A nurse is caring for a toddler who drinks 946 mL (32 oz) of whole milk per day and has a poor appetite. The nurse should identify the toddler as being at risk for which of the following conditions?

Choice A rationale Excessive milk intake in a toddler can lead to iron-deficiency anemia because milk is a poor source of iron and can fill the child's stomach, leading to a decreased appetite for iron-rich solid foods. The toddler's high consumption of milk (946 mL) significantly exceeds the recommended daily intake, which should be around 480-720 mL, thereby displacing other nutritionally essential foods. Choice B rationale Vitamin A toxicity is typically associated with excessive intake of vitamin A supplements or foods fortified with high levels of vitamin A, such as liver. While milk is fortified with vitamin A, consuming 946 mL daily is not enough to cause toxicity, as the quantity of vitamin A per serving is relatively low. The toddler's diet is more likely to be deficient in other nutrients due to the milk intake. Choice C rationale Impaired carbohydrate metabolism is not a direct consequence of consuming a high volume of whole milk. This condition, such as galactosemia, is a genetic disorder where the body cannot properly metabolize simple sugars. While milk contains lactose (a carbohydrate), this level of consumption does not cause impaired metabolism unless an underlying genetic condition is present. Choice D rationale Lactose intolerance is a condition where the body cannot digest lactose due to a deficiency in the lactase enzyme. If the toddler had lactose intolerance, they would likely present with gastrointestinal symptoms like diarrhea, gas, and abdominal pain after consuming milk. The question states the toddler has a poor appetite, not symptoms of intolerance.