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A client with rheumatoid arthritis is prescribed methotrexate. What is the most important teaching point for the nurse to provide?
- A. Take the medication with food to avoid gastrointestinal upset.
- B. Monitor for signs of infection, such as a sore throat.
- C. Increase fluid intake to prevent dehydration.
- D. Avoid direct sunlight to prevent photosensitivity.
Correct Answer: D
Rationale: The most important teaching point for a client prescribed methotrexate is to avoid direct sunlight to prevent photosensitivity. Methotrexate can make the skin more sensitive to sunlight, increasing the risk of sunburn and skin damage. Choices A, B, and C are important aspects of client care but are not specifically related to the side effect of photosensitivity caused by methotrexate.
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A client with diabetes mellitus is experiencing hyperglycemia. What laboratory value should the nurse monitor to evaluate long-term glucose control?
- A. Blood glucose level
- B. Glycosylated hemoglobin (A1C)
- C. Urine output
- D. Serum ketone level
Correct Answer: B
Rationale: The correct answer is B: Glycosylated hemoglobin (A1C). Glycosylated hemoglobin reflects long-term glucose control over the past three months. Monitoring blood glucose levels provides information on the current glucose status and immediate control, but it does not give a comprehensive view of long-term control. Urine output and serum ketone levels are important indicators for other aspects of diabetes management, such as hydration status and ketone production during hyperglycemic episodes, but they do not directly reflect long-term glucose control.
The nurse is providing teaching to a client with gastroesophageal reflux disease (GERD). Which instruction should the nurse include?
- A. Eat large meals to decrease acid production
- B. Avoid lying down immediately after eating
- C. Limit fluid intake with meals
- D. Drink carbonated beverages to aid digestion
Correct Answer: B
Rationale: The correct instruction for a client with GERD is to avoid lying down immediately after eating. This helps prevent stomach acid from flowing back into the esophagus, which can worsen symptoms. Eating large meals can actually increase acid production and exacerbate GERD. Limiting fluid intake with meals may be beneficial for some individuals, but it is not a key instruction for managing GERD. Drinking carbonated beverages can trigger reflux symptoms and should be avoided by individuals with GERD.
A client reports that the skin around the edges of a wound is red and swollen. What is the nurse's priority intervention?
- A. Monitor for signs of infection
- B. Reinforce the wound dressing
- C. Contact the healthcare provider
- D. Apply a warm compress to the wound
Correct Answer: A
Rationale: The correct answer is to monitor for signs of infection. Redness and swelling around a wound are indicative of a potential infection. The priority intervention for the nurse is to closely monitor the wound for further signs of infection, such as increased drainage or fever. Reinforcing the wound dressing may be necessary, but it is not the priority when infection is suspected. Contacting the healthcare provider is important, but the nurse should first assess and monitor the wound to provide comprehensive information when contacting the provider. Applying a warm compress can potentially worsen the infection by promoting bacterial growth, so it is contraindicated in this situation.
To auscultate for a carotid bruit, where should the nurse place the stethoscope?
- A. Base of the neck on the right side
- B. Above the clavicle
- C. Over the sternum
- D. Over the trachea
Correct Answer: A
Rationale: To auscultate for a carotid bruit, the nurse should place the stethoscope at the base of the neck, near the carotid artery. A carotid bruit is an abnormal sound that indicates turbulent blood flow in the carotid artery, potentially due to arterial narrowing or atherosclerosis. Placing the stethoscope above the clavicle, over the sternum, or over the trachea would not provide the nurse with the optimal location to assess for carotid artery abnormalities.
A client presents to the clinic with a large abscess on the right thigh. The healthcare provider incises and drains the abscess. Which instruction should the nurse provide to the client upon discharge?
- A. Avoid showering until the wound is completely closed
- B. Perform daily wound care and dressing changes
- C. Apply heat to the wound for 15 minutes twice a day
- D. Take the prescribed antibiotic until the wound is fully healed
Correct Answer: B
Rationale: After incision and drainage of an abscess, it is crucial to perform daily wound care and dressing changes to prevent infection and promote healing. Avoiding showering until the wound is completely closed (choice A) may not be practical or necessary. Applying heat to the wound (choice C) can increase the risk of infection and delay healing. While taking the prescribed antibiotic (choice D) is important, wound care and dressing changes are more directly related to promoting healing and preventing complications.