Which medication would a nurse question if prescribed for a pregnant client?

Warfarin is a medication that a nurse would question if prescribed for a pregnant client due to its known teratogenic effects. This anticoagulant has been associated with a range of complications during pregnancy, including fetal bleeding, teratogenesis, and potential for adverse outcomes such as growth restriction, brain malformations, and even fetal loss. The risk of these serious effects means that Warfarin is generally contraindicated during pregnancy, especially during the first trimester when organogenesis occurs.

In contrast, while Phenytoin, Isotretinoin, and Methotrexate all carry their own risks and concerns in pregnancy, they are not as universally contraindicated as Warfarin. Phenytoin can lead to fetal hydantoin syndrome, Isotretinoin is known to cause severe birth defects and is typically only prescribed with strict pregnancy prevention protocols, and Methotrexate can result in miscarriage and fetal malformations. However, Warfarin's specific profile makes it particularly concerning for use in pregnant patients, making it a medication that warrants questioning.