Question

a nurse is teaching about self - administering methotrexate to a client who has rheumatoid arthritis. which of the following statements should the nurse make?

• \use a nonsteroidal anti - inflammatory drug (nsaid) to reduce toxicity.\
• \you should have your liver function checked every 6 months.\
• \drink a minimum of 2 liters of water per day to promote the excretion of the medication.\
• \take it in the morning to prevent insomnia.\

Explanation:

• For the option "Use a nonsteroidal anti - inflammatory drug (NSAID) to reduce toxicity": Methotrexate and NSAIDs can increase the risk of renal impairment and other toxicities, so this is incorrect.
• For the option "You should have your liver function checked every 6 months": Methotrexate can cause hepatotoxicity, but liver function tests are usually done more frequently initially and then at appropriate intervals, not every 6 months as a general rule for self - administration teaching in this context.
• For the option "Drink a minimum of 2 liters of water per day to promote the excretion of the medication": Methotrexate is excreted by the kidneys, and adequate fluid intake (like 2 liters of water per day) helps in its excretion and reduces the risk of renal toxicity. This is a correct teaching point.
• For the option "Take it in the morning to prevent insomnia": Methotrexate does not typically cause insomnia related to its timing of administration in the context of rheumatoid arthritis treatment, so this is not a relevant teaching statement.

Answer:

C. "Drink a minimum of 2 liters of water per day to promote the excretion of the medication."