A nurse is providing medication teaching about disulfiram for a client who has alcohol use disorder. Which of the following statements by the client indicates an understanding of the teaching?

Choice A reason: Changing the stoma pouch 30 minutes after meals is not recommended, as meal timing does not dictate pouch changes. Pouches are typically changed every 3-7 days or if leaking, to prevent skin irritation. This statement reflects a misunderstanding, as it suggests an incorrect schedule unrelated to stoma care needs.
Choice B reason: Cutting the pouch opening 1/8 inch larger than the stoma ensures a snug fit, preventing leakage while protecting peristomal skin from irritation by digestive enzymes. Proper sizing maintains skin integrity and pouch adherence, supporting effective ostomy management. This statement demonstrates correct understanding of stoma care techniques.
Choice C reason: Cleaning the stoma with moisturizing soap is incorrect, as soaps with oils or fragrances can irritate peristomal skin and impair pouch adhesion. Mild, non-residue soap and water are recommended to maintain skin integrity. This statement indicates a misunderstanding of proper stoma cleaning practices.
Choice D reason: Expecting the stoma to be blistered is incorrect, as a healthy stoma should be pink, moist, and free of irritation. Blistering indicates complications like infection or poor pouch fit. This statement reflects a misunderstanding of normal stoma appearance and care, suggesting potential issues requiring intervention.

Choice A reason: Varicella, a viral infection, is not treated with antibiotics, which target bacteria. Returning to school after 24 hours of antibiotics is incorrect, as contagiousness persists until lesions crust, typically 5-7 days, risking transmission if the child returns prematurely.
Choice B reason: A negative titer result indicates immunity or resolved infection but is not a practical criterion for school return. Varicella contagiousness depends on lesion crusting, not serology, which is complex and unnecessary when clinical signs confirm reduced infectivity in affected children.
Choice C reason: Fever subsidence does not ensure non-contagiousness in Varicella. The virus spreads via respiratory droplets and lesions until crusted. Allowing return based on fever ignores transmission risk, as active lesions remain infectious, potentially spreading the virus in school settings.
Choice D reason: Varicella is contagious until lesions crust over, typically 5-7 days post-rash. Crusting indicates the end of viral shedding, ensuring safety for school return. This aligns with infection control guidelines, preventing transmission via contact or respiratory routes in communal settings.