# A 50-year-old client is being discharged on ciprofloxacin 500 mg PO twice daily for complicated UTI. Which client teaching is most important?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=375229&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A 50-year-old client is being discharged on ciprofloxacin 500 mg PO twice daily for complicated UTI. Which client teaching is most important?

## Option

1. Stop the medication once the urine looks clear.
2. Separate ciprofloxacin from calcium, magnesium, iron, zinc, dairy, and antacids by 2 hours before or 6 hours after; drink plenty of water; avoid prolonged sun exposure and use sunscreen; report new tendon pain (especially Achilles), severe diarrhea, palpitations, or unusual mood/sleep changes; avoid in pregnancy and patients under 18 unless specifically indicated. **✔ Correct answer**
3. Take it with milk and an antacid to prevent stomach upset.
4. Take it with grapefruit juice for better absorption.

**Correct answer: 2**

## Explanation

Fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin) are broad-spectrum antibiotics with significant black box warnings. Important teaching: (1) absorption is reduced by polyvalent cations — separate dose by 2 hours before or 6 hours after dairy, calcium, magnesium, iron, zinc, antacids, sucralfate, multivitamins; (2) drink plenty of water to limit crystalluria; (3) photosensitivity — use sunscreen and protective clothing, limit sun and tanning bed exposure; (4) tendon disorders including rupture (Achilles, biceps, others) — risk increases with age over 60, concurrent corticosteroids, kidney transplant; report new tendon pain, swelling, or "pop" sensation and stop the drug; avoid weight-bearing on affected limb until evaluated; (5) QT prolongation — avoid combinations with other QT-prolonging drugs and electrolyte abnormalities; (6) C. difficile colitis — report severe diarrhea or bloody stool; (7) CNS effects — confusion, agitation, hallucinations, peripheral neuropathy, mood/sleep changes, especially in elderly; (8) glucose disturbances — hypoglycemia and hyperglycemia, especially in diabetics; (9) avoid in pregnancy and children under 18 unless other options unavailable because of cartilage damage in animal studies; (10) FDA recommends not using fluoroquinolones for uncomplicated UTI, sinusitis, or bronchitis when alternatives exist because of risks. Milk/antacids, stopping when urine clears, and grapefruit juice are wrong.

## In-depth explanation

Polyvalent cation separation, sunscreen, tendon and CDiff and CNS surveillance. The 2-hour-before / 6-hour-after spacing rule is the most-tested NCLEX detail.

## Related questions

- [A nurse is caring for an alert adult client with type 1 diabetes who reports tremors, swea…](https://mymerci.kr/pages/nclex_q.php?qn_id=360524&lang=en)
- [A 68-year-old client with COPD is admitted with shortness of breath and SpO2 86% on room a…](https://mymerci.kr/pages/nclex_q.php?qn_id=362940&lang=en)
- [A 58-year-old client arrives at the emergency department with crushing substernal chest pa…](https://mymerci.kr/pages/nclex_q.php?qn_id=362976&lang=en)
- [A 72-year-old client is brought to the emergency department by family who report that the …](https://mymerci.kr/pages/nclex_q.php?qn_id=363003&lang=en)
- [A 79-year-old client is admitted from a long-term care facility with diarrhea, decreased o…](https://mymerci.kr/pages/nclex_q.php?qn_id=363089&lang=en)
- [A 76-year-old female with chronic heart failure and atrial fibrillation receives digoxin 0…](https://mymerci.kr/pages/nclex_q.php?qn_id=374883&lang=en)
- [A 70-year-old client on long-term digoxin therapy reports new yellow-green halos around li…](https://mymerci.kr/pages/nclex_q.php?qn_id=374884&lang=en)
- [A 58-year-old client with type 2 diabetes mellitus and migraine prophylaxis is taking prop…](https://mymerci.kr/pages/nclex_q.php?qn_id=374893&lang=en)

## Read in another language

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=375229&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=375229&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=375229&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=375229&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=375229&lang=vi)

---

More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en)

_For study reference only. Always follow current clinical guidelines and your institution’s protocols._