A nurse is caring for a client who has a major burn injury and is receiving total parenteral nutrition. Which of the following laboratory tests is the priority for the nurse to use to confirm the client is receiving adequate nutrition?
Prealbumin
Folic acid
Magnesium
Transferrin
The Correct Answer is A
Choice A reason: Prealbumin is a protein that is synthesized by the liver and reflects the current nutritional status of the client. It has a short half-life of 2 to 3 days, which makes it a sensitive indicator of changes in protein intake. Prealbumin levels are decreased in clients who are malnourished or have inflammation, infection, or liver disease. The nurse should monitor the prealbumin levels of the client who is receiving total parenteral nutrition to ensure that they are within the normal range of 15 to 36 mg/dL.
Choice B reason: Folic acid is a water-soluble vitamin that is involved in DNA synthesis, cell division, and red blood cell production. Folic acid levels are decreased in clients who have malabsorption, alcoholism, or certain medications, such as methotrexate or phenytoin. The nurse should assess the folic acid levels of the client who is receiving total parenteral nutrition, but it is not the priority test to confirm adequate nutrition.
Choice C reason: Magnesium is a mineral that is involved in many enzymatic reactions, muscle contraction, nerve transmission, and bone formation. Magnesium levels are decreased in clients who have malnutrition, diarrhea, vomiting, or diuretic use. The nurse should evaluate the magnesium levels of the client who is receiving total parenteral nutrition, but it is not the priority test to confirm adequate nutrition.
Choice D reason: Transferrin is a protein that transports iron in the blood and reflects the iron stores of the client. Transferrin levels are decreased in clients who have iron deficiency anemia, chronic disease, or liver disease. The nurse should check the transferrin levels of the client who is receiving total parenteral nutrition, but it is not the priority test to confirm adequate nutrition.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C"]
Explanation
Choice A reason: Nuts are not a complete protein, as they are low in the essential amino acid lysine¹. However, nuts can be combined with other plant-based foods, such as grains or legumes, to form a complete protein.
Choice B reason: Eggs are a complete protein, as they contain all nine essential amino acids in adequate amounts². Eggs are also a good source of protein, with about 6 grams per egg³.
Choice C reason: Poultry, such as chicken, turkey, or duck, is a complete protein, as it contains all nine essential amino acids in sufficient amounts⁴. Poultry is also a lean source of protein, with about 25 grams per 3-ounce serving.
Choice D reason: Legumes, such as beans, peas, or lentils, are not a complete protein, as they are low in the essential amino acid methionine. However, legumes can be combined with other plant-based foods, such as grains or nuts, to form a complete protein.
Choice E reason: Grains, such as wheat, rice, or oats, are not a complete protein, as they are low in the essential amino acid lysine. However, grains can be combined with other plant-based foods, such as legumes or nuts, to form a complete protein.
Correct Answer is B
Explanation
Choice A reason: Bran cereal is high in phosphorus, containing about 34% of the DV per cup (118 g) ( 1 ). Phosphorus is a mineral that helps build strong bones and teeth, but too much of it can cause problems for people with kidney disease. The kidneys normally filter out excess phosphorus from the blood, but when they are damaged, phosphorus can build up and cause bone loss, itching, and calcification of blood vessels and organs ( 2 ).
Choice B reason: A medium apple is low in phosphorus, containing only 3% of the DV per 182 g ( 3 ). Apples are also a good source of fiber, vitamin C, and antioxidants. They can help lower blood pressure, cholesterol, and blood sugar levels, which are beneficial for people with kidney disease ( 4 ).
Choice C reason: Scrambled eggs are moderate in phosphorus, containing about 12% of the DV per large egg (50 g) ( 5 ). Eggs are also high in protein, which can increase the workload of the kidneys and worsen kidney function. People with kidney disease should limit their protein intake to 0.8 g per kg of body weight per day, unless advised otherwise by their doctor ( 6 ).
Choice D reason: Ground turkey is high in phosphorus, containing about 16% of the DV per 3 oz (85 g) ( 7 ). Ground turkey is also high in protein, which can have the same negative effects as eggs on kidney function. People with kidney disease should choose lean meats and poultry, and eat them in moderation.
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