After teaching a client who is prescribed adalimumab for severe ulcerative colitis (UC), the nurse assesses the client's understanding. Which statement made by the client indicates a need for further teaching?

Choice A reason: Adalimumab (Humira) is a monoclonal antibody that is administered via subcutaneous injection, typically once every two weeks. It is not an oral medication taken daily with meals. This statement indicates a fundamental misunderstanding of the route and frequency of the drug administration, requiring immediate correction and retraining. Choice B reason: Gastrointestinal upset, including nausea and vomiting, are documented side effects of many biologic therapies, including TNF inhibitors. While not the most common side effect (injection site reactions are more frequent), it is an accurate statement reflecting potential adverse reactions the client might experience during therapy. Choice C reason: Adalimumab is an immunosuppressant that increases the risk of serious infections. Clients must be taught to avoid exposure to pathogens, which includes avoiding large crowds where viral or bacterial transmission is more likely. This statement demonstrates that the client correctly understands their increased susceptibility to illness while on this medication. Choice D reason: Hand hygiene is a critical component of infection prevention for any immunocompromised patient. Regular handwashing, especially after contact with animals or being in public spaces, is a necessary behavioral modification. This statement shows that the client understands the practical steps needed to protect their health during treatment.