a nurse is caring for a client who has a new prescription for methotrexate which of the following instructions should the nurse include in the teachin

ATI RN

ATI Proctored Pharmacology Test

1. A client has a new prescription for Methotrexate. Which of the following instructions should be included in the teaching?

A. Avoid drinking alcohol while taking this medication.
B. Take the medication with a high-fat meal.
C. Expect increased hair growth.
D. You should never stop taking the medication without consulting your healthcare provider.

Correct answer: A

Rationale: The correct instruction for a client taking Methotrexate is to avoid drinking alcohol. Methotrexate can cause liver toxicity, and alcohol consumption can increase this risk. It is important to emphasize the avoidance of alcohol while on this medication to prevent adverse effects and ensure treatment effectiveness. The other options are incorrect: Taking Methotrexate with a high-fat meal is not necessary as it can be taken with or without food. Increased hair growth is not an expected effect of Methotrexate; in fact, hair loss is a potential side effect. Stopping the medication without consulting a healthcare provider can be dangerous and may lead to worsening of symptoms or relapse, making option D incorrect.

2. When should a patient taking omeprazole be administered the medication?

A. Before bedtime
B. After dinner
C. In the morning on an empty stomach
D. With the patient's lunch meal

Correct answer: C

Rationale: Omeprazole should be administered in the morning on an empty stomach to maximize its effectiveness. This timing is important as omeprazole works best when taken before a meal to inhibit acid production by the stomach. Taking it on an empty stomach in the morning allows the medication to be absorbed efficiently and provides optimal therapeutic effects throughout the day. Choices A, B, and D are incorrect because taking omeprazole before bedtime, after dinner, or with lunch may not allow the medication to work effectively as it requires an empty stomach for better absorption and action.

3. What is the pharmacological action of metformin?

A. Blocks stimulation of beta1 and beta2.
B. Blocks vasoconstriction and aldosterone.
C. Acts at many levels in the CNS to produce an anxiolytic effect.
D. Decreases hepatic glucose production.

Correct answer: D

Rationale: The correct answer is D: Decreases hepatic glucose production. Metformin's primary pharmacological action is to decrease hepatic glucose production, leading to lower blood sugar levels and improved insulin sensitivity in the liver. Choices A, B, and C are incorrect because metformin does not block stimulation of beta1 and beta2 receptors, vasoconstriction, aldosterone, or act in the CNS to produce an anxiolytic effect. Therefore, these options are not reflective of metformin's mechanism of action.

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. A healthcare professional is providing discharge instructions to a client who has a new prescription for Enoxaparin. Which of the following instructions should the healthcare professional include?

A. Inject the medication into the muscle.
B. Massage the injection site after administration.
C. Rotate injection sites between the arms and thighs.
D. Administer the medication in the abdomen.

Correct answer: D

Rationale: The correct instruction is to administer Enoxaparin in the abdomen as a subcutaneous injection. This method helps prevent bleeding complications associated with the medication. Massaging the injection site after administration should be avoided to reduce the risk of local irritation or bleeding. While rotating injection sites between the arms and thighs is a good practice for some medications, it is not recommended for Enoxaparin. Consistent administration in the abdomen ensures optimal absorption and helps avoid complications.