MSFinals-4925

A 61-year-old man has been experiencing stiffness in both hands, wrists and ankles for over a year. After undergoing serological testing and radiological imaging, he was diagnosed with rheumatoid arthritis. His rheumatologist has decided to start him on methotrexate therapy. He has a medical history that includes gout, chronic obstructive pulmonary disease (COPD), diabetes, and stage 2 chronic kidney disease.
What should be done before beginning methotrexate treatment?