Over three follow-up visits to their pediatrician, an adolescent with diagnosed celiac disease shows: Visit 1:Weight gain appropriate, stools normal, energy improved Visit 2:Weight plateau, mild abdominal distention, intermittent diarrhea Visit 3:Weight loss, persistent diarrhea, low vitamin D level What is the nurse's best interpretation?

A. This condition is self-limiting and will resolve without intervention: Celiac disease is a lifelong autoimmune disorder triggered by gluten. It does not resolve spontaneously and requires strict dietary management. B. The patient likely has poor adherence to a gluten-free diet or hidden gluten exposure: The initial improvement followed by weight loss, recurrent diarrhea, and micronutrient deficiency strongly suggests gluten ingestion. This may occur from intentional nonadherence or accidental exposure through hidden sources. C. These changes reflect typical growth variations in adolescent patients with celiac disease: While adolescents may experience growth fluctuations, persistent diarrhea, weight loss, and nutrient deficiency are not expected variations. These findings point to ongoing intestinal injury. D. The patient is adhering well to a gluten-free diet: If the patient were strictly adhering, weight gain and normalized labs would be maintained. The decline in growth and vitamin D levels indicates continued intestinal malabsorption due to gluten exposure.