A nurse is caring for a client who has a new diagnosis of gastroesophageal reflux disease (GERD). Which of the following dietary recommendations should the nurse include in the teaching?

The correct answer is A: Avoid citrus fruits. Citrus fruits are acidic and can worsen symptoms of GERD by increasing stomach acid production and irritating the esophagus. By avoiding citrus fruits, the client can reduce the risk of acid reflux and discomfort. Eating large meals three times a day (B) can lead to overeating, causing pressure on the lower esophageal sphincter and increasing the risk of reflux. Drinking coffee with meals (C) can also trigger acid reflux due to its acidic nature. Consuming high-fat foods (D) can relax the lower esophageal sphincter and delay stomach emptying, leading to increased acid reflux symptoms.