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 D

Explanation

Choice A

Bananas are incorrect. While bananas contain some nutrients, they are not significant sources of vitamin D, calcium, or phosphate, which are key nutrients for preventing rickets.

Choice B

Apple juice is incorrect. Apple juice is not a significant source of vitamin D, calcium, or phosphate. It may contain some vitamins and minerals, but it is not a primary food source for preventing rickets.

Choice C

Oranges are incorrect. Like bananas and apple juice, oranges are not significant sources of vitamin D, calcium, or phosphate. While they contain vitamin C, which is important for overall health, they are not the best dietary source for preventing rickets.

Choice D

Fortified milk is correct. Rickets is a condition primarily caused by a deficiency of vitamin D, calcium, or phosphate. Vitamin D is crucial for the proper absorption of calcium and phosphorus in the body, which are essential for bone health and development. Fortified milk is an excellent dietary source for preventing rickets because it is often enriched with vitamin D and calcium, both of which are important for bone mineralization and growth.

A. Cut the spaghetti and meatballs into small pieces. B. Exchange the pasteurized whole milk with skim milk. C. Substitute the fried potatoes with a garden salad. D. Remove the fresh grapes from the meal tray.

Correct Answer is D

Explanation

Choice A

Cutting the spaghetti and meatballs into small pieces is inappropriate. This choice is not directly related to the risk of infection. It might be helpful for a client who has difficulty swallowing or chewing, but it doesn't address the compromised immune system and infection risk.

Choice B

Exchanging pasteurized whole milk with skim milk is inappropriate. The type of milk doesn't have a direct impact on infection risk. Both pasteurized whole milk and skim milk are considered safe for consumption. This choice doesn't address the specific concern of infection in a client with a low ANC.

Choice C

Substituting fried potatoes with a garden salad is inappropriate. While choosing healthier food options can be beneficial for overall health, the choice between fried potatoes and a garden salad doesn't necessarily impact the infection risk for a client with a low ANC. This choice also doesn't address the specific concern of infection in this context.

Choice D

Remove the fresh grapes from the meal tray is appropriate. The reason for this choice is that a client with an absolute neutrophil count (ANC) of 400 has a significantly compromised immune system, and they are at a high risk of infection due to their low neutrophil count. Neutrophils are a type of white blood cell that plays a crucial role in fighting off infections. A normal ANC falls within the range of 2500 to 8000 mm3 or cells/uL.

Fresh grapes, being a raw and uncooked food item, may carry a higher risk of containing bacteria or pathogens that could pose a threat to a client with such a low ANC. The nurse needs to ensure that the client's exposure to potential sources of infection is minimized.

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Naxlex Comprehensive Predictor Exams

In conducting community health teaching, the nurse plans to describe foods that will help prevent rickets. What food product should the nurse recommend as the best dietary source for preventing rickets?

Correct Answer is D

Explanation

The nurse is providing care for a client with an absolute neutrophil count (ANC) of 400. Which action should the nurse perform prior to delivering the meal tray to the client's room? Reference Range Neutrophils (ANC) [Reference Range: 2500 to 8000 mm3 or 2500 to 8000 cells/uL]

Correct Answer is D

Explanation

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