The client with type 2 diabetes mellitus is prescribed semaglutide. The client knows that this medication is used for diabetes but that it is also popular for weight loss. What is the mechanism of action of this drug?

Choice A reason: Ecchymosis, or bruising, may occur with a fracture due to soft tissue injury and bleeding but is not specific to fractures. It results from ruptured blood vessels in the skin, not bone disruption, and can occur in many trauma scenarios, making it less definitive than crepitus for fracture assessment.

Choice B reason: Crepitus, the grating sound or sensation from bone fragments rubbing together, is a hallmark of fractures. It occurs due to disrupted bone continuity, detectable during physical examination. This clinical manifestation is highly specific to fractures, making it the most accurate choice for a nurse’s assessment focus.

Choice C reason: Shock can occur with severe fractures due to blood loss or pain but is not a direct manifestation of the fracture itself. It reflects systemic response to trauma, not the localized bone injury, making it less specific than crepitus for identifying a fracture during assessment.

Choice D reason: Deformity is a common fracture sign due to bone misalignment but is not always present, especially in hairline or non-displaced fractures. Crepitus is more consistently detectable in physical exams, as it directly results from bone fragment movement, making it a more reliable clinical manifestation.

Choice A reason: Trimethoprim/sulfamethoxazole does not require extended sun exposure. In fact, it causes photosensitivity, increasing sunburn risk, so patients should avoid prolonged sunlight. Vitamin D synthesis is unrelated to this antibiotic’s mechanism or side effects, making this statement inaccurate and potentially harmful for patient safety.

Choice B reason: Trimethoprim/sulfamethoxazole does not typically cause brown urine. Brown urine may indicate hematuria or other conditions, but it is not a common side effect of this drug. The medication may cause gastrointestinal upset or rash, but urine discoloration is not expected, making this statement inaccurate.

Choice C reason: Follow-up with a healthcare provider is necessary to ensure UTI resolution and monitor for side effects like rash, renal impairment, or rare hematologic effects. This statement is inaccurate, as lack of follow-up could miss treatment failure or complications, undermining effective management of the infection.

Choice D reason: Trimethoprim/sulfamethoxazole can cause bone marrow suppression, leading to anemia, particularly in patients with folate deficiency or prolonged use. Monitoring complete blood counts is critical to detect hemolytic anemia or other hematologic toxicities, making this statement accurate and essential for safe patient management during treatment.