The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is experiencing a painful exacerbation of the disease. The parents ask the nurse if the child can perform range-of-motion exercises at this time. The nurse would make which response?

 A. "Range-of-motion exercises must be performed every day."
Explanation: While range-of-motion exercises are important for maintaining joint flexibility in juvenile idiopathic arthritis, it is not advisable to perform these exercises during painful exacerbations. The frequency and intensity of exercises may need to be adjusted based on the child's current condition. 
B. "Administer additional pain medication before performing range-of-motion exercises."
Explanation: While pain management is important in the care of a child with juvenile idiopathic arthritis, relying solely on pain medication before exercises may not be the most effective approach. Isometric exercises that are less likely to cause pain can be a better option during exacerbations.
C. "Have the child perform simple isometric exercises during this time."
Explanation:
During a painful exacerbation of juvenile idiopathic arthritis, it is important to maintain joint flexibility and prevent joint contractures. Simple isometric exercises that do not involve joint movement can help in maintaining muscle strength and joint flexibility without exacerbating pain. Range-of-motion exercises may be too painful during an exacerbation, but isometric exercises can be less painful and still beneficial.
D. "Avoid all exercise during painful periods."
Explanation: Complete avoidance of exercise during painful periods is not recommended. Maintaining joint flexibility and muscle strength is important for managing juvenile idiopathic arthritis. However, the type and intensity of exercises should be adjusted based on the child's pain level during exacerbations.