Before undergoing an intravenous pyelogram, the most important information for the nurse to gather is whether the patient has an allergy to shellfish.

• A. Shellfish Allergy
• B. Penicillin Allergy
• C. History of Asthma
• D. Kidney Disease

Answer: (A)

In this scenario the key safety concern is the risk of an adverse reaction to iodinated contrast used for the procedure. An intravenous pyelogram relies on iodinated contrast, so the nurse must determine if the patient might have a hypersensitivity to contrast agents. A shellfish allergy is the most relevant screening question because it is commonly used to flag potential reactions to iodinated contrast media. If a shellfish allergy is present, the care team can take precautions, such as premedication or choosing an alternative imaging method, to reduce the risk of a serious reaction.

Penicillin allergy, asthma history, and kidney disease are important in other contexts—penicillin allergy is about antibiotic reactions, asthma can indicate a risk for respiratory complications with contrast, and kidney disease relates to the risk of contrast-induced nephropathy. However, regarding immediate safety before using iodinated contrast, the shellfish allergy question best informs the nurse about potential hypersensitivity to the contrast agent.