A nurse is reinforcing dietary teaching with a client who has constipation about appropriate food choices. Which of the following food selections by the client demonstrates an understanding of the teaching?

Choice A reason: Detailed explanations suit older children, not toddlers with limited comprehension. Simple reassurance works better, making this less effective for exam preparation.

Choice B reason: Starting with immunizations increases fear and resistance in toddlers. Less invasive steps first build trust, so this heightens distress unnecessarily.

Choice C reason: Letting toddlers handle equipment reduces fear through familiarity. This age-appropriate tactic eases anxiety, preparing them effectively for a calm physical examination.

Choice D reason: Fully undressing upfront can distress toddlers, lowering cooperation. Gradual exposure during the exam maintains comfort, making this an unsuitable initial step.

Choice A reason: Limiting coffee reduces acid stimulation, but it’s not the primary GERD strategy. Elevating the bed prevents reflux via gravity, making this a secondary suggestion compared to positional therapy.

Choice B reason: Elevating the bed head keeps acid in the stomach during sleep, reducing esophageal irritation. This evidence-based intervention is a key GERD management technique for symptom relief.

Choice C reason: Large meals increase gastric pressure, exacerbating reflux in GERD. Smaller, frequent meals are advised instead, so this contradicts best practice, worsening the condition rather than helping.

Choice D reason: Lying down after eating promotes acid reflux into the esophagus, worsening GERD. Upright positioning post-meal is preferred, making this an incorrect and harmful recommendation.