Which laboratory value should the practical nurse (PN) monitor to determine if an antilipidemic medication is having the desired effect for the client?

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.

Choice A reason: Asking the spouse why the client is outside is irrelevant to the clinical concern. Fluoroquinolones cause photosensitivity, increasing sunburn risk. The focus should be on protecting the client from UV exposure, not investigating their location, making this choice unhelpful for addressing the drug’s side effect.

Choice B reason: Notifying the supervisor about an improved condition is premature and unrelated to the client being outdoors. Sitting outside does not indicate recovery, and the priority is addressing photosensitivity from fluoroquinolones, which risks skin damage, making this choice incorrect.

Choice C reason: Fluoroquinolones, like ciprofloxacin, increase photosensitivity by sensitizing skin to UV light, causing severe sunburn or rash. Reminding the client to use sunblock and protective clothing prevents dermal damage during sunlight exposure, directly addressing the drug’s side effect and ensuring safety.

Choice D reason: Encouraging staying indoors is overly restrictive and impractical. Photosensitivity can be managed with sunblock and clothing, allowing safe outdoor activity. This choice unnecessarily limits the client’s mobility, as proper precautions effectively mitigate the risk of UV-related skin damage.