A nurse is reinforcing teaching about the IPLEDGE program with a female client who has a new prescription for isotretinoin. The nurse should tell the client that which of the following is a requirement of the program?

D. One of the primary requirements of the iPledge program for sexually active females of childbearing potential is the use of two forms of contraception simultaneously, beginning one month before starting isotretinoin therapy, throughout therapy, and for one month after discontinuation of therapy. This is to ensure effective contraception and prevent pregnancy due to the teratogenic effects of isotretinoin. A. While mammograms are important screening tests for breast cancer, they are not a requirement of the iPledge program for female clients receiving isotretinoin. B. Papanicolaou (Pap) tests, which screen for cervical cancer, are not a requirement of the iPledge program. However, sexually active females of childbearing potential must have monthly pregnancy tests and must agree to use two forms of contraception simultaneously during isotretinoin therapy. C. There is no requirement for clients to take a daily supplement of vitamin A prior to initiating isotretinoin therapy as part of the iPledge program.