A nurse is caring for an elderly client admitted to the emergency department. When the nurse learns that the client has muscle wasting, which does the nurse suspect?
Positive nitrogen balance
Gluconeogenesis
Negative nitrogen balance
Ketosis
The Correct Answer is C
Choice A reason: Positive nitrogen balance occurs when nitrogen intake exceeds excretion, promoting muscle growth, as seen in athletes or pregnancy. In elderly clients with muscle wasting, protein breakdown exceeds synthesis, leading to muscle loss, making this an incorrect assumption for the observed condition.
Choice B reason: Gluconeogenesis is the liver’s process of synthesizing glucose from non-carbohydrate sources, like amino acids, during starvation or low carbohydrate intake. While it may occur in muscle wasting, it is not the primary cause or indicator, as muscle loss is driven by protein catabolism.
Choice C reason: Negative nitrogen balance indicates protein breakdown exceeds intake, common in elderly clients with muscle wasting due to inadequate protein consumption, illness, or reduced absorption. This leads to muscle loss, as amino acids are not sufficiently replaced, aligning with the observed symptoms.
Choice D reason: Ketosis occurs when the body burns fat for energy, producing ketones, typically during low-carbohydrate diets. While it may accompany malnutrition, it is not directly linked to muscle wasting, which is primarily driven by protein deficiency and catabolism in this context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Physical activity level influences energy expenditure but is secondary in unexplained weight loss. Low activity may contribute to muscle loss, but it does not directly indicate nutritional status or underlying causes like malnutrition or disease, which are more urgent to assess in a 65-year-old.
Choice B reason: Blood albumin levels (3.5-5.0 g/dL) reflect protein status and nutritional health, critical in unexplained weight loss. Low albumin indicates malnutrition or illness (e.g., cancer, liver disease), which may cause weight loss in older adults, making it the priority assessment to guide diagnosis and intervention.
Choice C reason: Current medications can cause weight loss (e.g., diuretics), but their impact is secondary to nutritional status. Assessing medications provides context but does not directly measure protein deficiency or disease, which albumin levels better indicate in the context of unexplained weight loss.
Choice D reason: Family history of chronic illness informs long-term risk but is not immediate in assessing recent weight loss. It provides background for conditions like cancer but does not directly address current nutritional or metabolic status, making it less urgent than albumin levels.
Correct Answer is C
Explanation
Choice A reason: Fried foods, high in saturated and trans fats, elevate low-density lipoprotein (LDL) cholesterol, promoting atherosclerosis and increasing heart disease risk. They offer no protective benefit, as their high fat content (9 kcal/gram) contributes to arterial plaque formation, making this an incorrect choice.
Choice B reason: Cardiac rehabilitation is a treatment after a heart attack, not a preventative measure. It improves recovery through exercise and education but does not prevent initial heart disease, as it addresses existing conditions rather than reducing risk factors like cholesterol or hypertension.
Choice C reason: Lean meats (turkey, chicken) and fish, low in saturated fat and rich in omega-3s (fish), reduce low-density lipoprotein (LDL) cholesterol and atherosclerosis risk. Providing 20-26 grams of protein per 3-ounce serving, they support heart health, making this a key preventative lifestyle change.
Choice D reason: Blood pressure medication manages hypertension, a heart disease risk factor, but is not a lifestyle change. It is a medical intervention, not a preventative dietary or behavioral modification, making it less aligned with proactive heart disease prevention compared to dietary changes.
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