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: Palpitations may indicate electrolyte imbalances, like hypokalemia, a serious side effect of hydrochlorothiazide, a thiazide diuretic. It increases potassium excretion, disrupting cardiac electrical activity, potentially causing arrhythmias. Withholding the dose and notifying the provider is critical to prevent life-threatening cardiac complications, requiring urgent electrolyte assessment.

Choice B reason: Nervousness is a vague symptom not typically linked to hydrochlorothiazide’s side effects. It may reflect anxiety or other unrelated issues, not necessitating immediate drug cessation. Electrolyte imbalances or hypotension are more concerning, making this choice less urgent for withholding the medication.

Choice C reason: Nausea is a common, non-specific side effect of many medications, including hydrochlorothiazide, but is not severe enough to warrant withholding the dose. It may resolve or be managed symptomatically. More critical side effects, like electrolyte imbalances, take precedence, making this choice incorrect.

Choice D reason: Anorexia is not a primary concern with hydrochlorothiazide. While it may occur with diuretic-induced dehydration, it is less urgent than cardiac symptoms like palpitations. This symptom does not directly indicate a life-threatening side effect, so withholding the drug is not immediately necessary.

A. Stop the drug if nausea, vomiting, and/or prostration occur B. Avoid all sources of alcohol while taking this drug, including cough syrups C. The medication should be taken at the same time each day D. Have weekly blood tests to determine therapeutic drug levels and serum sodium

Correct Answer is B

Explanation

Choice A reason: Stopping disulfiram for nausea or vomiting is incorrect, as these are expected in alcohol reactions, not side effects warranting discontinuation. Disulfiram inhibits aldehyde dehydrogenase, causing acetaldehyde buildup if alcohol is consumed, leading to these symptoms, which reinforce alcohol avoidance.

Choice B reason: Avoiding all alcohol, including in cough syrups, is critical, as disulfiram causes severe reactions (flushing, nausea) by blocking acetaldehyde metabolism. Even small amounts trigger symptoms, reinforcing abstinence in alcohol dependence treatment, making this the most important instruction for safety and efficacy.

Choice C reason: Taking disulfiram at the same time daily promotes adherence but is less critical than avoiding alcohol, which directly prevents severe reactions. Consistency aids therapeutic levels, but alcohol exposure poses immediate health risks, making this instruction secondary.

Choice D reason: Weekly blood tests are not standard for disulfiram, as therapeutic levels are not routinely monitored, and sodium is unaffected. Liver function may be checked periodically, but alcohol avoidance is the priority to prevent acute reactions, making this choice incorrect.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which symptom reported by a client alerts the practical nurse (PN) to withhold a scheduled dose of hydrochlorothiazide and notify the healthcare provider?

Correct Answer is A

Explanation

The practical nurse (PN) is reviewing the discharge medication instructions with a client for disulfiram. Which instruction should the PN reinforce with the client?

Correct Answer is B

Explanation

The practical nurse (PN) is providing discharge instructions to a client who had a partial thyroidectomy. When explaining the actions of the prescribed thyroid supplement levothyroxine sodium, which parameter should the PN tell the client is most important to monitor for potential side effects?

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