Which substances should a nurse advise a client with gastroesophageal reflux disease (GERD) to avoid?

Clients with gastroesophageal reflux disease (GERD) are often advised to avoid substances that can exacerbate their condition by increasing gastric acidity or lowering esophageal sphincter tone. Coffee is a well-known trigger for GERD symptoms due to its caffeine content, which can relax the lower esophageal sphincter. This relaxation can allow stomach contents to flow back into the esophagus, leading to heartburn and discomfort.

In contrast, nonfat milk and scrambled eggs are generally considered more benign options for individuals with GERD. Nonfat milk may even provide temporary relief for some clients due to its alkaline nature, and eggs, when prepared without added fat, can be a good source of protein that does not typically provoke symptoms. Fried chicken, while it can be troublesome due to its high fat content, isn't as directly implicated in the same way coffee is.

Thus, advising clients with GERD to avoid coffee is based on its known physiological effects that can worsen their symptoms.