A nurse is reviewing the laboratory reports of a client who is undergoing nutritional screening due to a risk for chronic kidney disease. The nurse should identify that which of the following results indicates the need for further assessment?
Serum creatinine 3.5 mg/dL
Hematocrit 45%
Blood urea nitrogen 18 mg/dL
Sodium 140 mEq/L
The Correct Answer is A
Choice A reason: Serum creatinine 3.5 mg/dL is high and indicates the need for further assessment. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys. High creatinine levels can indicate kidney damage or impaired renal function.
Choice B reason: Hematocrit 45% is within the normal range (37-47% for women, 40-50% for men), and it does not indicate the need for further assessment. Hematocrit is the percentage of red blood cells in the blood. Low hematocrit levels can indicate anemia, bleeding, or hemolysis.
Choice C reason: Blood urea nitrogen 18 mg/dL is within the normal range (7-20), and it does not indicate the need for further assessment. Blood urea nitrogen is a waste product of protein metabolism that is filtered by the kidneys. High blood urea nitrogen levels can indicate dehydration, kidney damage, or high protein intake.
Choice D reason: Sodium 140 mEq/L is within the normal range (135-145), and it does not indicate the need for further assessment. Sodium is an electrolyte that helps maintain fluid balance, blood pressure, and nerve impulses. Low or high sodium levels can cause confusion, seizures, or coma.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Hemoglobin 16 g/dL is within the normal range for adults and does not indicate an adverse effect of TPN.
Choice B reason: Temperature 36.1°C (97°F) is normal and does not indicate an infection or inflammation, which are possible complications of TPN.
Choice C reason: Blood glucose 98 mg/dL is normal and does not indicate hyperglycemia or hypoglycemia, which are common problems associated with TPN.
Choice D reason: Weight gain of 1.5 kg (3 lB. per day is excessive and indicates fluid overload, which can result from too rapid or too high infusion of TPN. Fluid overload can cause edema, hypertension, heart failure, and pulmonary congestion.
Correct Answer is B
Explanation
Choice A reason: Consume ten percent of total calories from saturated fat is not a correct instruction for the DASH diet. The DASH diet recommends limiting saturated fat intake to less than six percent of total calories, as saturated fat can raise blood cholesterol and increase the risk of heart disease.
Choice B reason: Consume foods that are high in calcium is a correct instruction for the DASH diet. The DASH diet emphasizes eating foods that are rich in calcium, such as low-fat dairy products, leafy green vegetables, and fortified cereals. Calcium helps regulate blood pressure and prevent osteoporosis.
Choice C reason: Increase intake of refined carbohydrates is not a correct instruction for the DASH diet. The DASH diet advises reducing intake of refined carbohydrates, such as white bread, white rice, and sweets. Refined carbohydrates can increase blood sugar and insulin levels and contribute to obesity and diabetes.
Choice D reason: Limit sodium intake to 3,200 milligrams per day is not a correct instruction for the DASH diet. The DASH diet recommends limiting sodium intake to less than 2,300 milligrams per day, or even lower to 1,500 milligrams per day for some people. Sodium can increase blood pressure and fluid retention and damage the kidneys and blood vessels.
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