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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Gum appearance is unrelated to carbamazepine’s side effects or sore throat. While some antiseizure drugs cause gingival hyperplasia, carbamazepine does not, and gum assessment does not clarify the sore throat’s cause, which may indicate infection or agranulocytosis, making this choice irrelevant.
Choice B reason: Bowel sounds assess gastrointestinal function, not relevant to a sore throat or carbamazepine’s effects. Sore throat may signal agranulocytosis, a rare side effect, but bowel sounds do not provide data on infection or hematologic issues, making this choice inappropriate.
Choice C reason: Carotid pulse volume evaluates cardiovascular status but is unrelated to sore throat or carbamazepine’s side effects. Sore throat may indicate infection or agranulocytosis, requiring systemic assessment like temperature, not vascular checks, making this choice irrelevant for the reported symptom.
Choice D reason: Temperature is critical, as sore throat may indicate infection or agranulocytosis, a rare but serious carbamazepine side effect causing low white blood cells. Fever suggests infection, necessitating urgent reporting. This assessment provides key data to differentiate causes, guiding timely intervention.
Correct Answer is D
Explanation
Choice A reason: The cost of medications, while a practical concern, does not indicate a need to assess the prescription’s safety or appropriateness. It reflects financial issues, not a clinical discrepancy. The PN should address cost concerns separately, but this does not warrant immediate prescription review.
Choice B reason: Frustration with daily pill-taking reflects emotional fatigue, not a clinical issue requiring prescription assessment. It may prompt adherence counseling, but it does not suggest errors in the prescription itself, such as incorrect medication or dosage, making this choice incorrect.
Choice C reason: Taking pills at 8:00 am at home versus 9:00 am in the hospital is a minor timing difference, not necessitating prescription review. Hospital schedules often differ, and this does not indicate a safety concern or error in the medication order.
Choice D reason: A new, unfamiliar pill raises concerns about potential prescription errors, allergies, or inappropriate medication. The PN must verify the prescription against the client’s history and medical record to ensure safety, as unfamiliarity may indicate a mistake or new therapy requiring confirmation.
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