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 C
Explanation
Choice A
Providing pamphlets about heart-healthy diet selections should not be implemented. Providing information is important, but it might not be as effective if the client is strongly resistant. Engaging in a conversation first can help tailor the information to the client's needs.
Choice B
Referring the client to a dietitian for nutrition education should not be implemented. A dietitian can provide valuable education, but it might be more beneficial to address the client's concerns and resistance before making the referral.
Choice C
Discussing client's concerns about the change in diet should be implemented. When a client is resistant or unwilling to make changes to their diet and lifestyle, it's important for the nurse to engage in open and empathetic communication. Option C, discussing the client's concerns about the change in diet, is the most appropriate initial response.
By engaging in a conversation with the client, the nurse can better understand the client's perspective, reasons for resistance, and potential barriers to making dietary changes. This approach allows the nurse to address the client's concerns, provide information, and work collaboratively to find solutions that might be more acceptable to the client.
Choice D
Suggesting exercise as an alternative to increase HDL levels should not be implemented. Exercise is important for heart health, but it's important to address the client's resistance to dietary changes first. Additionally, dietary changes and exercise can work together to improve overall heart health.
Correct Answer is A
Explanation
Choice A
Broccoli is appropriate recommendation. Given the client's history of iron deficiency anaemia and the current haemoglobin level below the reference range, it's important to recommend foods that are good sources of iron. Among the options provided, broccoli is the most suitable choice. Iron from plant-based sources (non-heme iron) might be less easily absorbed than iron from animal sources (heme iron), but combining them with foods high in vitamin C can enhance iron absorption. Broccoli is a vegetable that contains both iron and vitamin C, making it a favourable choice to support the client's iron intake and help address the anaemia.
Choice B
Carrots are inappropriate. While carrots are a nutritious vegetable, they are not particularly high in iron.
Choice C
Cheddar cheese is inappropriate. Dairy products like cheddar cheese are not significant sources of iron.
Choice D
Whole milk is inappropriate. Whole milk is not a significant source of iron either. Additionally, calcium in milk might hinder iron absorption if consumed together.
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