A client receives a prescription for golimumab for psoriasis. Which information should the practical nurse (PN) obtain prior to administration?

Allergy to iodine

Flu vaccination date

Recent tuberculosis test

Use of oral contraceptives

Answer and Explanation

The Correct Answer is C

Choice A reason: Iodine allergy is irrelevant to golimumab, a tumor necrosis factor (TNF) inhibitor, as it is not iodine-based. Allergic reactions to biologics are possible but unrelated to iodine sensitivity, making this choice unnecessary for ensuring safe administration of the medication.

Choice B reason: Flu vaccination status is relevant for general health but not critical before golimumab administration. While immunosuppression increases infection risk, tuberculosis screening is more urgent, as TNF inhibitors can reactivate latent TB, posing a severe health threat.

Choice C reason: A recent tuberculosis test is essential, as golimumab suppresses TNF, increasing the risk of reactivating latent TB into active disease. Screening with a tuberculin test or interferon-gamma assay prevents potentially fatal infections, making this the most critical information before starting therapy.

Choice D reason: Oral contraceptive use is unrelated to golimumab’s safety or efficacy. While some drugs interact with contraceptives, golimumab does not, and psoriasis treatment does not involve reproductive considerations, making this choice irrelevant for pre-administration assessment.

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Correct Answer is A

Explanation

Choice A reason: Increasing pain before the next opioid dose suggests inadequate analgesia, possibly due to tolerance or disease progression. Consulting the charge nurse facilitates dosage adjustment or schedule changes, ensuring effective pain control in terminal cancer, where maintaining comfort is critical for quality of life.

Choice B reason: Notifying the provider that the dosage has been increased is incorrect, as the PN cannot unilaterally adjust controlled substances. Pain management requires collaboration, and premature notification without consultation risks legal and clinical errors, making this choice inappropriate.

Choice C reason: Withholding opioid doses risks uncontrolled pain, which is unethical in terminal cancer care. The client’s increasing pain indicates a need for dosage review, not cessation, as opioids are essential for palliation, making this choice harmful and contrary to care goals.

Choice D reason: Administering opioids only when pain exceeds 5 is arbitrary and delays relief. Breakthrough pain before scheduled doses requires proactive dosage or interval adjustments, not reactive thresholds, to maintain consistent analgesia, making this choice inadequate for managing terminal cancer pain.

A. Observe the client’s ability to easily and quickly open the pill box B. Explain the need to store the medication in the original container C. Remind the client to obtain a fresh supply of pills every 30 days D. Assist in clearly labeling the pill container with directions for use

Correct Answer is B

Explanation

Choice A reason: Observing the client’s ability to open the pill box ensures accessibility but does not address nitroglycerin’s stability. Nitroglycerin degrades when exposed to air, light, or plastic, reducing potency. The original container is critical for maintaining efficacy, making this choice secondary.

Choice B reason: Nitroglycerin must be stored in its original amber glass container to protect it from light, air, and moisture, which degrade its potency. Plastic pill boxes allow exposure, reducing effectiveness for angina relief. Explaining this ensures the client maintains the drug’s therapeutic integrity.

Choice C reason: Reminding the client to refresh nitroglycerin every 30 days is relevant due to its short shelf life, but the priority is proper storage. Without the original container, even fresh pills lose potency, making this choice less critical than ensuring correct storage conditions.

Choice D reason: Labeling the pill box improves usability but does not address nitroglycerin’s stability. Plastic containers expose the drug to air and light, reducing efficacy. Proper storage in the original container is more critical to ensure the drug remains effective for emergency use.

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A client receives a prescription for golimumab for psoriasis. Which information should the practical nurse (PN) obtain prior to administration?

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Naxlex Comprehensive Predictor Exams

A client with terminal cancer reports increasing pain that occurs 1 to 2 hours before the next scheduled dose of a prescribed opioid analgesic. Which action should the practical nurse (PN) implement?

Correct Answer is A

Explanation

Sublingual nitroglycerin is prescribed PRN for an older adult female client with a history of chest pain. The client shows the practical nurse (PN) a plastic pill box that she purchased so the medication can always be readily available in her purse. Which action should the PN take?

Correct Answer is B

Explanation

A client receives a new prescription for montelukast. Which information should the practical nurse (PN) include when reinforcing the client's teaching?

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