The practical nurse (PN) is reinforcing information with a client who has been diagnosed with human immunodeficiency virus (HIV) about the antiretroviral medication regimen. Which client statement should the PN recognize as requiring an additional review of the information?

Choice A reason: Taking a benzodiazepine with morphine is incorrect, as it increases sedation and respiratory depression risk, a dangerous opioid side effect. This indicates misunderstanding, as morphine’s primary management focuses on pain and side effects like constipation, not concurrent sedative use.

Choice B reason: Observing bowel movements and using a stool softener shows understanding, as morphine causes constipation by slowing gastrointestinal motility via opioid receptors. Proactive management with stool softeners prevents complications like impaction, aligning with safe opioid use in cancer pain management.

Choice C reason: Grapefruit juice avoidance is irrelevant to morphine, as it affects drugs metabolized by CYP3A4, not opioids. Morphine is metabolized via glucuronidation, unaffected by grapefruit. This indicates misunderstanding, as it does not address morphine’s key side effects or management.

Choice D reason: Watching for agitation or insomnia is not a primary concern with morphine, which causes sedation. These symptoms may relate to other conditions, but they do not reflect understanding of morphine’s effects, like constipation, making this choice incorrect.

Choice A reason: A neurological exam assesses brain function but does not directly address glipizide-related symptoms like confusion and blurred vision, which suggest hypoglycemia. Glipizide, a sulfonylurea, lowers blood glucose, and these symptoms are likely due to low glucose levels, making glucose testing more urgent than a neurological evaluation.

Choice B reason: Administering glucagon treats severe hypoglycemia but is premature without confirming low blood glucose. Glipizide increases insulin release, potentially causing hypoglycemia, but a fingerstick glucose test is needed first to verify the cause of symptoms. This choice is incorrect without diagnostic confirmation.

Choice C reason: Measuring vital signs provides general health data but does not specifically address confusion and blurred vision caused by glipizide-induced hypoglycemia. Low blood glucose is the likely cause, and testing glucose levels is more direct and urgent than monitoring vital signs, which are secondary in this context.

Choice D reason: Obtaining a fingerstick blood glucose is critical, as glipizide can cause hypoglycemia, leading to confusion and blurred vision. These symptoms result from insufficient glucose in the brain and eyes. Confirming low glucose guides immediate treatment, such as glucose administration, making this the most appropriate action.