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

Rationale: A. "You may crush or chew the medication": Metformin XR is an extended-release formulation and should not be crushed or chewed. Altering the tablet disrupts the extended-release mechanism, leading to rapid absorption, increased side effects, and loss of therapeutic benefit. B. "This medication may turn your urine orange": Orange-colored urine is commonly associated with rifampin or phenazopyridine use, not metformin. Metformin does not cause urine discoloration, so this teaching would not be accurate for a client with type II diabetes. C. "This medication may cause an increase in perspiration": Increased sweating is linked to hypoglycemia, especially with sulfonylureas or insulin, but metformin does not usually cause this effect. Its side effects are more commonly gastrointestinal, such as diarrhea, nausea, and abdominal discomfort. D. "Take the medication with a meal": Taking metformin with meals helps reduce gastrointestinal side effects, which are the most common complaints with this drug. Food improves tolerability without decreasing the drug’s effectiveness.