A nurse is caring for a client who has a major burn injury and is receiving total parenteral nutrition. Which of the following laboratory tests is the priority for the nurse to use to confirm the client is receiving adequate nutrition?
Prealbumin
Folic acid
Magnesium
Transferrin
The Correct Answer is A
Choice A reason: Prealbumin is a protein that is synthesized by the liver and reflects the current nutritional status of the client. It has a short half-life of 2 to 3 days, which makes it a sensitive indicator of changes in protein intake. Prealbumin levels are decreased in clients who are malnourished or have inflammation, infection, or liver disease. The nurse should monitor the prealbumin levels of the client who is receiving total parenteral nutrition to ensure that they are within the normal range of 15 to 36 mg/dL.
Choice B reason: Folic acid is a water-soluble vitamin that is involved in DNA synthesis, cell division, and red blood cell production. Folic acid levels are decreased in clients who have malabsorption, alcoholism, or certain medications, such as methotrexate or phenytoin. The nurse should assess the folic acid levels of the client who is receiving total parenteral nutrition, but it is not the priority test to confirm adequate nutrition.
Choice C reason: Magnesium is a mineral that is involved in many enzymatic reactions, muscle contraction, nerve transmission, and bone formation. Magnesium levels are decreased in clients who have malnutrition, diarrhea, vomiting, or diuretic use. The nurse should evaluate the magnesium levels of the client who is receiving total parenteral nutrition, but it is not the priority test to confirm adequate nutrition.
Choice D reason: Transferrin is a protein that transports iron in the blood and reflects the iron stores of the client. Transferrin levels are decreased in clients who have iron deficiency anemia, chronic disease, or liver disease. The nurse should check the transferrin levels of the client who is receiving total parenteral nutrition, but it is not the priority test to confirm adequate nutrition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice C reason: This statement shows that the client has understood the importance of vitamin D and calcium for bone health. Fortified milk, fatty fish, and cheese are good sources of both nutrients, which help to maintain bone density and prevent osteoporosis.
Choice A reason: This statement is incorrect, as vitamin A supplementation can have adverse effects on bone health. Excessive intake of vitamin A can increase the risk of fractures and reduce bone mineral density.
Choice B reason: This statement is partially correct, as calcium supplementation can help to meet the daily requirement of calcium for bone health. However, calcium alone is not enough, as vitamin D is also needed to facilitate the absorption of calcium and prevent its loss from the bones.
Choice D reason: This statement is irrelevant, as none of the foods mentioned are particularly beneficial for bone health. Orange juice, lean meats, and egg whites are good sources of vitamin C, protein, and biotin, respectively, but they do not provide significant amounts of vitamin D or calcium.
Correct Answer is B
Explanation
Choice A reason: Measuring the client's gastric residual every 12 hr is not frequent enough to monitor the feeding tolerance and prevent aspiration. The nurse should measure the gastric residual before each intermittent feeding or every 4 to 6 hr during continuous feeding¹².
Choice B reason: Flushing the client's tube with 30 mL of water every 4 hr is an appropriate action to maintain the tube patency, prevent clogging, and hydrate the client. The nurse should flush the tube before and after each medication administration, feeding, or gastric residual check¹³.
Choice C reason: Keeping the client's head elevated at 15° during feedings is not sufficient to prevent reflux and aspiration. The nurse should elevate the head of the bed at least 30° to 45° during feedings and for at least 30 min to 1 hr after feedings¹⁴.
Choice D reason: Obtaining the client's electrolyte levels every 4 hr is not necessary unless the client has signs of fluid or electrolyte imbalance, such as edema, dehydration, or abnormal vital signs. The nurse should monitor the client's weight, intake and output, and laboratory values as ordered by the provider¹⁵.
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