A nurse is reviewing the laboratory results of a client who has Crohn's disease and experienced an exacerbation 7 days ago. Which of the following laboratory results should the nurse identify as an indication the client is experiencing malnutrition?
Hematocrit 37%
Iron 160 mcg/dL
Prealbumin 9 mg/dL.
C-reactive protein 15 mg/L
The Correct Answer is C
A) Hematocrit 37% is within the normal range for adults, indicating that the client’s red blood cell volume is adequate. While anemia can be a concern in clients with Crohn's disease, this value does not specifically indicate malnutrition.
B) Iron 160 mcg/dL is above the normal range (typically 50-170 mcg/dL). Elevated iron levels can result from supplementation or other factors, but it does not directly indicate malnutrition. Iron status alone is not a reliable marker for overall nutritional status.
C) Prealbumin 9 mg/dL is significantly below the normal range (15-36 mg/dL). Low prealbumin levels are a strong indicator of malnutrition because prealbumin has a short half-life and reflects recent changes in protein status and dietary intake. This result suggests the client has been experiencing inadequate nutritional intake or absorption.
D) C-reactive protein (CRP) 15 mg/L indicates inflammation, which is common during an exacerbation of Crohn's disease. While elevated CRP levels signal active inflammation, they do not specifically indicate malnutrition. CRP is more commonly used as a marker of inflammatory activity rather than nutritional status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Measure the client's manifestations using an anxiety rating scale: This action is essential as the first step because it allows the nurse to accurately assess the severity of the client's anxiety. Understanding the level of anxiety helps in planning appropriate interventions and monitoring the effectiveness of any treatment provided. Accurate assessment is foundational in clinical decision making.
B) Initiate a referral to a local support group: While beneficial, referring the client to a support group should follow an initial assessment. Support groups can offer long-term benefits, but immediate needs and severity must be evaluated first.
C) Assist in finding alternative ways to cope: Helping the client develop coping strategies is an important intervention. However, before suggesting specific coping mechanisms, the nurse needs to understand the current level of anxiety and how it affects the client. This ensures that the coping strategies are appropriately tailored.
D) Administer an antianxiety medication: Administering medication can be crucial in managing severe anxiety, but this step should come after a thorough assessment. The nurse needs to determine if medication is necessary and what dosage might be appropriate, based on the anxiety rating scale and other assessment findings.
Correct Answer is B
Explanation
A) Provide detailed directions for the client's expected behavioral changes
Giving detailed directions may overwhelm the client, increasing anxiety. It's more effective to offer support and simple, clear guidance to reduce stress.
B) Request the client write down an evaluation of personal strengths
Encouraging the client to focus on personal strengths can boost self-esteem and resilience, helping them cope with anxiety by promoting a positive self-image and reinforcing their ability to manage stress.
C) List alternative interpretations of the client's illogical thinking
While reframing thoughts can be helpful, this approach might be too confrontational initially. It's important to build trust and allow the client to explore thoughts at their own pace.
D) Encourage the client to participate in group recreational activities to help concentration
While recreational activities can be beneficial, they may not directly address anxiety management. Individual reflection on strengths can be a more immediate way to enhance coping skills.
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