A nurse is teaching a class about dietary guidelines to promote cardiovascular health. Which of the following recommendations should the nurse include in the teaching?

Choice A rationale:
A client whose hematocrit is 42% (Choice A) falls within the normal range for hematocrit values, which is typically around 37-52% for adult women and 40-54% for adult men. While low hematocrit values can indicate anemia, a value of 42% is not indicative of iron-deficiency anemia on its own.
Choice B rationale:
A client whose RBC count is 5.2 million/mm3 (Choice B) is within the normal range for red blood cell counts, which is roughly 4.5-5.5 million/mm3 for adult women and 4.5-6.1 million/mm3 for adult men. Although low RBC counts can be associated with anemia, the value provided is not suggestive of iron-deficiency anemia without further context.
Choice C rationale:
A client whose ferritin level is 8 ng/mL (Choice C) is the correct choice. Ferritin is a protein that stores iron, and low levels of ferritin are a strong indicator of iron-deficiency anemia. Ferritin levels less than 12 ng/mL are often considered indicative of depleted iron stores.
Choice D rationale:
A client whose hemoglobin is 15 g/dL (Choice D) falls within the normal range for hemoglobin values, which is typically around 12-15.5 g/dL for adult women and 13.5-17.5 g/dL for adult men. While low hemoglobin can suggest anemia, a value of 15 g/dL is not indicative of iron-deficiency anemia on its own.

Choice A rationale:
A hoarse voice is a manifestation of dysphagia, which is difficulty swallowing. Dysphagia can occur after a stroke due to weakness or paralysis of the muscles involved in swallowing. It can lead to problems like aspiration, where food or liquid enters the airway instead of the digestive tract, causing coughing, choking, and changes in the voice.
Choice B rationale:
Weight gain is not typically associated with dysphagia. Dysphagia tends to lead to weight loss rather than weight gain, as individuals may avoid eating due to the discomfort and difficulty associated with swallowing.
Choice C rationale:
Expressive aphasia is not directly related to dysphagia. Expressive aphasia is a language disorder that impairs a person's ability to produce language. It's caused by damage to specific areas of the brain, often not directly linked to swallowing difficulties.
Choice D rationale:
Continuous smiling is not a typical manifestation of dysphagia. Dysphagia is related to difficulties in swallowing and does not typically manifest as continuous smiling. It's more likely to cause distress, discomfort, and changes in vocal quality.