Question

a nurse is teaching a client about methotrexate therapy for rheumatoid arthritis. which of the following statements should the nurse include in the teaching? (select all that apply.)

• avoid being near people who are sick with a communicable illness.
• periodic laboratory tests are required.
• the effects of the medication are immediate.
• report bruising or petechiae.
• avoid drinking alcohol.

Explanation:

• Avoid being near people who are sick with a communicable illness: Methotrexate suppresses the immune system, so clients are at higher risk of infection. Avoiding sick people helps prevent illness.
• Periodic laboratory tests are required: Methotrexate can affect blood counts and liver function, so regular lab tests monitor for these effects.
• The effects of the medication are immediate: Methotrexate for rheumatoid arthritis takes weeks to months to show full effects, so this is incorrect.
• Report bruising or petechiae: Methotrexate can cause thrombocytopenia (low platelet count), leading to bruising/petechiae. Reporting these helps detect bleeding issues.
• Avoid drinking alcohol: Methotrexate and alcohol both affect the liver; combining them increases liver damage risk.

Answer:

A. Avoid being near people who are sick with a communicable illness
B. Periodic laboratory tests are required
D. Report bruising or petechiae
E. Avoid drinking alcohol