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 A
Explanation
Choice A reason: TPN is a form of nutrition that is delivered directly into the bloodstream through a central venous catheter. It is used for clients who have impaired or nonfunctional gastrointestinal tracts, such as those with acute kidney injury, bowel obstruction, or short bowel syndrome.
Choice B reason: The TPN does not necessarily have higher levels of vitamins than the recommended daily intake. The TPN is individually tailored to meet the client's nutritional needs, which may vary depending on their condition, weight, and laboratory values.
Choice C reason: The TPN does not ensure that the client's glucose level stays within the expected range. In fact, TPN can cause hyperglycemia due to the high concentration of dextrose in the solution. The client's blood glucose level should be monitored frequently and insulin should be administered as prescribed to prevent complications.
Choice D reason: The TPN is not higher in fats and protein, but lower in carbohydrates. The TPN contains a balanced mixture of macronutrients, including carbohydrates, proteins, and lipids, as well as micronutrients, such as electrolytes, vitamins, and minerals. The ratio of these components may vary depending on the client's nutritional needs and goals.
Correct Answer is B
Explanation
Choice A reason: Anticholinesterase medications should be taken 30 minutes before meals, not with meals. This is because they enhance the action of acetylcholine, which improves muscle strength and swallowing ability.
Choice B reason: Positioning the head of the client's bed to 40° while eating helps prevent aspiration and facilitates swallowing. This is the best action for the nurse to take for a client who has myasthenia gravis.
Choice C reason: Encouraging the client to lie down after eating is not advisable, as it increases the risk of aspiration and reflux. The client should remain upright for at least 30 minutes after eating.
Choice D reason: Providing the client with food cut into small bites is not enough to ensure safe and adequate nutrition. The client may still have difficulty swallowing and chewing. The nurse should also offer soft, moist, and easy-to-swallow foods, and avoid foods that are dry, sticky, or hard.
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