A nurse is evaluating teaching for a client who has Rheumatoid Arthritis and a new prescription for Methotrexate. Which of the following statements by the client indicates understanding of the teaching?

Correct Answer: C

Rationale: In this scenario, option C is the correct answer because it demonstrates the client's understanding of a potential side effect of Methotrexate, which is the development of sores in the mouth. This response indicates that the client is aware of the importance of monitoring and promptly reporting adverse effects to their healthcare provider. Option A is incorrect because blood monitoring for Methotrexate typically requires more frequent monitoring than once a year to ensure safety and efficacy. Option B is incorrect because Methotrexate is usually taken with food to minimize gastrointestinal side effects. Option D is incorrect because Methotrexate does not interact with oral contraceptives, so stopping them is unnecessary. Educationally, this question highlights the importance of patient education in medication management, especially in chronic conditions like Rheumatoid Arthritis. Understanding common side effects and when to report them is crucial for patient safety and treatment effectiveness. It also underscores the need for nurses to provide clear and accurate information to empower patients in managing their health.

Correct Answer: D

Rationale: Butorphanol is an opioid agonist/antagonist that can precipitate withdrawal symptoms in opioid-dependent individuals. Symptoms of abstinence syndrome can include abdominal pain, fever, and anxiety. This occurs because butorphanol competes with and displaces opioid agonists from receptors, leading to withdrawal symptoms in opioid-dependent clients.

Correct Answer: D

Rationale: The correct answer is 'Orthostatic hypotension.' Amitriptyline can lead to orthostatic hypotension, a sudden drop in blood pressure when standing up, which can cause dizziness and increase the risk of falls. It is crucial for the nurse to monitor the client for signs of orthostatic hypotension, such as dizziness or lightheadedness when changing positions, and to educate the client to move slowly when transitioning from lying or sitting to standing.

Correct Answer: D

Rationale: In this scenario, the nurse should monitor the client's liver function tests (option D) when they are taking Acarbose for type 2 Diabetes Mellitus. Acarbose is a medication that can affect liver function, so monitoring liver enzymes such as ALT, AST, and bilirubin is crucial to detect any signs of hepatotoxicity or liver damage early on. The other options (A) WBC, (B) Serum potassium, and (C) Platelet count are not directly related to the medication Acarbose or its potential side effects. Monitoring white blood cell count, serum potassium levels, and platelet count are important in other clinical contexts but are not specifically indicated for a client taking Acarbose for diabetes mellitus. Educationally, this question highlights the importance of understanding the specific monitoring parameters required for various medications used in managing diabetes mellitus. It emphasizes the need for nurses to have a comprehensive understanding of pharmacology to provide safe and effective care to clients with diabetes and other chronic conditions. Monitoring for medication side effects through appropriate laboratory tests is a critical aspect of ensuring patient safety and optimal health outcomes.

Correct Answer: D

Rationale: Levothyroxine should be initiated at a low dose and titrated gradually over several weeks to achieve therapeutic levels. This approach helps to minimize the risk of adverse effects, particularly in older adult clients who may be more sensitive to medication changes. Starting at a low dose allows for close monitoring of the client's response and adjustment of the dosage as needed to optimize treatment outcomes.