Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is providing teaching to a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following information should the nurse provide?
A. Take the medication in the morning to prevent insomnia.
Methotrexate is not typically associated with insomnia, and the timing of administration should be according to the provider's instructions.
B. Drink 2 to 3 L of water per day while on the medication.
Drinking 2 to 3 L of water per day helps prevent kidney damage and reduces the risk of side effects such as methotrexate toxicity.
C. Expect to have a fever for the first days of therapy.
Fever is not a common expected side effect of methotrexate and should be reported to the provider.
D. Administer the medication with an NSAID to enhance effectiveness.
Combining methotrexate with NSAIDs can increase the risk of toxicity; this should only be done under direct medical supervision.
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Full Explanation
A. Methotrexate is not typically associated with insomnia, and the timing of administration should be according to the provider's instructions.
B. Drinking 2 to 3 L of water per day helps prevent kidney damage and reduces the risk of side effects such as methotrexate toxicity.
C. Fever is not a common expected side effect of methotrexate and should be reported to the provider.
D. Combining methotrexate with NSAIDs can increase the risk of toxicity; this should only be done under direct medical supervision.
Similar Questions
A nurse in an emergency department is caring for a client who has abdominal pain.
A nurse is providing teaching to a client who has constipation. Which of the following information should the nurse include?
(Select all that apply.)
A. Increase intake of low fiber foods.
Increasing the intake of high-fiber foods, not low-fiber ones, as fiber helps to soften stools and promote bowel movements.
B. Avoid drinking hot liquids.
Drinking warm or hot liquids can stimulate bowel movements, so they should not be avoided.
C. Include probiotic foods in the daily diet.
Including probiotic foods in the diet can help maintain a healthy gut flora, which is beneficial for digestion and preventing constipation.
D. Increase fluid intake to 1500 mL daily.
It is crucial to increase fluid intake, aiming for at least 1500 mL daily, to help soften the stool and support regular bowel movements.
E. Increase daily exercise.
Increasing daily exercise, especially walking, can stimulate the muscles involved in the digestive process and help prevent constipation.
F. Increase daily exercise.
Increasing daily exercise, especially walking, can stimulate the muscles involved in the digestive process and help prevent constipation.
Full Explanation
A. Increasing the intake of high-fiber foods, not low-fiber ones, as fiber helps to soften stools and promote bowel movements.
B. Drinking warm or hot liquids can stimulate bowel movements, so they should not be avoided.
C. Including probiotic foods in the diet can help maintain a healthy gut flora, which is beneficial for digestion and preventing constipation.
D. It is crucial to increase fluid intake, aiming for at least 1500 mL daily, to help soften the stool and support regular bowel movements.
E. Increasing daily exercise, especially walking, can stimulate the muscles involved in the digestive process and help prevent constipation.
A nurse is preparing to administer lorazepam 1 mg PO at bedtime. The amount available is lorazepam 2 mg tablets. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
Full Explanation
To administer the correct dose of lorazepam, which is 1 mg, when only 2 mg tablets are available, the nurse should administer half a tablet. This is because each tablet contains 2 mg of lorazepam, and the prescribed dose is 1 mg. Therefore, dividing the tablet into two equal parts will provide the necessary 1 mg dose. The answer, rounded to the nearest tenth as per the instruction, is 0.5.
An older adult client is scheduled to have an elective surgical procedure and informs the nurse that she wants to be designated as a "do not resuscitate" (DNR) case. Which of the following responses should the nurse provide?
A. "You need to let your provider know your wishes after the procedure."
Waiting until after the procedure to inform the provider is not appropriate for discussing end-of-life wishes.
B. "This is a minor procedure; there is no need for this request."
The seriousness of the procedure does not determine the necessity of a DNR request; it's the client's right to express this choice.
C. "You need to discuss your request with the hospital chaplain."
While spiritual support can be helpful, discussing DNR orders typically involves the healthcare team and the client directly.
D. "Your provider needs to talk with you concerning your request."
The provider should directly discuss the client's wishes regarding a DNR order to ensure understanding and documentation.
Full Explanation
A. Waiting until after the procedure to inform the provider is not appropriate for discussing end-of-life wishes.
B. The seriousness of the procedure does not determine the necessity of a DNR request; it's the client's right to express this choice.
C. While spiritual support can be helpful, discussing DNR orders typically involves the healthcare team and the client directly.
D. The provider should directly discuss the client's wishes regarding a DNR order to ensure understanding and documentation.