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 C

Explanation

Choice A

Urinary ketones are not most important. Monitoring urinary ketones can provide information about the utilization of glucose and fat as energy sources. However, it is not the primary lab value to monitor in TPN administration.

Choice B

Serum protein is not most important. Monitoring serum protein levels is important to assess nutritional status, but it might not be as immediate a concern as serum osmolarity.

Choice C

Serum osmolarity is the most important. When caring for a client receiving total parenteral nutrition (TPN), monitoring serum osmolarity is most important. TPN is a highly concentrated solution containing various nutrients, and it is infused directly into the bloodstream. Serum osmolarity reflects the concentration of particles (such as electrolytes, glucose, and other solutes) in the blood. Monitoring serum osmolarity is crucial to prevent complications related to fluid and electrolyte imbalances that can arise from the administration of TPN.

Choice D

Capillary glucose is not the most important. Monitoring capillary glucose levels is important, especially in clients receiving TPN with added glucose. Hyperglycaemia is a potential complication of TPN. While glucose monitoring is important, it is secondary to monitoring serum osmolarity, which encompasses a broader range of solute concentrations.

A. Baked potato with low fat butter. B. Roasted turkey sandwich. C. Salad greens with tomatoes. D. One slice of cheese pizza.

Correct Answer is B

Explanation

Choice A

Potatoes are incorrect. Potatoes are high in carbohydrates and can cause a rapid increase in blood sugar levels, so they are not the best choice for someone with diabetes trying to avoid refined sugars and carbs.

Choice B

Avocado is correct. Avocado is a good choice for someone with Type 2 diabetes who wants to avoid refined sugars and carbohydrates. Avocado is a healthy source of monounsaturated fats, fibre, and various vitamins and minerals. It has a low glycaemic index and doesn't significantly raise blood sugar levels, making it a suitable option for people with diabetes.

Choice C

Grapes are incorrect. Grapes are a fruit with natural sugars, and although they contain fibre, they can still cause spikes in blood sugar levels.

Choice D

Pretzels are incorrect. Pretzels are usually made from refined flour and are high in simple carbohydrates, causing rapid spikes in blood sugar levels. They are not a good choice for someone with diabetes aiming to avoid refined sugars and carbs.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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