A nurse is caring for an adolescent who has spina bifida and is paralyzed from the waist down. Which of the following statements by the client should indicate to the nurse a need for further teaching?

Rationale: A. Drinking adequate water is appropriate and helps prevent urinary tract infections and constipation. B. Using a suppository for bowel regulation is an acceptable method of managing neurogenic bowel. C. Catheterizing only twice daily is insufficient for bladder management in a client with spina bifida and paralysis. Clean intermittent catheterization is usually needed every 3–4 hours to prevent urinary retention, infection, and kidney damage. This statement indicates a need for further teaching. D. Performing wheelchair exercises is beneficial for circulation, muscle strength, and overall health.