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).
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A
Client with a nasogastric tube to low, intermittent suction is not correct. While there is a risk of aspiration with a nasogastric tube in place, the tube is intended to help drain stomach contents, reducing the risk of aspiration. However, if the tube is not properly positioned or managed, there could still be some risk.
Choice B
Client who has sensory aphasia and is receiving a clear liquid diet is correct. Sensory aphasia refers to a language disorder that affects a person's ability to understand language and communication. This client may have difficulty swallowing safely and effectively, which increases the risk of aspiration. Additionally, a clear liquid diet consists of thin liquids that are more likely to be aspirated compared to thicker fluids.
Choice C
Client receiving 30% oxygen via a non-rebreather face mask is not correct. Oxygen therapy can increase the risk of drying the airways and potentially increasing the risk of aspiration, but if the oxygen mask is properly fitted and humidified, the risk may be minimized.
Choice D
Client experiencing dysphagia who is prescribed a full liquid diet is not correct. Dysphagia refers to difficulty swallowing, which can increase the risk of aspiration. However, a full liquid diet includes thicker liquids that are less likely to be aspirated compared to thin liquids. Still, the risk of aspiration exists, especially if the client has severe dysphagia.
Correct Answer is B
Explanation
Choice A
Protein is not essential. While protein can influence blood sugar levels to some extent, its effect is much smaller compared to carbohydrates. Protein is not typically counted as a primary factor in insulin dosing.
Choice B
Carbohydrates are essential. For a client with type 1 diabetes mellitus who uses both short-acting (mealtime) and long-acting (basal) insulin, counting carbohydrates is essential for meal planning and insulin dosing. Carbohydrates have the most direct and significant impact on blood sugar levels. When carbohydrates are consumed, they are broken down into glucose, which enters the bloodstream and can lead to increased blood sugar levels
Choice C
Dairy is not essential. Dairy products can contain carbohydrates (such as lactose), but the carbohydrate content varies and is not as significant as in foods like grains, fruits, and starchy vegetables.
Choice D
Fats are not essential. Fats have minimal direct impact on blood sugar levels. However, they can affect the overall rate of digestion and absorption of carbohydrates, potentially influencing the timing of insulin administration. But carbohydrate counting remains the primary focus for insulin adjustment.
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