A nurse is teaching a client about foods and beverages that can cause diarrhea. Which of the following should the nurse include in the teaching?

Choice A reason: A teacher who notices a mole change but doesn't have time to see a dermatologist is not in a state of wellness. A mole change could indicate skin cancer, which is a serious health problem that requires prompt medical attention. Ignoring or delaying the diagnosis and treatment of skin cancer could compromise the teacher's physical and emotional well-being.

Choice B reason: A fitness trainer who is struggling to cope with the death of her mother is not in a state of wellness. The death of a loved one is a major life stressor that can affect the fitness trainer's mental and emotional health. Grieving is a normal and healthy process, but it can also interfere with the fitness trainer's daily functioning and quality of life. The fitness trainer may need professional help or support from family and friends to cope with the loss.

Choice C reason: A hospice client who is comfortable and at peace with dying is in a state of wellness. Wellness is not only the absence of disease, but also the presence of positive health behaviors and attitudes. A hospice client who is comfortable and at peace with dying has accepted the reality of their condition and has made peace with themselves and others. The hospice client may also receive palliative care, which aims to relieve pain and suffering and improve the quality of life for terminally ill patients and their families.

Choice D reason: A type 1 diabetic who gives himself extra insulin so he can eat cookies is not in a state of wellness. A type 1 diabetic who gives himself extra insulin so he can eat cookies is engaging in unhealthy and risky behavior that could harm his physical health. Extra insulin could cause hypoglycemia, which is a condition where the blood sugar level drops too low and can lead to seizures, coma, or death. Eating cookies could also increase the blood sugar level and contribute to complications such as nerve damage, kidney damage, or cardiovascular disease. A type 1 diabetic who wants to eat cookies should follow a balanced diet and monitor his blood sugar level regularly.

Choice A reason: William, who exercises three times a week, does not have a modifiable risk factor for osteoporosis. Exercise is actually beneficial for bone health, as it stimulates bone formation and reduces bone loss. Exercise also improves muscle strength, balance, and coordination, which can prevent falls and fractures.

Choice B reason: Samantha, who has a family history of osteoporosis, does not have a modifiable risk factor for osteoporosis. Family history is a genetic factor that cannot be changed or controlled. Having a parent or sibling with osteoporosis increases the risk of developing the condition, especially if they have had a fracture.

Choice C reason: Juanita, who smokes two packs of cigarettes a day, has a modifiable risk factor for osteoporosis. Smoking is a lifestyle factor that can be changed or controlled. Smoking increases the risk of osteoporosis by reducing the blood supply to the bones, decreasing the absorption of calcium, and lowering the levels of estrogen, which protects the bones.

Choice D reason: Tori, who is postmenopausal at age 40, does not have a modifiable risk factor for osteoporosis. Menopause is a natural process that occurs when the ovaries stop producing estrogen, which leads to bone loss and increased risk of fractures. Menopause cannot be prevented or reversed, but its effects on bone health can be managed with hormone therapy, calcium, and vitamin D supplements.