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: The correct answer is option C: "I'll let the doctor know if I develop sores in my mouth while taking this medication." This statement indicates understanding because one of the side effects of Methotrexate is mucosal ulceration, which can manifest as sores in the mouth. By recognizing and reporting this side effect to the healthcare provider, the client can receive appropriate management and potentially prevent further complications. Option A is incorrect because the frequency of blood monitoring for Methotrexate is more frequent than once a year due to its potential for adverse effects on the bone marrow, liver, and kidneys. Option B is incorrect because Methotrexate is usually taken with food to reduce gastrointestinal side effects. Option D is incorrect because Methotrexate does not interact with oral contraceptives, so there is no need to stop taking them while on Methotrexate therapy. In an educational context, it is crucial for nurses to ensure that clients understand the side effects and monitoring requirements of medications like Methotrexate to promote safe and effective treatment. Teaching clients about potential side effects and when to seek medical attention empowers them to take an active role in their healthcare and enhances medication adherence and safety.

Correct Answer: D

Rationale: Butorphanol, an opioid agonist/antagonist, can lead to abstinence syndrome in clients who are opioid-dependent. This syndrome may present with symptoms like abdominal pain, fever, and anxiety. It is crucial for healthcare professionals to consider this risk when administering Butorphanol to clients with a history of substance use disorder.

Correct Answer: D

Rationale: Amitriptyline is known to cause orthostatic hypotension, a sudden drop in blood pressure when moving from lying down or sitting to a standing position. Monitoring for orthostatic hypotension is crucial to prevent falls and related injuries. Educating the client about moving slowly and changing positions gradually can help mitigate this adverse effect.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Liver function test. Acarbose is a medication used to treat type 2 diabetes mellitus by inhibiting the enzymes responsible for breaking down carbohydrates. This medication can potentially affect liver function, so it is crucial to monitor the client's liver enzymes regularly to detect any signs of liver damage or toxicity. Option A) WBC (White Blood Cell) count is not directly related to the monitoring of Acarbose therapy for diabetes. Changes in WBC count are typically associated with infections or immune system disorders rather than the side effects of this medication. Option B) Serum potassium levels are not specifically impacted by Acarbose therapy. Monitoring potassium levels is more relevant in clients taking medications like diuretics or certain heart medications that can affect potassium balance. Option C) Platelet count is not typically affected by Acarbose therapy. Platelet counts are usually monitored in conditions related to clotting disorders or certain medications that can impact platelet function. Educationally, understanding the rationale behind monitoring specific laboratory tests for clients on different medications is essential for nurses to provide safe and effective care. By comprehending the potential side effects and monitoring requirements of medications like Acarbose, nurses can proactively assess and manage any adverse effects, ensuring optimal patient outcomes.

Correct Answer: D

Rationale: In the case of a client with Hypothyroidism starting Levothyroxine in a long-term care facility, the nurse should expect the dosage schedule to start with a low dose (Option D) that will be gradually increased. This is the correct answer because initiating treatment for Hypothyroidism with Levothyroxine typically involves a cautious approach to prevent adverse effects like cardiac complications or hyperthyroidism. Option A, starting at a high dose and tapering, is incorrect because it poses a higher risk of adverse effects and does not align with standard practice guidelines for Levothyroxine initiation. Option B, remaining on the initial dosage, is also incorrect as dosages are usually adjusted based on the client's response to treatment. Option C, adjusting the dosage daily based on blood levels, is not typically done as it takes time for Levothyroxine to reach therapeutic levels in the body. From an educational perspective, understanding the rationale behind the gradual increase in Levothyroxine dosage is crucial for nursing practice. It ensures safe and effective medication management, highlights the importance of monitoring for signs of hyperthyroidism or cardiac issues, and emphasizes the need for ongoing assessment and dosage adjustments based on the client's clinical response. This approach aligns with evidence-based pharmacological principles and promotes optimal client outcomes in the long-term care setting.