A nurse in a provider's office is reinforcing teaching about skin care with a client who has a new diagnosis of systemic lupus erythematosus.
Which of the following statements by the client indicates an understanding of the teaching?

Choice A rationale:

The nurse should include the instruction to wash hands with soap and water for 20 seconds in the teaching. This is a fundamental aspect of hand hygiene in healthcare settings. The rationale for this choice is that proper handwashing with soap and water for at least 20 seconds is the most effective way to remove dirt, debris, and transient microorganisms from the hands. It helps prevent the spread of infections, including those caused by viruses and bacteria.

Choice B rationale:

Wearing sterile gloves when in contact with body fluids is not directly related to hand hygiene education. While wearing gloves is an essential infection control practice, it is not a substitute for proper handwashing. Hand hygiene should be performed before donning gloves and after removing them.

Choice C rationale:

Using alcohol-based cleanser when hands are visibly soiled is not the best instruction for hand hygiene. Alcohol-based hand sanitizers are effective when hands are not visibly soiled. In cases of visible soiling, handwashing with soap and water is recommended to physically remove dirt and contaminants.

Choice D rationale:

Artificial nails should not be worn when performing direct client care as they can harbor microorganisms and make it challenging to clean the hands adequately. The use of artificial nails can increase the risk of transmitting infections to patients, which is why they should be discouraged in healthcare settings.

The correct answer is Choice B: Administer the medication to the toddler each evening.

Choice B rationale: Montelukast is a leukotriene receptor antagonist used for the long-term management of asthma, especially in preventing nighttime symptoms. It is typically prescribed to be administered once daily in the evening to provide optimal therapeutic benefits. By instructing the parents to give the medication each evening, the nurse promotes adherence to the prescribed dosing schedule and helps maximize the medication's effectiveness in controlling the toddler's asthma symptoms.

Choice A rationale: While some medications can be mixed with juice or other liquids to make them more palatable for children, montelukast should not be dissolved in a drink. Instead, it can be mixed with a spoonful of cold, soft food, such as applesauce or ice cream, if necessary, to facilitate administration. Mixing with juice could potentially alter the medication's efficacy or create an unpleasant taste.

Choice C rationale: Montelukast is not indicated for use as a quick-relief medication prior to physical activity. It is a maintenance medication intended for long-term asthma control rather than immediate relief of acute symptoms. Providing an additional dose of montelukast before physical activity would not serve the intended purpose and could increase the risk of side effects.

Choice D rationale: Montelukast is not meant to be used as a rescue medication for acute asthma attacks. It is a long-term control medication that helps prevent asthma attacks and improve overall symptom management. For acute asthma attacks, the toddler would require a fast-acting beta-agonist or other appropriate rescue medication prescribed by their healthcare provider. Administering montelukast during an acute asthma attack would not provide the rapid relief needed to alleviate symptoms and could potentially delay appropriate treatment.