NCLEX Pediatric Practice Exam

Tinnitus, or ringing in the ears, is a classic sign of salicylate toxicity from long-term aspirin use. In a child taking aspirin for rheumatic fever, elevated salicylate levels can affect the inner ear and auditory nerves, producing tinnitus and sometimes hearing loss. This is a warning sign that requires prompt evaluation and likely cessation or dose adjustment of aspirin to prevent more serious toxicity.

While stomach upset can occur with NSAIDs, it is a common, less alarming side effect and not as urgent as signs of toxicity. Local skin itching from a lotion is not related to aspirin toxicity, and a cough is not the typical presentation of salicylate toxicity in this context.

Also important to remember: aspirin in children carries a risk of Reye syndrome, a life-threatening condition, so any new or worsening symptoms should be evaluated quickly by a clinician.