The practical nurse (PN) is caring for a client who has been taking ibuprofen for arthritic pain. Which action should the PN include in the client’s plan of care (POC)?

Choice A reason: The cost of medications, while a practical concern, does not indicate a need to assess the prescription’s safety or appropriateness. It reflects financial issues, not a clinical discrepancy. The PN should address cost concerns separately, but this does not warrant immediate prescription review.

Choice B reason: Frustration with daily pill-taking reflects emotional fatigue, not a clinical issue requiring prescription assessment. It may prompt adherence counseling, but it does not suggest errors in the prescription itself, such as incorrect medication or dosage, making this choice incorrect.

Choice C reason: Taking pills at 8:00 am at home versus 9:00 am in the hospital is a minor timing difference, not necessitating prescription review. Hospital schedules often differ, and this does not indicate a safety concern or error in the medication order.

Choice D reason: A new, unfamiliar pill raises concerns about potential prescription errors, allergies, or inappropriate medication. The PN must verify the prescription against the client’s history and medical record to ensure safety, as unfamiliarity may indicate a mistake or new therapy requiring confirmation.

Choice A reason: Montelukast is a leukotriene receptor antagonist that inhibits leukotrienes, mediators of inflammation in allergic responses. By blocking these, it reduces airway inflammation, bronchoconstriction, and mucus production, preventing asthma or allergic rhinitis symptoms. This prophylactic action targets the immune response to allergens, stabilizing respiratory function before symptoms escalate.

Choice B reason: Montelukast does not increase mucus production. Instead, it reduces mucus by inhibiting leukotriene-driven inflammation in the airways. Increased mucus is a symptom of uncontrolled asthma or allergies, which montelukast aims to prevent. This choice is incorrect as it contradicts the drug’s mechanism of reducing inflammatory responses in the lungs.

Choice C reason: Montelukast does not contract respiratory smooth muscles. It prevents bronchoconstriction by blocking leukotrienes, which cause smooth muscle contraction in asthma. By inhibiting this pathway, it promotes airway relaxation, not contraction. This choice is incorrect, as it misrepresents the drug’s role in maintaining open airways.

Choice D reason: Montelukast does not repair damaged lung tissue. Its primary role is to prevent inflammation and bronchoconstriction caused by allergens. Lung tissue repair involves other physiological processes, not influenced by montelukast. This choice is incorrect, as it falsely attributes tissue regeneration to a drug focused on immune modulation.