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 D
Explanation
Choice A reason: Green tea is not a beverage that enhances the absorption of nonheme iron, but rather inhibits it. Green tea contains tannins, which are compounds that bind to iron and prevent its absorption. The nurse should advise the client to avoid drinking green tea or other beverages that contain tannins, such as black tea, with meals that contain iron.
Choice B reason: Coffee is not a beverage that enhances the absorption of nonheme iron, but rather inhibits it. Coffee also contains tannins, as well as caffeine, which can interfere with iron absorption. The nurse should recommend the client to limit or avoid coffee intake, especially with iron-rich foods.
Choice C reason: Milk is not a beverage that enhances the absorption of nonheme iron, but rather inhibits it. Milk contains calcium, which can compete with iron for absorption. The nurse should suggest the client to consume milk and other dairy products separately from iron-containing foods.
Choice D reason: Orange juice is a beverage that enhances the absorption of nonheme iron, as it is rich in vitamin C. Vitamin C can increase the absorption of nonheme iron by converting it from the ferric form to the more absorbable ferrous form. The nurse should encourage the client to drink orange juice or other citrus juices with meals that contain iron.
Correct Answer is C
Explanation
Choice A reason: The client should not replace salt with soy sauce, as soy sauce is not kosher. Soy sauce is made from fermented soybeans and wheat, which are not allowed in a kosher diet. The client should use kosher salt or other kosher seasonings instead.
Choice B reason: The client's primary vegetables should not be squash and corn, as they are not considered kosher. Squash and corn are classified as kitniyot, which are legumes, grains, seeds, and other plant products that are not allowed in a kosher diet. The client should eat more leafy greens, root vegetables, and fruits, which are kosher.
Choice C reason: The client can eat meat and nondairy margarine together, as they are both kosher. Nondairy margarine is made from vegetable oils, which are pareve, meaning they are neither meat nor dairy. The client should avoid eating meat and dairy products together, as they are not kosher.
Choice D reason: The client does not need to use their right hand when eating food, as this is not a requirement of a kosher diet. This is a practice of some Muslims, who believe that the right hand is for eating and the left hand is for cleaning. The client should follow the rules of kashrut, which are the Jewish laws of kosher food.
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