A nurse is collecting data from a client who reports feeling stress. Which of the following should the nurse identify as an external stressor?

A. Recurring urinary tract infections. Chronic infections act as internal stressors because they arise from within the body, leading to physical discomfort and emotional strain. While they can contribute to stress, they do not originate from an external source, such as environmental or situational factors. B. Report of feeling depressed. Depression is an internal emotional state rather than an external stressor. Although it can be triggered by external events, depression itself comes from psychological and physiological processes within the individual rather than from outside influences. C. Lack of nutritional knowledge. Limited knowledge about nutrition is an internal factor affecting decision-making rather than an external stressor. External stressors involve changes in one's environment or circumstances that create pressure, whereas knowledge gaps influence behavior but do not directly impose stress from an outside source. D. A recent move to a new city. Moving to a new city is an external stressor as it involves environmental change, social adaptation, and logistical challenges. Adjusting to a new home, job, or social network can be overwhelming, increasing stress levels due to uncertainty, unfamiliar surroundings, and the need for adjustment.