The practical nurse (PN) is caring for a client receiving a prescription for paroxetine who suddenly exhibits restlessness, tachycardia, fever, and elevated blood pressure. Which action should the PN implement first?

Choice A reason: Asking the spouse why the client is outside is irrelevant to the clinical concern. Fluoroquinolones cause photosensitivity, increasing sunburn risk. The focus should be on protecting the client from UV exposure, not investigating their location, making this choice unhelpful for addressing the drug’s side effect.

Choice B reason: Notifying the supervisor about an improved condition is premature and unrelated to the client being outdoors. Sitting outside does not indicate recovery, and the priority is addressing photosensitivity from fluoroquinolones, which risks skin damage, making this choice incorrect.

Choice C reason: Fluoroquinolones, like ciprofloxacin, increase photosensitivity by sensitizing skin to UV light, causing severe sunburn or rash. Reminding the client to use sunblock and protective clothing prevents dermal damage during sunlight exposure, directly addressing the drug’s side effect and ensuring safety.

Choice D reason: Encouraging staying indoors is overly restrictive and impractical. Photosensitivity can be managed with sunblock and clothing, allowing safe outdoor activity. This choice unnecessarily limits the client’s mobility, as proper precautions effectively mitigate the risk of UV-related skin damage.

Choice A reason: Keratolytic agents, like salicylic acid, break down keratin in psoriatic plaques, softening scaly skin and reducing peeling. This promotes shedding of thickened, dead skin cells, improving skin texture. Softer, less scaly skin directly indicates the medication’s effect on hyperkeratotic lesions, confirming therapeutic success.

Choice B reason: Absence of purulent drainage indicates no infection but is not the primary goal of keratolytics. These agents target scale reduction, not infection. Psoriasis lesions are typically not purulent, so this finding is unrelated to the medication’s intended effect on skin texture.

Choice C reason: Reduced redness and swelling suggest decreased inflammation, which is not the primary action of keratolytics. Anti-inflammatory agents, like corticosteroids, target these symptoms, while keratolytics focus on scale removal. This finding is irrelevant to the medication’s specific role in psoriasis management.

Choice D reason: Full range of motion without pain relates to joint function, possibly in psoriatic arthritis, but is unrelated to keratolytics, which treat skin lesions. Keratolytics do not affect joint inflammation or mobility, making this choice incorrect for assessing the medication’s skin-specific effects.