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?

A. Isotretinoin is not associated with cervical cancer risk, and this requirement is not part of the iPLEDGE program. B. Mammogram is not a requirement of the iPLEDGE program. C. While vitamin A supplementation may be recommended, it is not a specific requirement of the iPLEDGE program. D. This is a key requirement of the iPLEDGE program due to the teratogenic effects of isotretinoin.