Pharmacology Proctored ATI Practice Exam

What instructions should a nurse include for a client with rheumatoid arthritis starting methotrexate therapy?

1. Increase calcium intake

2. Do not drink alcoholic beverages while taking this medication, report unexplained bruising to provider, avoid people who have infections

3. Engage in high-impact exercises

4. Drink at least 8 glasses of water a day

The correct answer is: Do not drink alcoholic beverages while taking this medication, report unexplained bruising to provider, avoid people who have infections

This answer is correct because B includes important instructions for a client starting methotrexate therapy. Methotrexate can cause bone loss, so increasing calcium intake is not necessary. Engaging in high-impact exercises can worsen joint pain and damage for clients with rheumatoid arthritis, so this option is incorrect. While drinking enough water is important for overall health, it is not specific to methotrexate therapy. Instead, it is important for clients to avoid alcohol and report any unexplained bruising, as these are potential side effects of methotrexate. Additionally, clients should be advised to avoid people who have infections since methotrexate can weaken the immune system.