A nurse is planning care for a client who has anorexia and has manifestations of malnutrition. When reviewing the client's laboratory values. which of the following test results should the nurse expect to be low?

Troponin

Albumin

D-dimer

Creatinine

Answer and Explanation

The Correct Answer is B

A. Troponin:
Troponin is a protein found in the heart muscle. Elevated levels of troponin in the blood indicate damage to the heart, often due to a heart attack or other cardiac issues. This marker is crucial in diagnosing heart-related problems.

B. Albumin:
Albumin is a protein produced by the liver and is essential for maintaining blood volume and regulating fluid balance. It also helps transport various substances in the blood. Low levels of albumin are indicative of malnutrition, liver disease, or kidney disorders.

C. D-dimer:
D-dimer is a substance in the blood that is released when a blood clot breaks up. Elevated levels of D-dimer can indicate the presence of an abnormal blood clot, but it is not specific to malnutrition. It is often used in diagnosing conditions like deep vein thrombosis (DVT) or pulmonary embolism (PE).

D. Creatinine:
Creatinine is a waste product produced by the muscles and excreted by the kidneys. Creatinine levels in the blood can indicate how well the kidneys are functioning. Elevated levels can suggest kidney damage or other kidney-related issues but are not directly related to malnutrition.

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Free Nursing Study Resources

Correct Answer is ["A","D","E"]

Explanation

A. Perform leg exercises every 2 hr:
After surgery, especially abdominal surgery, patients are at risk of developing deep vein thrombosis (DVT) due to decreased mobility. Performing leg exercises every 2 hours helps in improving blood circulation and preventing blood clots in the legs.

B. Irrigate the nasogastric tube every 4 to 8 hr:
Irrigating the nasogastric tube (inserting fluid into the tube) at regular intervals is not a standard practice. Nasogastric tubes are primarily used for decompression (removing stomach contents) or drainage, not for irrigation. Inserting fluids without a specific medical reason can disrupt the balance in the gastrointestinal tract and lead to complications.

C. Maintain bed rest for 48 hr following surgery:
Encouraging early mobility is a standard practice after surgery. Prolonged bed rest increases the risk of complications such as pneumonia, blood clots, and muscle weakness. Patients are typically encouraged to start moving and walking around as soon as it's safe to do so, usually within a few hours to a day after surgery, depending on the type of surgery and the patient's overall condition.

D. Encourage hourly use of an incentive spirometer while awake:
An incentive spirometer is a medical device used to help patients improve the functioning of their lungs. It encourages patients to take slow, deep breaths, which helps in expanding the lungs and preventing atelectasis (partial lung collapse) that can occur after surgery when patients may not be taking deep breaths as usual.

E. Document the color, consistency, and amount of nasogastric drainage:
Monitoring and documenting the characteristics of nasogastric drainage is essential for assessing the patient's condition. Changes in the color, consistency, or amount of drainage can indicate various issues, including bleeding, infection, or bowel perforation. This documentation helps the healthcare team make informed decisions about the patient's care.

A. Bradycardia B. Report of epigastric fullness C. Severe upper abdominal pain D. Hyperactive bowel sounds

Correct Answer is C

Explanation

A. Bradycardia
Bradycardia is not a direct symptom of gastrointestinal perforation. When a perforation occurs, the body's response is often to increase the heart rate (tachycardia) due to the stress and shock.

B. Report of epigastric fullness
Epigastric fullness might be a symptom of peptic ulcer disease but is not specific to gastrointestinal perforation.

C. Severe upper abdominal pain
Correct choice. Severe upper abdominal pain, particularly sudden and intense pain, can be indicative of gastrointestinal perforation. This is a medical emergency and requires immediate attention.

D. Hyperactive bowel sounds
Gastrointestinal perforation can lead to absent or hypoactive bowel sounds due to inflammation and irritation of the abdominal cavity, not hyperactive bowel sounds.

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A nurse is planning care for a client who has anorexia and has manifestations of malnutrition. When reviewing the client's laboratory values. which of the following test results should the nurse expect to be low?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting in the plan of care for a client who had surgery for a bowel obstruction. The client has a nasogastric tube in place. Which of the following actions should the nurse include in the client's plan of care? (Select all that apply.)

Correct Answer is ["A","D","E"]

Explanation

A nurse is collecting data from a client who has peptic ulcer disease. Which of the following findings is a manifestation of gastrointestinal perforation?

Correct Answer is C

Explanation

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