In performing health screening for a postmenopausal female client, which assessment data indicates the need for referral to a nutritionist?

Reference Range

Total Calcium [Reference Range: Adult 9 to 10.5 mg/dL or 2.25 to 2.62 mmol/L]

High Density Lipoproteins (HDL) [Reference Range: Female: greater than 55 mg/dL or greater than 0.91 mmol/L] Glycosylated haemoglobin (A1C) Reference Range: 4% to 5.9%]

Serum HDL (high-density lipoprotein) of 35 mg/dl (0.91 mmol/L).

Serum HbA1c (glycosylated haemoglobin) of 4.8% (0.05).

BMI (body mass index) of 22 kg/m2.

Total serum calcium of 10 mg/dl (2.5 mmol/L).

Answer and Explanation

The Correct Answer is A

Choice A

Serum HDL (high-density lipoprotein) of 35 mg/dL (0.91 mmol/L). Among the options provided, a serum HDL level of 35 mg/dL (0.91 mmol/L) is the assessment data that indicates the need for referral to a nutritionist. HDL is often referred to as "good" cholesterol because it helps remove excess cholesterol from the bloodstream, reducing the risk of cardiovascular disease. In this case, the HDL level of 35 mg/dL is below the recommended reference range for females (greater than 55 mg/dL or greater than 0.91 mmol/L), which could suggest a potential need for dietary and lifestyle interventions to improve cardiovascular health.

Choice B

Serum HbA1c (glycosylated haemoglobin) of 4.8% (0.05) is incorrect. This HbA1c level is within the normal reference range (4% to 5.9%) and indicates good blood sugar control.

Choice C

BMI (body mass index) of 22 kg/m² is incorrect. A BMI of 22 is within the normal weight range and might not necessarily indicate the need for a nutritionist referral.

Choice D

Total serum calcium of 10 mg/dL (2.5 mmol/L) is incorrect. This calcium level is within the normal reference range and might not require a nutritionist referral, unless there are other specific concerns related to calcium intake.

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Correct Answer is B

Explanation

Choice A

Describing the value of eating smaller portion sizes is not appropriate. While portion control is important, this advice alone might not address the overall dietary quality and exercise component necessary for effective weight loss.

Choice B

Encouraging a well-balanced diet and moderate exercise is appropriate. This intervention focuses on promoting healthy and sustainable weight loss. A well-balanced diet helps ensure that the client is getting all the necessary nutrients while aiming for a calorie deficit for weight loss. Moderate exercise complements dietary changes and contributes to overall health and weight management.

Choice C

Exploring the reasons, the client wants to lose weight is inappropriate. While understanding the client's motivations is valuable, this doesn't directly provide guidance on how to achieve the goal of losing 10 pounds.

Choice D

Determining if the client has a history of anorexia is inappropriate. While assessing for eating disorders is important in general, assuming there's no indication of anorexia, the focus should be on providing guidance for safe and effective weight loss.

A. High protein. B. High roughage. C. Low cholesterol. D. Low salt.

Correct Answer is A

Explanation

Choice A

High protein should be encouraged. The small reddened area on the coccyx is concerning for a potential pressure ulcer (also known as a pressure sore or bed sore). Pressure ulcers can occur when there is prolonged pressure on a specific area of the skin, often in individuals who are bedridden or have limited mobility. Adequate nutrition, including a high protein diet, is essential for preventing and promoting the healing of pressure ulcers. Protein is crucial for tissue repair and wound healing. A diet high in protein can aid in the recovery of damaged skin and promote the healing process. It helps to maintain and rebuild skin tissue, which is particularly important when dealing with potential pressure ulcers.

Choice B

High roughage should not be encouraged. While dietary fibre (roughage) is important for overall bowel health and regularity, it may not have a direct impact on wound healing in this context.

Choice C

Low cholesterol should not be encouraged. A low cholesterol diet is typically recommended to manage cardiovascular health and reduce the risk of heart disease. While overall health is important, cholesterol levels may not have a direct impact on wound healing in this case.

Choice D

Low salt should not be encouraged. A low salt diet is often recommended for individuals with certain medical conditions, such as hypertension or heart failure. While maintaining a balanced diet is important, salt intake may not be the primary concern when addressing wound healing.

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Naxlex Comprehensive Predictor Exams

An adult woman with a body mass index (BMI) of 21 tells the nurse that she wants to lose 10 pounds (4.5 kg). Which intervention is most important for the nurse to implement?

Correct Answer is B

Explanation

The nurse is conducting diet teaching for the family of an older client who has a small reddened area on the coccyx. Based on this finding, which diet should the nurse encourage for this client?

Correct Answer is A

Explanation

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