The practical nurse (PN) is reinforcing information with a client who has been diagnosed with human immunodeficiency virus (HIV) about the antiretroviral medication regimen. Which client statement should the PN recognize as requiring an additional review of the information?

Choice A reason: Peak and trough levels are relevant for drugs like vancomycin, not meloxicam, an NSAID. Meloxicam’s efficacy is assessed clinically via pain reduction, not blood levels, as it inhibits inflammation-causing prostaglandins, making this choice irrelevant for costochondritis management.

Choice B reason: Reassessing pain 30 minutes after meloxicam administration evaluates its effectiveness, as this NSAID reduces cyclooxygenase activity, decreasing prostaglandin-mediated pain and inflammation in costochondritis. Timely reassessment ensures adequate relief, guiding further interventions for breathing discomfort, making this the appropriate intervention.

Choice C reason: Involuntary lip and tongue movements are linked to antipsychotics causing tardive dyskinesia, not meloxicam. This NSAID does not affect neurological pathways causing movement disorders. Monitoring for this is irrelevant, as meloxicam’s primary risks are gastrointestinal, not neurological.

Choice D reason: Strict intake and output monitoring is unnecessary for meloxicam, which targets inflammation, not fluid balance. While long-term use may affect renal function, pain reassessment is more immediate for costochondritis, making this choice less relevant than evaluating therapeutic pain relief.

Choice A reason: Suggesting a snack after administering an incorrect insulin dose risks hypoglycemia, as 2 extra units can excessively lower blood glucose. Insulin dosing must match the glucose level per the sliding scale to prevent adverse effects, making this choice unsafe and reactive.

Choice B reason: Repeating the glucose level is unnecessary if the recorded level is reliable. The error lies in the drawn dose, not the glucose measurement. Correcting the dose to match the recorded glucose is more direct, as insulin dosing relies on accurate glucose data.

Choice C reason: Reducing the insulin dose by 2 units corrects the error, aligning with the sliding scale for the recorded glucose level. Excess insulin can cause hypoglycemia, affecting brain and organ function. This action ensures safe administration, preventing potentially severe metabolic consequences.

Choice D reason: Recording the discrepancy does not correct the dosing error and risks administering an unsafe dose. Documentation is secondary to ensuring the correct insulin amount is given, as 2 extra units could lead to hypoglycemia, requiring immediate correction, not just notation.