The nurse is providing discharge education to a client status post mechanical mitral valve replacement. Which statement made by the client indicates the need for further education?

A. I will limit lifting to 10 pounds for the next month: Activity restrictions after valve replacement help prevent strain on the sternum and promote healing. Limiting heavy lifting for a defined period is appropriate and demonstrates understanding of post-operative precautions. B. I will brush my teeth at least twice a day: Good oral hygiene is important to reduce the risk of infective endocarditis in clients with mechanical heart valves. Brushing teeth twice daily reflects proper preventive care and is encouraged. C. I will expect to hear a clicking sound from my chest: Mechanical valves often produce an audible click due to the opening and closing of the prosthetic leaflets. Awareness of this sound prevents unnecessary anxiety and demonstrates correct patient education. D. I will stop taking apixaban after three months: Mechanical mitral valve replacements require lifelong anticoagulation, typically with warfarin, to prevent thromboembolism. Stopping anticoagulation prematurely could lead to valve thrombosis or systemic emboli, indicating a misunderstanding that requires further education.