Which of the following patients should the nurse consider as having a higher risk for malnutrition?

Choice A rationale
Increasing calorie intake by 200 cal per day may not be beneficial for this client. The client has a BMI of 26, which is considered overweight. Therefore, a goal to increase calorie intake may contribute to further weight gain.
Choice B rationale
Listing foods that are high in calcium which should be avoided is not a relevant goal for this client. Calcium is an essential nutrient and there is no indication that the client needs to avoid it.
Choice C rationale
Replacing cigarettes with smokeless tobacco products is not a healthy goal. Smokeless tobacco products also contain harmful chemicals and can lead to health problems.
Choice D rationale

Walking for 30 min 5 days a week is a beneficial goal for this client. Regular physical activity can help manage weight, lower blood pressure, and reduce the risk of heart disease. It can also help the client quit smoking by reducing cravings and withdrawal symptoms.

Choice A rationale
While acetaminophen can be used to relieve discomfort, it should be used with caution in patients with liver disease like cirrhosis, as it can potentially cause further liver damage.

Choice B rationale
Patients with cirrhosis, especially those with ascites, are often advised to limit their sodium intake. High-sodium foods can contribute to fluid retention and worsen ascites. Therefore, avoiding high-sodium foods such as canned soups/vegetables, processed meats, and prepackaged frozen dinners is a key part of managing cirrhosis.
Choice C rationale
While maintaining adequate nutrition is important in cirrhosis, eating three large meals per day is not typically recommended. Instead, smaller, more frequent meals are often suggested.
Choice D rationale
While physical activity is generally beneficial, patients with cirrhosis and particularly those with complications such as ascites or encephalopathy may need to modify their activity levels based on their symptoms and overall health.