A nurse is assisting with a class about the long-term effects of childhood obesity.
Which of the following conditions should the nurse include as a potential complication of childhood obesity?

Choice A rationale
Consuming large meals can exacerbate GERD symptoms. Smaller, more frequent meals are recommended to reduce the volume of food in the stomach at any one time, thereby reducing the pressure on the lower esophageal sphincter.
Choice B rationale
Identifying and avoiding foods that cause discomfort is a key strategy in managing GERD. Foods that commonly trigger GERD symptoms include fatty foods, spicy foods, acidic foods, and caffeine.
Choice C rationale

Using pillows to elevate the head and upper body during sleep can help prevent nighttime GERD symptoms. Gravity helps keep stomach acid in the stomach, reducing the chance of it flowing back into the esophagus.
Choice D rationale
Lying down after a meal can exacerbate GERD symptoms. It is recommended to wait at least three hours after eating before lying down.

Choice A rationale
Pursed-lip breathing can help improve oxygenation and reduce shortness of breath in clients with COPD. However, it is not the priority action when a client reports difficulty breathing.
Choice B rationale
Increasing the oxygen flow rate without a physician’s order can lead to oxygen toxicity or suppress the respiratory drive in clients with COPD. Therefore, this is not the priority action.
Choice C rationale
Coughing and expectorating secretions can help clear the airways, but it is not the priority action when a client reports difficulty breathing.

Choice D rationale
Evaluating the client’s respiratory status is the priority action. The nurse should assess the client’s breath sounds, respiratory rate, use of accessory muscles, and oxygen saturation to determine the severity of the client’s difficulty breathing and guide further interventions.