A nurse is reviewing discharge instructions with a client who has rheumatoid arthritis and a new prescription for prednisone. Which client statement indicates an understanding of the teaching?

A. Prednisone is a corticosteroid that frequently causes fluid retention and increased appetite, typically leading to weight gain rather than weight loss. Clients often develop a "moon face" or truncal obesity as a result of altered fat distribution and sodium retention. Expecting weight loss indicates a misunderstanding of the metabolic side effects of long-term glucocorticoid therapy, requiring further education on dietary monitoring and calorie control. B. Taking NSAIDs like aspirin or ibuprofen while on prednisone significantly increases the risk of gastrointestinal ulceration and hemorrhage. Both drug classes are irritating to the gastric mucosa and interfere with the protective prostaglandin barrier in the stomach. The nurse must instruct the client to avoid these combinations and instead use acetaminophen or other prescribed agents that do not exacerbate the risk of peptic ulcer disease. C. A sore throat is not a normal or expected side effect of prednisone and could indicate the development of an opportunistic infection, such as oral candidiasis, due to immunosuppression. Prednisone inhibits the inflammatory response, which can mask early signs of infection while making the client more susceptible to pathogens. The client should be taught to report any symptoms of infection, like a sore throat or fever, to the provider immediately. D. Corticosteroids like prednisone can cause increased urinary excretion of potassium, leading to hypokalemia. Increasing dietary intake of potassium-rich foods, such as bananas, helps to counteract this effect and maintain normal electrolyte balance. This statement demonstrates that the client understands the importance of nutritional interventions to mitigate the metabolic complications associated with chronic steroid use for their rheumatoid arthritis management.