Suppose you have a Karnaugh map with some 0s, 1s, and a few "don't cares". Your job is to use the K-map to simplify the expression to the most basic sum-of-products form. When going through the simplification process, for the "don't care" conditions pick the one that allows for the most simplification.
The "don't care" means just that--it doesn't care if it's a 0 or 1, so pick the one that makes things easier to work with and simplify.
Matt
EDIT: I did not see your example at first. The X's in the truth table simply mean that you can ignore them. They have no effect on the outputs Q or Q0