Question

a nurse is caring for a 20-year-old client who has a prescription for isotretinoin for severe nodulocystic acne vulgaris. before the client can obtain a refill, the nurse should advise the client that which of the following tests is required?

serum calcium
pregnancy test
24-hr urine collection for protein
aspartate aminotransferase level

Explanation:

Identify the drug and its primary risks

Using the Pregnancy Categories and Teratogenic Effects knowledge points

Isotretinoin is a highly effective systemic retinoid used for severe nodulocystic acne, but it is a notorious human teratogen (FDA Pregnancy Category X). Exposure during pregnancy carries an extremely high risk of severe birth defects, spontaneous abortion, and premature delivery.

Determine the mandatory monitoring requirements

Because of these severe teratogenic risks, female clients of childbearing potential (such as this 20-year-old client) must participate in a strict risk management program (iPLEDGE). This program mandates negative pregnancy tests before starting therapy and monthly before obtaining each prescription refill.

Answer:

• Serum calcium
• Pregnancy test (Correct answer)
• 24-hr urine collection for protein
• Aspartate aminotransferase level