A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicates an understanding of the teaching? (Select all that apply.)

Rationale: A. Maintaining a healthy weight reduces pressure on the abdomen and can help prevent worsening of a hiatal hernia. B. Elevating the head of the bed helps prevent reflux of gastric contents during sleep. C. Reducing fluids is not recommended; adequate hydration is important. D. Remaining upright (not lying down) after meals is recommended; lying down for half an hour increases reflux risk. E. Limiting caffeine, spicy foods, and other reflux-triggering foods helps reduce symptoms associated with hiatal hernia.