The NP sees a well, 18-month-old with a two-day history of clear nasal discharge, dry cough, intermittent fever to 101.4 or 38.5C, and mild crankiness. She's up to date with all recommended vaccination. Parents report everyone at home has this cold. Testing for RSV, COVID-19, influenza are all negative. She is alert, age appropriately resists the exam, which is consistent with viral URI.  Her father states, “We got her fever under control by giving her two different medicines around the clock.” He presents two medication bottles, one with liquid acetaminophen and one with liquid ibuprofen. The NP considers that alternating between ibuprofen and acetaminophen for a child with fever will:

 A. Result in additive effect in fever reduction.
B. Is encouraged in order to prevent febrile seizures.
C. Is only recommended in higher fever, such as when the fever is 100 degrees F or 38.8 degrees C or greater.
D. Is not recommended due to higher potential for adverse effects.

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