A nurse is teaching a client who is receiving enteral nutrition via bolus feedings. Which of the following statements by the client indicates an understanding of the teaching?

A. Apples: Apples are naturally low in phenylalanine, the amino acid that clients with phenylketonuria (PKU) cannot properly metabolize. Fruits like apples are generally safe and are encouraged in a low-phenylalanine diet because they help meet nutritional needs without contributing excess protein or phenylalanine.
B. Milk: Milk is high in protein and contains significant amounts of phenylalanine, making it unsuitable for individuals with PKU. Consuming milk can lead to elevated phenylalanine levels, which are harmful to the developing fetus and can cause cognitive impairments and developmental delays. Pregnant women with PKU must strictly avoid high-protein foods such as milk.
C. Carrots: Carrots are low in protein and phenylalanine, making them a safe and beneficial food choice for clients with PKU. They provide important nutrients like beta-carotene and fiber without compromising phenylalanine restrictions. Including vegetables like carrots supports balanced nutrition during pregnancy.
D. Coffee: Coffee itself contains minimal or no phenylalanine unless additives such as milk or cream are used. While caffeine intake should be moderated during pregnancy, plain coffee does not significantly impact phenylalanine levels and is not a food that must be avoided specifically because of PKU.

A. "This lab measures your average blood glucose over a 3-month period." The hemoglobin A1c test reflects the average blood glucose levels over the past 2 to 3 months by measuring the percentage of glucose attached to hemoglobin in red blood cells. Since red blood cells have a lifespan of about 120 days, this test provides a long-term view of glycemic control.
B. "An increase in your hemoglobin A1c level indicates glycemic control." An increase in hemoglobin A1c levels actually indicates poor glycemic control, not improvement. Higher values mean blood glucose has been elevated over time, which can lead to complications such as neuropathy, nephropathy, and retinopathy in diabetic patients.
C. "This lab value is a good indicator of short-term nutritional status." The hemoglobin A1c test is not used to assess short-term nutritional status. Instead, it measures long-term blood glucose trends. For evaluating short-term changes in nutrition, blood glucose logs or postprandial glucose readings are better tools to use.
D. "You will need to fast before getting this test." Fasting is not required for the hemoglobin A1c test. The result is not affected by recent food intake, making it convenient for patients. This feature makes it more practical than fasting plasma glucose or oral glucose tolerance tests when assessing overall glycemic control in diabetes management.