Final answer:
The patient statement that indicates the need for further teaching is option d. "I use a cotton swab to remove earwax."
Step-by-step explanation:
The patient statement that indicates the need for further teaching is option d. "I use a cotton swab to remove earwax." Using a cotton swab to remove earwax is not recommended as it can push the wax further into the ear canal and cause damage. It is important to educate the patient on this and advise them to avoid inserting any objects into their ears. Proper ear hygiene includes using a fingertip and towel to dry the ears, avoiding the use of ear candles, and using tap water for irrigation if necessary.