A nurse is caring for a 16-year-old female adolescent in an urgent care clinic. Exhibits Which of the following instructions should the nurse provide to the adolescent with infectious mononucleosis?

Choice A rationale: Amoxicillin is contraindicated in infectious mononucleosis due to the frequent occurrence of a morbilliform rash when administered during Epstein-Barr virus infection. This non-allergic rash results from immune activation and not true penicillin allergy, but its appearance can complicate diagnosis and treatment. Antibiotic therapy is unnecessary unless there is secondary bacterial infection. The rapid strep test is negative, and the Monospot confirms viral etiology, so antibiotics offer no therapeutic benefit. Choice B rationale: Contact sports must be avoided in infectious mononucleosis due to risk of splenic rupture, a rare but serious complication. The Epstein-Barr virus causes splenomegaly through lymphoid tissue proliferation, and even minor abdominal trauma may lead to organ rupture. The spleen often remains enlarged for several weeks post-infection, so abstaining from impact sports (e.g., football, gymnastics) for 4–6 weeks post-diagnosis reduces this life-threatening risk. Ultrasound may guide readiness, but strict caution is required. Choice C rationale: Warm compresses are typically soothing for muscular discomfort or localized inflammation but do not provide meaningful relief in viral pharyngitis linked to mononucleosis. Sore throat in this case is caused by lymphoid hyperplasia and tonsillar inflammation due to viral replication, for which systemic symptom control (e.g., analgesics, rest) is more effective. Warm compress use is not standard for throat pain management and offers negligible clinical utility. Choice D rationale: While hydration is important, prescribing an arbitrary intake of 3 liters/day may be excessive for an adolescent female and could increase discomfort. Standard hydration guidance supports regular fluid intake based on thirst and activity level. Infectious mononucleosis causes fatigue and pharyngitis, making hydration a supportive measure, but overprescribing fluid intake is not evidence-based and could be misinterpreted. Monitoring signs of adequate hydration is more appropriate than rigid volume mandates