Prescribing Safety Assessment (PSA) Practice Exam

When should methotrexate be withheld?

1. When the patient has mild dehydration

2. For an active infection

3. When the patient is experiencing nausea

4. Before elective surgeries

The correct answer is: For an active infection

Methotrexate should be withheld for an active infection because it is an immunosuppressive medication. It can impair the body's ability to fight infections by reducing the function of immune cells. In patients with active infections, continuing methotrexate may exacerbate the situation and lead to more severe complications. This is particularly important given that infections can worsen in the context of immunosuppression. Mild dehydration does not typically require withholding methotrexate, as long as hydration can be adequately managed. Nausea alone is not a contraindication for continuing treatment with methotrexate, as it can often be managed with supportive care. While elective surgeries may require careful consideration regarding the timing of methotrexate, simply withholding the medication before surgery is not a mandated practice unless there are specific concerns related to the surgery or the patient's overall condition.