A nurse is instructing the parents of a client who has a new prescription for methylphenidate. Which of the following instructions should the nurse include?

A. Avoid activities that require alertness such as driving: Although methylphenidate is a central nervous system stimulant used to improve focus, it can initially cause side effects such as dizziness, drowsiness, or blurred vision. Clients (or parents of clients) are instructed to exercise caution with hazardous activities until they know how the medication affects them. B. Reduce calorie intake: Methylphenidate often suppresses the appetite, leading to weight loss and potential growth suppression in children. The nurse should encourage maintaining or increasing caloric intake, not reducing it. C. Take this medication before bedtime: Because it is a stimulant, methylphenidate can cause insomnia. The last dose of the day should typically be taken before 4:00 PM (or at least 6 hours before bedtime) to prevent sleep disturbances. D. Increase caffeine intake: Caffeine is also a stimulant. Combining it with methylphenidate can potentiate adverse effects such as tachycardia (rapid heart rate), palpitations, anxiety, and insomnia. Parents should be instructed to limit or avoid caffeine in the child's diet.