A nurse is caring for a client who is malnourished. The client states, "When I do eat, I usually just eat bread and butter to get something in me." The nurse should recognize that the client is at risk for which of the following complications?

Choice B reason: Lentils are a rich source of folate, which is a B vitamin that is essential for the development of the neural tube and the prevention of neural tube defects in the fetus . One cup of cooked lentils provides about 358 micrograms of folate, which is 90% of the recommended daily intake for pregnant women.

Choice A reason: Mashed potatoes are not a good source of folate, as they contain only 8 micrograms of folate per cup, which is 2% of the recommended daily intake for pregnant women. Potatoes are mainly a source of carbohydrates, potassium, and vitamin C.

Choice C reason: Green peppers are a moderate source of folate, as they contain 42 micrograms of folate per cup, which is 11% of the recommended daily intake for pregnant women. Green peppers are also a source of vitamin C, vitamin A, and fiber.

Choice D reason: Carrots are a low source of folate, as they contain 24 micrograms of folate per cup, which is 6% of the recommended daily intake for pregnant women. Carrots are mainly a source of vitamin A, beta-carotene, and fiber.

Choice A reason: Consuming high-calorie foods early in the day is not a good strategy for weight loss, as it can lead to overeating and increased fat storage. The nurse should advise the client to eat a balanced breakfast that includes protein, fiber, and healthy fats, which can help curb appetite and boost metabolism.

Choice B reason: Limiting carbohydrate intake to 30 grams per day is too restrictive and may cause nutritional deficiencies, ketosis, and adverse effects on mood and cognition. The nurse should recommend a moderate carbohydrate intake of 45 to 65 percent of total calories, with an emphasis on complex carbohydrates from whole grains, fruits, vegetables, and legumes.

Choice C reason: Consuming 500 fewer calories per day can result in a weight loss of about 1 pound per week, which is a safe and realistic goal for a client who has a BMI of 35. The nurse should help the client identify sources of excess calories in their diet and suggest ways to reduce them, such as choosing low-calorie beverages, using smaller plates, and avoiding distractions while eating.

Choice D reason: Following a liquid meal plan for 4 weeks is not a sustainable or healthy way to lose weight, as it can cause muscle loss, electrolyte imbalance, and rebound weight gain. The nurse should encourage the client to eat regular meals that include a variety of foods from all food groups, with appropriate portion sizes and nutrient density.