A nurse is teaching a group of clients about risk factors for developing diabetes mellitus. The nurse should include which of the following as a risk factor for diabetes?

Choice A reason: Dietary restrictions will not eventually allow the intake of gluten to resume. Gluten is a protein found in wheat, barley, rye, and some oats. It causes damage to the small intestine in people with celiac disease. The only treatment for celiac disease is a lifelong gluten-free diet.

Choice B reason: This condition may cause secondary lactose intolerance. Lactose is a sugar found in milk and dairy products. It is broken down by an enzyme called lactase in the small intestine. People with celiac disease may have reduced levels of lactase due to the damage to the small intestine caused by gluten. This can lead to lactose intolerance, which is the inability to digest lactose properly. Symptoms of lactose intolerance include bloating, gas, diarrhea, and abdominal pain after consuming dairy products.

Choice C reason: Nutritional therapy for this condition does not include limiting proteins and calories. People with celiac disease need adequate amounts of proteins and calories to maintain their health and prevent malnutrition. They also need to ensure that they get enough vitamins, minerals, and fiber from gluten-free sources.

Choice D reason: A normal diet cannot resume after a period of remission. Celiac disease is a chronic autoimmune disorder that does not have a cure. Even if the symptoms improve or disappear, the damage to the small intestine can still occur if gluten is consumed. Therefore, a strict gluten-free diet must be followed for life.

Choice A reason: The client's creatinine level of 1.0 mg/dL is within the normal range, but it does not indicate that the treatment for benign prostatic hyperplasia has been effective. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys and excreted in urine. It reflects the kidney function, not the prostate condition.

Choice B reason: The client's urine output of 35 mL/hr is below the normal range, which is 40 to 60 mL/hr. This indicates that the client may have dehydration, kidney impairment, or urinary retention, which are complications of benign prostatic hyperplasia. A low urine output does not indicate that the treatment has been effective.

Choice C reason: The client's stool color and consistency are not related to the treatment for benign prostatic hyperplasia. Stool characteristics depend on various factors, such as diet, medication, and bowel function. A soft, brown stool does not indicate that the treatment has been effective.

Choice D reason: The client's ability to urinate without straining is a sign that the treatment for benign prostatic hyperplasia has been effective. Benign prostatic hyperplasia is a condition in which the prostate gland enlarges and compresses the urethra, causing difficulty in urination. A treatment that reduces the size of the prostate or relaxes the bladder neck muscles can improve the urine flow and reduce the straining.