A nurse is teaching a client who has rheumatoid arthritis about taking methotrexate. Which of the following information should the nurse include?

A. Rinse mouth 2 times per day with an alcohol-based mouthwash: Alcohol-based mouthwashes can cause further irritation to the mouth, especially for clients taking methotrexate, which can increase the risk of mouth sores and ulcers. B. Take an antiemetic 1 hr following administration: While methotrexate can cause nausea, taking an antiemetic should be done based on the client's needs and as directed by the healthcare provider, not necessarily 1 hour after administration. C. Take the medication with an NSAID: Methotrexate should not be taken with NSAIDs, as they can increase the risk of toxicity, particularly affecting the kidneys and liver. Methotrexate is usually prescribed alone, or with other medications that do not have these interactions. D. Drink 2 to 3 L of water per day: Clients on methotrexate should maintain adequate hydration to help prevent kidney toxicity, a known risk of methotrexate. Drinking 2 to 3 liters of water per day helps promote kidney function and reduces the risk of dehydration and kidney damage.