A nurse is caring for a client who follows a vegan diet. The nurse should identify that the client is at risk for which of the following deficiencies?

Choice A reason: Peas are not a good choice for a mechanical soft diet, as they are small and round and can pose a choking hazard. Peas also require some chewing to break them down, which may be difficult for the client.

Choice B reason: Dried apricots are not a good choice for a mechanical soft diet, as they are hard and sticky and can damage the teeth or dentures. Dried apricots also require a lot of chewing to swallow them, which may be painful or tiring for the client.

Choice C reason: Canned pears are a good choice for a mechanical soft diet, as they are soft and moist and can be easily mashed with a fork. Canned pears do not require much chewing and can be swallowed smoothly.

Choice D reason: Cashews are not a good choice for a mechanical soft diet, as they are hard and crunchy and can injure the gums or oral mucosa. Cashews also require a lot of chewing and can get stuck in the teeth or dentures.

Choice A reason: Increasing the caloric intake before pregnancy is not an appropriate dietary guideline, as it can lead to excessive weight gain and obesity, which can increase the risk of gestational diabetes, hypertension, and other complications. The nurse should advise the client to maintain a healthy weight and a balanced diet before and during pregnancy.

Choice B reason: Increasing the total intake of seafood to 20 ounces per week is not an appropriate dietary guideline, as it can expose the client to high levels of mercury, which can harm the developing fetus. The nurse should advise the client to limit the intake of seafood to 8 to 12 ounces per week, and avoid fish that are high in mercury, such as shark, swordfish, and king mackerel.

Choice C reason: Decreasing ascorbic acid in the diet is not an appropriate dietary guideline, as it can impair the immune system and the absorption of iron, which are both important for the health of the mother and the fetus. The nurse should advise the client to consume adequate amounts of ascorbic acid, which is found in citrus fruits, tomatoes, broccoli, and other foods.

Choice D reason: Increasing folic acid to 400 micrograms per day prior to getting pregnant is an appropriate dietary guideline, as it can prevent neural tube defects, such as spina bifida and anencephaly, in the fetus. The nurse should advise the client to take a daily prenatal vitamin that contains folic acid, and eat foods that are rich in folate, such as leafy greens, beans, and fortified cereals.