A nurse is caring for a client who has Stage IV lung cancer and was prescribed opioid medications for pain management. The client is unable to engage in most physical activity. Which of the following manifestations should the nurse anticipate?

Rationale: A. Bleeding is not a common side effect of opioids. While cancer itself or certain treatments (like chemotherapy or thrombocytopenia) may increase bleeding risk, opioid use does not directly cause bleeding. B. Mucositis is inflammation and ulceration of the mucous membranes, commonly seen with chemotherapy or radiation therapy, not from opioid use. C. Opioid medications generally cause the opposite effect—constipation, rather than diarrhea. Diarrhea may occur in some cancer patients due to treatment or disease, but it is not expected from opioid therapy. D. Opioids slow gastrointestinal motility by binding to mu-opioid receptors in the gut. This can lead to constipation and, if untreated, fecal impaction, especially in clients who are immobile or have limited physical activity. Anticipating this effect allows the nurse to implement preventive measures, such as increasing fluid and fiber intake if tolerated, encouraging mobility as possible, and using stool softeners or laxatives.