prompt medical attention. Checking the pulse rate accurately and seeking medical advice are essential components of safe medication management. Choices B, C, and D are incorrect. Choice B is related to checking the pulse rate but does not address the critical action of contacting the provider if it is below 60/min. Increasing intake of sodium (Choice C) is inappropriate as high sodium levels can worsen heart failure. Taking Digoxin with food if nausea occurs (Choice D) does not address a critical aspect of Digoxin administration related to heart rate monitoring.

5. What should you assess for in a patient who is on Valproate?

A. Suicidal thoughts
B. Monitor for seizures
C. Bipolar disorder
D. Migraines

Correct answer: A

Rationale: The correct answer is A: Suicidal thoughts. When a patient is prescribed Valproate, it is crucial to assess for suicidal thoughts as it is a serious side effect associated with this medication. Valproate has been linked to an increased risk of suicidal ideation and behavior, particularly in patients with epilepsy or bipolar disorder. Monitoring for signs of depression or changes in behavior is essential to ensure patient safety and well-being. Choices B, C, and D are incorrect because while monitoring for seizures, managing bipolar disorder, and treating migraines are also important considerations when a patient is on Valproate, assessing for suicidal thoughts takes priority due to the serious nature of this potential side effect.