Which client information should the practical nurse (PN) obtain prior to preparing a dose of the influenza vaccine?

Choice A reason: Peak and trough levels are relevant for drugs like antibiotics, not meloxicam, a nonsteroidal anti-inflammatory drug (NSAID). Meloxicam’s efficacy is assessed clinically, not via blood levels, as it reduces inflammation and pain, making this choice irrelevant for costochondritis management.

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

Choice C reason: Involuntary lip and tongue movements are associated with antipsychotics, not meloxicam. This NSAID does not cause neurological side effects like tardive dyskinesia. Monitoring for this is irrelevant, as meloxicam’s primary concerns are gastrointestinal or renal, not movement disorders.

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

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.