The Nurse Has Completed Teaching a Patient About MDI Use

The nurse has completed teaching a patient about MDI use.Which statement by the patient indicates to the nurse that further patient teaching is needed?

A) "I will shake the MDI to check for fullness each time before using."
B) "I will take a slow,deep breath in after pushing down on the MDI."
C) "I will check the MDI counter."
D) "I will attach a spacer to the MDI to make it easier for me to use."