A nurse is caring for a client prescribed methotrexate for rheumatoid arthritis. Which of the following client history findings requires the nurse to question the administration of this medication?
- A. Osteoporosis
- B. Hypertension
- C. Peptic ulcer disease
- D. Immunosuppression
Correct Answer: C
Rationale: The correct answer is C: Peptic ulcer disease. Methotrexate can exacerbate peptic ulcer disease, leading to serious complications. This finding warrants questioning the administration of methotrexate to prevent harm to the client. Choices A, B, and D are not directly contraindicated with methotrexate use. Osteoporosis, hypertension, and immunosuppression are not typically reasons to question the administration of methotrexate for rheumatoid arthritis.
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A nurse has provided education to a client regarding prescribed levothyroxine sodium. Which of the following client statements demonstrates understanding of medication administration?
- A. I should take my medication as needed to alleviate symptoms
- B. I should take the medication in divided doses to ensure therapeutic drug levels
- C. I should take the medication in the morning to prevent insomnia
- D. I should take the medication on a full stomach
Correct Answer: C
Rationale: Levothyroxine should be taken once in the morning to prevent insomnia and maintain therapeutic levels.
A client is prescribed spironolactone. Which of the following findings would indicate an adverse effect of this medication?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hyponatremia
- D. Hypernatremia
Correct Answer: A
Rationale: Hyperkalemia is the correct answer as it is an adverse effect associated with spironolactone, a potassium-sparing diuretic. Spironolactone works by blocking the aldosterone receptor in the distal convoluted tubule, leading to decreased potassium excretion and potential hyperkalemia. Hypokalemia (choice B) and hyponatremia (choice C) are not typically associated with spironolactone use. Hypernatremia (choice D) is also an unlikely finding with spironolactone.
A nurse is caring for a client taking ciprofloxacin for an infection. Which of the following adverse effects should the nurse include in the client education?
- A. Constipation
- B. Tendon rupture
- C. Dry mouth
- D. Nasal congestion
Correct Answer: B
Rationale: The correct answer is B: Tendon rupture. Ciprofloxacin belongs to the fluoroquinolone class of antibiotics, which is associated with the adverse effect of tendon rupture. Tendon rupture is a severe but rare side effect that can occur with the use of ciprofloxacin. Educating the client about this potential adverse effect is crucial to promote awareness and early recognition of symptoms, such as tendon pain, swelling, or inflammation. Choices A, C, and D are not typically associated with ciprofloxacin use and are less relevant for client education in this scenario.
A client has been prescribed lisinopril. Which of the following medication interactions should the nurse instruct this client about?
- A. Potassium supplements
- B. Ciprofloxacin
- C. Escitalopram
- D. Magnesium supplements
Correct Answer: A
Rationale: The correct answer is A: Potassium supplements. Clients taking lisinopril should avoid potassium supplements and potassium-sparing diuretics due to the risk of hyperkalemia. This interaction can lead to dangerously high levels of potassium in the blood, which can be harmful. Choice B, Ciprofloxacin, is not typically associated with a significant interaction with lisinopril. Choice C, Escitalopram, is an antidepressant and does not have a known significant interaction with lisinopril regarding potassium levels. Choice D, Magnesium supplements, are generally safe to take with lisinopril and do not pose a significant risk of hyperkalemia.
A nurse is providing care to a client with staphylococcus epidermidis who is prescribed vancomycin. Identify the adverse effect associated with the antibiotic therapy.
- A. Hepatotoxicity
- B. Constipation
- C. Infusion reaction
- D. Immunosuppression
Correct Answer: C
Rationale: The correct answer is C: Infusion reaction. Vancomycin can cause infusion reactions like 'Red Man Syndrome,' which involves rashes, flushing, tachycardia, and hypotension. Hepatotoxicity (choice A) is not a common adverse effect of vancomycin. Constipation (choice B) is not typically associated with vancomycin use. Immunosuppression (choice D) is not a direct adverse effect of vancomycin therapy.