The primary health care provider prescribes methotrexate (MTX) for a patient with a new diagnosis of rheumatoid arthritis. What statement regarding the medication will the nurse include when providing health teaching?

Choice A reason: Methotrexate typically takes 4 to 6 weeks to begin showing therapeutic effects in rheumatoid arthritis. Telling the patient it will work in 1 to 2 weeks is misleading and may lead to premature discontinuation or frustration with treatment. Patients should be counseled to allow time for the medication to take effect. Choice B reason: Alcohol consumption while taking methotrexate is contraindicated due to the increased risk of hepatotoxicity. Even moderate alcohol intake can exacerbate liver damage, especially in patients with preexisting liver conditions or those on long-term therapy. Choice C reason: Methotrexate is an immunosuppressant and can reduce the body’s ability to fight infections. Patients should be advised to avoid crowded places, monitor for signs of infection, and report symptoms such as fever or sore throat promptly. This is a critical safety teaching point. Choice D reason: While cost and financial assistance programs are relevant, they are not the priority teaching point regarding methotrexate’s safety and use. The nurse should focus first on the medication’s effects and precautions before discussing financial logistics.