A nurse is teaching a client who has rheumatoid arthritis about illness management. Which of the following instructions should the nurse include in the teaching?

A. Taking a hot shower in the morning can help decrease stiffness and improve joint mobility for clients with rheumatoid arthritis. Heat therapy is beneficial for morning stiffness. B. Cold packs should not be applied directly to the skin as it may cause skin damage. Cold therapy is used for inflammation, but not for prolonged periods on the skin. C. Biological response modifiers are not used specifically to prevent infection; they modify immune response and may increase infection risk. D. Clustering physical activities can lead to fatigue. The nurse should recommend spreading activities throughout the day to conserve energy.