The nurse receives a prescription for ibuprofen for a client with a headache. What finding in the client's electronic medical record should cause the nurse to question this prescription?

A. The client is in the third trimester of pregnancy: NSAIDs such as ibuprofen can cause premature closure of the fetal ductus arteriosus and reduce amniotic fluid in the third trimester. They also increase the risk of maternal bleeding. Pregnancy status is a critical contraindication that requires questioning the prescription. B. The client is allergic to acetaminophen: An acetaminophen allergy does not contraindicate ibuprofen use, as the medications have different chemical structures and mechanisms of action. Ibuprofen can be safely administered unless there are other NSAID sensitivities. C. The client has a history of rheumatoid arthritis: Rheumatoid arthritis is an indication for NSAID therapy. While monitoring for gastrointestinal or renal effects is necessary, a history of arthritis does not contraindicate ibuprofen for acute pain management. D. The client has an elevated white blood cell count: Leukocytosis may indicate infection or inflammation, but it does not directly contraindicate ibuprofen use. NSAIDs may mask fever, but this finding alone does not preclude administration.