Methotrexate is ordered for a client with a malignant tumor, and the nurse is providing education about self-care after the chemotherapy is given. Which statements by the nurse are appropriate for the client receiving methotrexate? (Select all that apply.)

Correct Answer: B,C,D

Rationale:
B: Avoid foods that are too hot, too cold, or rough in texture. Methotrexate can cause mucositis, making the oral cavity sensitive. Avoiding extreme temperatures and rough textures helps prevent irritation and discomfort.
C: Avoid areas with large crowds or gatherings. Methotrexate suppresses the immune system, increasing the risk of infection. Avoiding crowds reduces the risk of exposure to infections.
D: Prepare for hair loss. Methotrexate can cause hair loss as a side effect. Preparing the client for this possibility helps manage expectations and emotional impact.

Incorrect:
A: Hair loss is not expected with this drug. This statement is incorrect as hair loss is a common side effect of methotrexate.
E: Restrict fluid intake to reduce nausea and vomiting. Restricting fluid intake can lead to dehydration, which is not recommended during chemotherapy.