A nurse is teaching a client who is receiving enteral nutrition via intermittent tube feedings. Which of the following statements by the client indicates an understanding of the teaching?

Choice A reason: Abdominal obesity is a risk factor for developing diabetes mellitus. Abdominal obesity, also known as central obesity or visceral fat, is the accumulation of fat around the abdomen and organs. Abdominal obesity can cause insulin resistance, inflammation, and metabolic syndrome, which are all associated with diabetes.

Choice B reason: Elevated HDL level is not a risk factor for developing diabetes mellitus. HDL stands for high-density lipoprotein, which is a type of cholesterol that carries excess cholesterol from the tissues to the liver for disposal. HDL is also known as "good" cholesterol, as it helps protect against heart disease and stroke. A high HDL level is desirable and beneficial for health.

Choice C reason: History of hypotension is not a risk factor for developing diabetes mellitus. Hypotension means low blood pressure, which is usually defined as less than 90/60 mm Hg. Hypotension can cause symptoms such as dizziness, fainting, fatigue, and blurred vision. Hypotension can be caused by dehydration, blood loss, medication side effects, or other conditions.

Choice D reason: History of hyperthyroidism is not a risk factor for developing diabetes mellitus. Hyperthyroidism means overactive thyroid gland, which produces too much thyroid hormone. Thyroid hormone regulates metabolism, growth, and development. Hyperthyroidism can cause symptoms such as weight loss, nervousness, palpitations, heat intolerance, and insomnia. Hyperthyroidism can be caused by Graves' disease, thyroid nodules, or thyroiditis.

Choice A reason: Dry eyes are not caused by vitamin D deficiency, but by other factors such as aging, medication, environmental conditions, or eye diseases. Vitamin D does not have a direct role in eye health or function.

Choice B reason: Fractures are caused by vitamin D deficiency, as vitamin D helps the body absorb calcium, which is essential for bone health and strength. Vitamin D deficiency can lead to osteoporosis, a condition in which the bones become brittle and prone to breaking.

Choice C reason: Infection is not caused by vitamin D deficiency, but by other factors such as exposure to pathogens, weakened immune system, or poor hygiene. Vitamin D may have some role in modulating immune responses, but it is not a primary factor in preventing infection.

Choice D reason: Swelling is not caused by vitamin D deficiency, but by other factors such as injury, inflammation, fluid retention, or allergic reaction. Vitamin D does not have a direct role in regulating fluid balance or reducing inflammation.