A client with cancer is prescribed methotrexate. Which supplement should the healthcare provider recommend to reduce the risk of methotrexate toxicity?

Correct Answer: A

Rationale: In the context of pharmacology, understanding the interactions between medications and supplements is crucial to ensure optimal patient outcomes. In this case, the correct supplement to recommend with methotrexate therapy is folic acid. Methotrexate is a folate antagonist, meaning it interferes with the body's ability to use folic acid, a necessary vitamin for DNA synthesis and cell division. By supplementing with folic acid, the adverse effects of methotrexate can be mitigated without compromising its efficacy in treating cancer. Regarding why the other options are incorrect: - Magnesium: While magnesium is an essential mineral for various bodily functions, it does not directly counteract methotrexate toxicity. - Vitamin D: Vitamin D plays a role in bone health and immune function but does not specifically address the mechanism of methotrexate toxicity. - Iron: Iron is essential for red blood cell production and oxygen transport but does not have a direct impact on methotrexate toxicity. Educationally, this question highlights the importance of understanding drug-supplement interactions and the rationale behind supplement recommendations in pharmacology. It underscores the significance of tailored interventions to optimize drug therapy outcomes and minimize adverse effects. By grasping the specific roles of supplements in mitigating drug toxicity, healthcare providers can deliver more effective and personalized care to patients undergoing complex treatment regimens.

Correct Answer: B

Rationale: In teaching a client starting therapy with rituximab, it is crucial for the nurse to instruct the client to report fever (Option B) among the listed findings. This is because rituximab, a biologic agent used to treat various conditions including autoimmune disorders and certain cancers, can suppress the immune system, making patients more susceptible to infections. Fever can indicate an infection, which can be severe in immunocompromised individuals on rituximab. The other options - dizziness (Option A), urinary frequency (Option C), and dry mouth (Option D) - are less likely to be directly related to rituximab therapy. While dizziness can occur as a side effect of rituximab, it is not as urgent or indicative of a serious complication as fever in this context. Urinary frequency and dry mouth are typically not associated with rituximab use and are less concerning compared to potential infections. From an educational perspective, understanding the side effects and potential complications of medications like rituximab is essential for nurses to provide safe and comprehensive care to their patients. In this scenario, emphasizing the importance of recognizing and promptly reporting signs of infection, such as fever, can help prevent serious consequences and improve patient outcomes.

Correct Answer: D

Rationale: In the context of pharmacology, specifically with cyclophosphamide use in a client with breast cancer, it is crucial for the nurse to monitor for potential adverse effects. The correct answer is D) Hemorrhagic cystitis. Cyclophosphamide, an alkylating agent, is known to cause hemorrhagic cystitis, which is characterized by bladder irritation leading to hematuria. Monitoring for this adverse effect is essential to prevent complications and provide timely interventions. Option A) Hypertension is incorrect because cyclophosphamide is not typically associated with hypertension as a side effect. Option B) Hyperglycemia is also incorrect as it is not a common adverse effect of cyclophosphamide. Option C) Ototoxicity is not associated with cyclophosphamide use, making it an incorrect choice. Educationally, understanding the side effects and monitoring parameters for specific medications is crucial for nurses to ensure patient safety and optimize outcomes. By knowing the expected side effects of medications like cyclophosphamide, nurses can implement proactive monitoring and interventions, enhancing the quality of care provided to patients undergoing cancer treatment.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Sore throat. When a client is starting therapy with topotecan, a topoisomerase inhibitor commonly used in chemotherapy, it is crucial for the nurse to instruct the client to report any signs of infection promptly. Topotecan can suppress the bone marrow, leading to decreased production of white blood cells, increasing the risk of infection. Therefore, a sore throat could be indicative of an infection that needs immediate attention to prevent complications. Option A) Hair loss is a common side effect of many chemotherapy drugs, including topotecan, but it is not typically a sign of an urgent or serious issue that requires immediate reporting. Option B) Fatigue is also a common side effect of chemotherapy but is not specific to topotecan. While it is important for the nurse to address fatigue, it is not the most critical finding to report immediately in this case. Option D) Red urine is a known side effect of topotecan due to its excretion pathway, but it is not typically a cause for immediate concern unless accompanied by other symptoms like pain or difficulty urinating. In an educational context, understanding the side effects and potential complications of chemotherapy drugs like topotecan is crucial for nurses to provide safe and effective care to clients undergoing cancer treatment. Teaching clients to recognize and report early signs of infection is vital in preventing serious complications and ensuring timely intervention.

Correct Answer: C

Rationale: In pharmacology, understanding the side effects and monitoring parameters for specific medications is crucial for safe and effective patient care. In the case of capecitabine, a chemotherapy medication, the nurse should monitor for neutropenia. Neutropenia is a common side effect of chemotherapy drugs like capecitabine, which suppress bone marrow function, leading to a decrease in neutrophils, an essential type of white blood cell responsible for fighting infections. Option A, hyperglycemia, is not typically associated with capecitabine and is more commonly seen with medications like corticosteroids or certain antipsychotics. Option B, hypocalcemia, is not a known side effect of capecitabine but may occur with medications that affect calcium metabolism or parathyroid function. Option D, bradycardia, is not a common side effect of capecitabine but may be seen with medications that affect cardiac conduction. Understanding the specific side effects of medications helps nurses provide comprehensive care by monitoring for and managing potential complications. In oncology, monitoring for neutropenia is crucial to prevent infections and ensure patient safety during cancer treatment.