Answer:

C. Dysphagia

Rationale: 

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that causes a decline in respiratory function, including shortness of breath and an inability to cough. The patient is also at a nutritional risk because of muscle wasting and dysphagia. Other factors that may contribute to nutritional issues in the ALS patient include constipation, increased metabolic rate, and difficulties performing activities of daily living.