A client has a new prescription for methotrexate to treat Rheumatoid Arthritis. The nurse should expect to monitor the client for which of the following adverse effects?

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Bone marrow suppression. Methotrexate is a disease-modifying antirheumatic drug (DMARD) commonly used to treat Rheumatoid Arthritis. One of the most significant adverse effects of methotrexate is bone marrow suppression, which can lead to decreased production of blood cells (anemia, leukopenia, thrombocytopenia). Monitoring for signs of infection, anemia, and easy bruising is crucial when a patient is on methotrexate therapy. Option A) Insomnia is incorrect because methotrexate is not known to cause insomnia as an adverse effect. Option B) Hypertension is also incorrect because methotrexate does not typically cause hypertension. Option D) Constipation is not a common adverse effect of methotrexate either. Educationally, understanding the potential adverse effects of medications is essential for nurses to provide safe and effective care to their patients. Monitoring for specific adverse effects based on the medication prescribed can help prevent complications and improve patient outcomes. In the case of methotrexate, being vigilant for bone marrow suppression is critical in ensuring the patient's safety and well-being.

Correct Answer: B

Rationale: The correct instruction for a client taking furosemide is to eat a diet high in potassium. Furosemide is a loop diuretic that can lead to potassium loss, potentially causing hypokalemia. Consuming foods rich in potassium can help maintain normal potassium levels in the body and counteract the potential side effect of furosemide.

Correct Answer: B

Rationale: Urinary retention is a common anticholinergic effect associated with amitriptyline, a tricyclic antidepressant. Amitriptyline can cause relaxation of the bladder sphincter muscles, leading to urinary retention. Monitoring for this adverse effect is crucial to prevent complications and ensure prompt intervention if needed.

Correct Answer: B

Rationale: The correct answer is B: Alcohol. Clients should avoid alcohol while taking metronidazole due to the risk of a disulfiram-like reaction. This reaction can cause symptoms like flushing, headache, nausea, and vomiting when alcohol is consumed while on metronidazole. Dairy products, leafy green vegetables, and grapefruit juice do not have significant interactions with metronidazole.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Metoclopramide. Metoclopramide is a prokinetic agent that enhances gastric emptying and is commonly prescribed for diabetic patients with gastroparesis to alleviate symptoms like nausea. It works by increasing the contractions of the stomach and small intestines, thus helping to move food through the digestive system more efficiently. Option A) Lubiprostone is a medication used for chronic constipation and irritable bowel syndrome with constipation, not for gastroparesis. Option C) Bisacodyl is a stimulant laxative used to treat constipation by stimulating bowel movements, which is not indicated for treating gastroparesis. Option D) Loperamide is an antidiarrheal agent that slows down gut motility and is used to treat diarrhea, which is not appropriate for managing gastroparesis symptoms. In an educational context, it is important for pharmacology students to understand the mechanism of action of different medications and how they are specifically used in various clinical situations. Understanding the rationale behind selecting the correct medication for a given condition is crucial for safe and effective patient care.