A nurse is providing education to a client who is reviewing a consent form for a surgical procedure. Which of the following statements by the client indicates an understanding of the consent?

Choice A reason: Taking diuretics with the evening meal increases nighttime urination, worsening urge incontinence by stimulating bladder activity during sleep. Diuretics should be taken earlier (e.g., morning) to align with daytime voiding schedules, reducing urgency episodes. This instruction is counterproductive for bladder retraining, making it inappropriate.
Choice B reason: Planning to urinate every 3 hours while awake establishes a scheduled voiding regimen, a key component of bladder retraining. This helps condition the bladder to delay urgency, reducing involuntary contractions and improving control. It aligns with evidence-based strategies for managing urge incontinence, making it the correct instruction.
Choice C reason: Limiting fluid intake to 1 liter per day risks dehydration and concentrated urine, which can irritate the bladder and worsen urge incontinence. Adequate hydration (2-3 L/day) supports bladder health and retraining by maintaining normal urine volume, making this instruction harmful and incorrect.
Choice D reason: Performing Kegel exercises once daily is insufficient for effective bladder retraining. Multiple daily sets (e.g., 3-4 times) strengthen pelvic floor muscles, improving bladder control. This frequency is too low to achieve therapeutic benefits for urge incontinence, making it less effective than scheduled voiding.

Choice A reason: Applying nitroglycerin ointment in a thin, even layer ensures consistent absorption for angina relief, as specified by dosing guidelines (e.g., using a dosing paper). This maximizes efficacy and minimizes side effects like hypotension, aligning with manufacturer instructions, making it the correct teaching point.
Choice B reason: Applying to the forearm is not standard, as nitroglycerin ointment is typically applied to the chest, upper arm, or back for optimal absorption. Forearm application may reduce effectiveness due to skin thickness, making this an incorrect site choice.
Choice C reason: Applying every 4 hours is incorrect, as nitroglycerin ointment is typically applied 2-3 times daily, with a 12-hour nitrate-free interval to prevent tolerance. This frequency is too frequent and risks side effects, making it an inaccurate instruction.
Choice D reason: Massaging nitroglycerin ointment into the skin is contraindicated, as it alters absorption rates and may cause inconsistent dosing or irritation. The ointment is spread lightly and covered, making this instruction incorrect and potentially harmful for proper administration.