# A school-age child started montelukast for asthma. Highlight the findings that require prompt medication follow-up.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522647&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A school-age child started montelukast for asthma. Highlight the findings that require prompt medication follow-up.

| Domain | Finding |
| --- | --- |
| Sleep | New recurrent nightmares and sleepwalking |
| Behavior | New aggression and marked irritability at school |
| Perception | Reports seeing people who are not present |
| Safety | Says there is no reason to live |
| Asthma | Uses the written rescue plan correctly |
| Technique | Caregiver tracks symptoms in a diary |
| Nutrition | Eats the usual breakfast |
| Activity | Completed a calm reading assignment |

## Explanation

New nightmares, aggression, hallucination-like behavior, and suicidal statements are serious neuropsychiatric signals requiring immediate discontinuation and contact with the prescriber.

## In-depth explanation

Quick answer
Escalate new behavior, sleep, perception, or self-harm symptoms.

Why this is correct
Montelukast neuropsychiatric effects can occur with or without a prior psychiatric history. Families should not wait for a routine appointment when these symptoms appear.

Easy analogy or mental picture
Use a family-centered medication-safety loop: verify age or pregnancy context, identify the exposure and new cue, prevent further harm, stabilize the client, and confirm the response.

Memory hook
Population, indication, dose or route, contraindication, urgent cue, protective action, and reassessment.

NCLEX decision rule
Choose the action that protects the maternal, newborn, or pediatric client from the most immediate medication-related harm while preserving authorized treatment.

Why the other choices are wrong
Options that normalize a danger sign, substitute an unapproved route or dose, or delay reassessment leave the client exposed to preventable harm.References
1DailyMed: montelukast sodiumBoxed warning for serious neuropsychiatric events, caregiver counseling, monitoring, and immediate discontinuation if symptoms occur

## Clinical scenario

Maternal, newborn, and pediatric medication safety review
Verify the client's age or pregnancy stage, indication, weight or laboratory context, route, interacting therapies, contraindications, caregiver teaching, 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=522647&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=522647&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=522647&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=522647&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=522647&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._