A nurse is assessing a client prior to administering morphine. Which of the following findings should the nurse identify as a contraindication to the administration of this medication?

Choice A reason: Morphine is contraindicated in clients with absent bowel sounds because it can worsen or precipitate paralytic ileus. Opioids decrease gastrointestinal motility, and in the presence of absent bowel sounds, this could lead to severe complications such as bowel obstruction or perforation. This makes it the most urgent contraindication. Choice B reason: A respiratory rate of 14/min is within the normal range (12–20 breaths per minute). Morphine can cause respiratory depression, but this finding does not indicate a contraindication at baseline. The nurse should monitor closely after administration, but it is safe to proceed. Choice C reason: A blood pressure of 100/60 mm Hg is on the lower side but still acceptable. Morphine can cause vasodilation and hypotension, so caution is warranted, but this value alone does not contraindicate administration. Monitoring blood pressure after administration is appropriate. Choice D reason: A urine output of 100 mL/hr is adequate and indicates normal renal function. Morphine is metabolized primarily in the liver and excreted by the kidneys, but this urine output does not suggest impairment.