A nurse is teaching a client who is taking metformin XR for type 2 diabetes mellitus. Which of the following instructions should the nurse include in the teaching?

Choice A reason: Metformin XR (extended-release) should be taken with a meal to reduce gastrointestinal side effects such as nausea, vomiting, and abdominal discomfort. Taking it with food enhances absorption and improves tolerability, which is especially important for long-term adherence in managing type 2 diabetes. Choice B reason: Extended-release tablets should never be crushed or chewed, as this disrupts the controlled release mechanism and can lead to rapid absorption, increasing the risk of side effects and toxicity. Patients must be instructed to swallow the tablet whole. Choice C reason: Increased perspiration is not a common side effect of metformin. While hypoglycemia can cause sweating, metformin alone rarely causes hypoglycemia unless combined with other antidiabetic agents. This statement is misleading and not part of standard teaching. Choice D reason: Metformin does not cause urine discoloration. Urine turning orange may be associated with medications like rifampin or phenazopyridine, not metformin. This statement is incorrect and unrelated to the drug’s known profile.