# A client takes propylthiouracil. Highlight the findings that require immediate medication follow-up.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522073&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client takes propylthiouracil. Highlight the findings that require immediate medication follow-up.

| Domain | Finding |
| --- | --- |
| Infection | Temperature 38.7 C with a new sore throat |
| Liver | Dark urine and yellow sclera |
| Liver | New right upper-quadrant pain |
| Blood | Absolute neutrophil count is 700/mm3 |
| Therapy | Dose is taken at the prescribed times |
| Vital sign | Heart rate decreased from 108/min to 82/min |
| Skin | No rash or swelling |
| Follow-up | Endocrinology appointment is scheduled |

## Explanation

Fever and sore throat can signal agranulocytosis, while dark urine, jaundice, and right upper-quadrant pain can signal severe liver injury.

## In-depth explanation

Quick answer
Escalate infection and liver-injury warning symptoms.

Why this is correct
PTU carries a boxed warning for severe liver injury and can cause agranulocytosis; these symptoms require immediate evaluation rather than routine follow-up.

Easy analogy or mental picture
Think of medication safety as a control panel: identify the dangerous signal, change the correct control, and verify the response.

Memory hook
Cue, action, response, reassessment.

NCLEX decision rule
Choose the action that prevents the most immediate medication-related harm while preserving the continuing indication.

Why the other choices are wrong
Options that delay escalation, ignore a contraindication, or change therapy without authorization do not close the safety loop.References
1DailyMed: PropylthiouracilBoxed severe liver injury warning, agranulocytosis, symptom recognition, and restricted use

## Clinical scenario

Medication safety review
Verify the indication, current assessment, laboratory trend, timing, interactions, authorized action, and measurable follow-up.

## Related questions

- [A client is admitted to the emergency department after ingesting an unknown amount of acet…](https://mymerci.kr/pages/nclex_q.php?qn_id=362720&lang=en)
- [A client with chronic heart failure is prescribed metoprolol 25 mg orally twice daily. Bef…](https://mymerci.kr/pages/nclex_q.php?qn_id=362756&lang=en)
- [A 28-year-old client with type 1 diabetes receives regular insulin 6 units and NPH insulin…](https://mymerci.kr/pages/nclex_q.php?qn_id=362792&lang=en)
- [A client receives IV vancomycin 1 g every 12 hours for MRSA bacteremia. Before the next do…](https://mymerci.kr/pages/nclex_q.php?qn_id=362833&lang=en)
- [A client with bipolar disorder has been taking lithium carbonate 600 mg orally three times…](https://mymerci.kr/pages/nclex_q.php?qn_id=362894&lang=en)
- [A nurse is monitoring a client receiving a continuous IV heparin infusion for pulmonary em…](https://mymerci.kr/pages/nclex_q.php?qn_id=363988&lang=en)
- [A nurse is preparing to initiate a weight-based continuous IV unfractionated heparin infus…](https://mymerci.kr/pages/nclex_q.php?qn_id=364107&lang=en)
- [A nurse is providing discharge teaching to a 65-year-old client newly prescribed warfarin …](https://mymerci.kr/pages/nclex_q.php?qn_id=364872&lang=en)

## Read in another language

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=522073&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=522073&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=522073&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=522073&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=522073&lang=vi)

---

More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en)

_For study reference only. Always follow current clinical guidelines and your institution’s protocols._