# A 12-year-old taking methimazole develops fever and a severe sore throat. Which action should the nurse take?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522650&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A 12-year-old taking methimazole develops fever and a severe sore throat. Which action should the nurse take?

## Option

1. Give the next dose with food and reassess the throat in 1 week.
2. Stop methimazole and obtain urgent prescriber-directed blood-count evaluation. **✔ Correct answer**
3. Replace methimazole with propylthiouracil without an order.
4. Reassure the family that fever proves the thyroid level is normal.

**Correct answer: 2**

## Explanation

Fever and severe sore throat can signal life-threatening methimazole-associated agranulocytosis and require immediate interruption and evaluation.

## In-depth explanation

Quick answer
Treat fever plus sore throat during methimazole therapy as possible agranulocytosis.

Why this is correct
Pediatric propylthiouracil has its own severe liver-injury risk and is not an independent nursing substitution.

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: methimazolePreferred antithyroid drug in pediatric patients when medication is required, agranulocytosis warning, and liver-injury evaluation

## 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.

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