A nurse is providing teaching about natural food sources that contain folate to a client who plans to become pregnant. The nurse should identify that which of the following foods contains the highest amount of folate?

Choice A reason: Acute stress causes an increase in metabolism, as the body activates the sympathetic nervous system and releases hormones such as adrenaline and cortisol. These hormones increase the heart rate, blood pressure, and oxygen consumption, and mobilize glucose and fatty acids for energy. The nurse should explain to the clients that acute stress can have beneficial effects, such as enhancing alertness, memory, and performance, but it can also have harmful effects, such as impairing digestion, immunity, and growth.

Choice B reason: Stress causes a negative nitrogen balance in the body, not a positive one. Nitrogen balance is the difference between the amount of nitrogen ingested and the amount of nitrogen excreted. A positive nitrogen balance means that the body is retaining more nitrogen than it is losing, which indicates growth, healing, or pregnancy. A negative nitrogen balance means that the body is losing more nitrogen than it is retaining, which indicates malnutrition, illness, or injury. The nurse should inform the clients that stress can cause a negative nitrogen balance, as the body breaks down protein for energy and loses nitrogen through urine, sweat, and wounds.

Choice C reason: Protein requirements increase in times of stress, not decrease. Protein is essential for tissue repair, immune function, and hormone synthesis. The nurse should advise the clients that stress can increase the protein needs of the body, as the body loses protein through catabolism, inflammation, and infection. The nurse should recommend the clients to consume adequate amounts of high-quality protein, such as eggs, milk, cheese, meat, fish, poultry, soy, and nuts.

Choice D reason: Glucose is broken down more quickly during times of stress, not more slowly. Glucose is the main source of energy for the brain and the muscles. The nurse should educate the clients that stress can increase the glucose levels in the blood, as the body releases glucose from the liver and muscles to provide fuel for the stress response. The nurse should also warn the clients that chronic stress can lead to insulin resistance, diabetes, and cardiovascular disease.

Choice A reason: Elevating the head of the client's bed can help prevent aspiration and facilitate swallowing. The nurse should keep the client's head elevated at least 30 degrees during and after feeding, and check for signs of aspiration, such as coughing, choking, or wheezing.

Choice B reason: Using a syringe to give the client fluids is not a safe method, as it can cause the fluids to enter the airway too quickly and cause aspiration. The nurse should use a spoon or a cup to give the client fluids, and thicken them if needed to make them easier to swallow.

Choice C reason: Instructing the client to chew on the left side of their mouth is not a good idea, as the left side is paralyzed and has reduced sensation. The client may not be able to chew or feel the food on that side, and may accidentally bite their tongue or cheek. The nurse should instruct the client to chew on the right side of their mouth, which is unaffected by the stroke.

Choice D reason: Instructing the client to swallow with their head tilted back is not a good practice, as it can open the airway and allow food or liquid to enter the lungs. The nurse should instruct the client to swallow with their head tilted slightly forward, which can close the airway and direct the food or liquid to the esophagus.