Prior to administering pain medication to an adult postoperative client, what information should the practical nurse (PN) obtain? (Select all that apply.)

The correct answer is Choice B: Administer the medication to the toddler each evening.

Choice B rationale: Montelukast is a leukotriene receptor antagonist used for the long-term management of asthma, especially in preventing nighttime symptoms. It is typically prescribed to be administered once daily in the evening to provide optimal therapeutic benefits. By instructing the parents to give the medication each evening, the nurse promotes adherence to the prescribed dosing schedule and helps maximize the medication's effectiveness in controlling the toddler's asthma symptoms.

Choice A rationale: While some medications can be mixed with juice or other liquids to make them more palatable for children, montelukast should not be dissolved in a drink. Instead, it can be mixed with a spoonful of cold, soft food, such as applesauce or ice cream, if necessary, to facilitate administration. Mixing with juice could potentially alter the medication's efficacy or create an unpleasant taste.

Choice C rationale: Montelukast is not indicated for use as a quick-relief medication prior to physical activity. It is a maintenance medication intended for long-term asthma control rather than immediate relief of acute symptoms. Providing an additional dose of montelukast before physical activity would not serve the intended purpose and could increase the risk of side effects.

Choice D rationale: Montelukast is not meant to be used as a rescue medication for acute asthma attacks. It is a long-term control medication that helps prevent asthma attacks and improve overall symptom management. For acute asthma attacks, the toddler would require a fast-acting beta-agonist or other appropriate rescue medication prescribed by their healthcare provider. Administering montelukast during an acute asthma attack would not provide the rapid relief needed to alleviate symptoms and could potentially delay appropriate treatment.

Choice A rationale:

Facial erythema (redness of the face) is not a typical manifestation of pertussis (whooping cough) Pertussis primarily presents with a severe cough, often followed by a "whooping" sound during inhalation, and can cause complications like pneumonia and apnea. Facial erythema is not a characteristic sign of the disease.

Choice B rationale:

A beefy, red tongue is not a common manifestation of pertussis. This description is more suggestive of other conditions, such as vitamin deficiencies or certain infections. Pertussis primarily involves respiratory symptoms, and a red tongue is not a typical finding associated with the disease.

Choice C rationale:

Fever is a common manifestation of pertussis, and it is often one of the early symptoms. However, it is not the most specific sign of the disease, as many other infections can also cause fever. While fever can occur in pertussis, it is not the most distinctive feature of the condition.

Choice D rationale:

Koplik spots are not associated with pertussis but rather with measles (rubeola) Koplik spots are small white or grayish-blue spots with a red halo that appear on the mucous membranes inside the cheeks and are characteristic of measles. Pertussis is primarily known for its characteristic cough and paroxysms of coughing, not for Koplik spots.