An older adult patient who is malnourished presents to the emergency department with a serum albumin that is low with total protein that is also low. Which clinical manifestation should the nurse expect?
Restlessness
Edema
Pallor
Confusion
The Correct Answer is B
Rationale:
A. Restlessness can occur with electrolyte imbalances or hypoxia, but it is not a hallmark of low albumin or protein malnutrition.
B. Low serum albumin and total protein decrease plasma oncotic pressure, allowing fluid to shift from the vascular space into interstitial tissues, leading to peripheral and sometimes generalized edema (anasarca).
C. Pallor is more indicative of anemia, which may coexist but is not a direct effect of hypoalbuminemia.
D. Confusion can result from electrolyte disturbances, hypoxia, or hepatic encephalopathy, but it is not a direct manifestation of low albumin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Clostridium difficile spores are resistant to alcohol and can persist on surfaces. Daily disinfection with a sporicidal agent is essential to prevent transmission.
B. Alcohol-based hand sanitizers are ineffective against C. difficile spores. Handwashing with soap and water is required after contact with the client or contaminated surfaces.
C. A protective environment is used for immunocompromised clients, not for those with C. difficile.
D. Masks are not necessary for routine C. difficile care because the bacteria are spread via the fecal-oral route, not airborne.
Correct Answer is C
Explanation
Rationale:
A. Magnesium levels may actually drop, not rise, during refeeding syndrome due to intracellular shifts.
B. Calcium levels are typically not elevated as a direct result of refeeding syndrome.
C. Refeeding syndrome occurs when malnourished patients receive rapid carbohydrate reintroduction, triggering insulin release. This drives phosphate, potassium, and magnesium into cells, with phosphate depletion being the hallmark and most clinically significant electrolyte disturbance. Hypophosphatemia can cause muscle weakness, respiratory failure, and cardiac dysfunction.
D. Sodium levels may fluctuate, but hyponatremia is not the primary concern in refeeding syndrome.
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