A nurse is caring for a client who is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion by the nurse?

Choice A rationale:
Protecting the airway is the highest priority during a tonic-clonic seizure. Tonic-clonic seizures involve intense muscle contractions, which can lead to biting the tongue, aspiration of secretions, or even respiratory arrest if the airway is obstructed. Turning the client's head to the side helps to maintain a clear airway and prevent these complications.
It is essential to act quickly to prevent injury and ensure adequate oxygenation. Delaying airway management could have serious consequences.

Choice B rationale:
Checking motor strength is not a priority during the active phase of a seizure. It is more important to focus on protecting the airway and preventing injury.
Motor strength can be assessed after the seizure has subsided.

Choice C rationale:
Loosening clothing around the waist may be helpful to promote comfort and breathing, but it is not the first priority. It is more important to address the airway and prevent aspiration.

Choice D rationale:
Documenting the time the seizure began is important for accurate record-keeping and assessment of seizure patterns, but it is not the first priority in the immediate management of the seizure. Documentation can be done after the client's airway and safety are ensured.

Choice A rationale:
Losing 2 pounds in 2 weeks is not a significant weight loss and may not be a cause for concern in this context. It's important to monitor weight trends over time, but this isolated statement doesn't necessarily require immediate discussion.
Choice B rationale:

Engaging in physical activity like swimming is generally beneficial for individuals with rheumatoid arthritis. It can help improve joint mobility, reduce pain, and enhance overall well-being. The nurse might encourage the client to discuss any specific concerns or limitations with their healthcare provider, but the activity itself is not alarming.
Choice C rationale:
Taking an antibiotic concurrently with naproxen can potentially increase the risk of adverse effects. Some antibiotics, like those in the fluoroquinolone class (e.g., ciprofloxacin, levofloxacin), can interact with naproxen and increase the risk of tendonitis or tendon rupture. This interaction warrants further discussion to ensure the client is aware of potential risks and to explore alternative medications if necessary.
Choice D rationale:
Using applesauce to facilitate medication intake is a common and acceptable practice. It does not affect the absorption or efficacy of naproxen.