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

Choice A reason: Adequate hydration is essential when taking methotrexate to help prevent renal toxicity and support metabolic clearance. Drinking 2 to 3 liters of water daily is a recommended strategy to reduce adverse effects. Choice B reason: While antiemetics may be used to manage nausea, they are not routinely recommended one hour after methotrexate administration. Timing and necessity depend on individual tolerance and should be guided by a healthcare provider. Choice C reason: Alcohol-based mouthwash can exacerbate mucosal irritation and increase the risk of stomatitis, a known side effect of methotrexate. Patients should use non-alcohol-based rinses or saline solutions instead. Choice D reason: NSAIDs can interact with methotrexate and increase the risk of toxicity, particularly affecting renal function. Concurrent use should be carefully evaluated and monitored by a healthcare provider.