A nurse is providing calorie-count information to a client who has a BMI of 35. Which of the following instructions should the nurse include?

Choice A reason: Consuming high-calorie foods early in the day is not a good strategy for weight loss, as it can lead to overeating and increased fat storage. The nurse should advise the client to eat a balanced breakfast that includes protein, fiber, and healthy fats, which can help curb appetite and boost metabolism.

Choice B reason: Limiting carbohydrate intake to 30 grams per day is too restrictive and may cause nutritional deficiencies, ketosis, and adverse effects on mood and cognition. The nurse should recommend a moderate carbohydrate intake of 45 to 65 percent of total calories, with an emphasis on complex carbohydrates from whole grains, fruits, vegetables, and legumes.

Choice C reason: Consuming 500 fewer calories per day can result in a weight loss of about 1 pound per week, which is a safe and realistic goal for a client who has a BMI of 35. The nurse should help the client identify sources of excess calories in their diet and suggest ways to reduce them, such as choosing low-calorie beverages, using smaller plates, and avoiding distractions while eating.

Choice D reason: Following a liquid meal plan for 4 weeks is not a sustainable or healthy way to lose weight, as it can cause muscle loss, electrolyte imbalance, and rebound weight gain. The nurse should encourage the client to eat regular meals that include a variety of foods from all food groups, with appropriate portion sizes and nutrient density.

Choice A reason: Calcium is not a dietary supplement that can help with wound healing, although it is important for bone health and muscle contraction. Calcium deficiency can cause osteoporosis, muscle cramps, and abnormal heart rhythms, but it does not affect wound healing.

Choice B reason: Potassium is not a dietary supplement that can help with wound healing, although it is essential for nerve and muscle function and fluid balance. Potassium deficiency can cause weakness, fatigue, arrhythmias, and muscle cramps, but it does not affect wound healing.

Choice C reason: Vitamin C is a dietary supplement that can help with wound healing, as it is involved in collagen synthesis, tissue repair, and immune response. Vitamin C deficiency can cause scurvy, which is characterized by bleeding gums, poor wound healing, and anemia.

Choice D reason: Vitamin D is not a dietary supplement that can help with wound healing, although it is necessary for calcium absorption, bone health, and immune function. Vitamin D deficiency can cause rickets, osteomalacia, and increased risk of infections, but it does not affect wound healing.