A nurse is assessing a client who has been prescribed lactulose for the management of hepatic encephalopathy. Which of the following statements by the client about the effects of lactulose indicates that the nurse must provide further education?

I expect my bowel movements to become more frequent and softer.

I may experience bloating as a side effect of this medication.

Lactulose will help reduce the level of ammonia in my blood.

I should avoid eating any fiber while taking lactulose to prevent excessive gas.