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. Biological response modifiers (e.g., TNF inhibitors) help manage RA by modifying immune responses, but they increase the risk of infection, not prevent it. B. Cold therapy should not be applied directly to the skin—it should be wrapped in a towel to prevent skin damage. Cold therapy is used for acute inflammation, not stiffness. C. Heat therapy, such as a hot shower or warm compress, helps reduce morning stiffness and joint pain in clients with rheumatoid arthritis (RA). D. Clustered activity can lead to fatigue. Instead, activities should be spread out with rest periods.