A nurse is reviewing a client's laboratory results for effectiveness of total parenteral nutrition (TPN). Which of the following laboratory values is the best indicator for the nurse to monitor for short-term effectiveness of the TPN?
Hemoglobin
Total albumin
Transferrin
Prealbumin
The Correct Answer is D
Prealbumin (also known as transthyretin): Prealbumin is a protein synthesized in the liver and has a shorter half-life compared to albumin. It is considered a more sensitive marker for
short-term nutritional changes and can reflect the effectiveness of TPN within a few days.
Prealbumin levels can indicate the response to nutritional interventions and provide a more immediate assessment of nutritional adequacy.
Hemoglobin: Hemoglobin is a measure of the oxygen-carrying capacity of red blood cells and is typically used to assess anemia. While hemoglobin can be affected by nutritional status, it is not a specific marker for the short-term effectiveness of TPN.
Total albumin: Total albumin is a measure of protein status and can be affected by various factors, including inflammation and liver disease. However, it has a longer half-life and slower response to nutritional changes, so it may not be the best indicator for short-term effectiveness.
Transferrin: Transferrin is a protein involved in iron transport and can be used as an indicator of iron status. However, it may not reflect short-term changes in nutritional status and is not specific to TPN effectiveness.
Monitoring prealbumin levels can help determine the short-term effectiveness of TPN and guide adjustments to the nutritional plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Low potassium levels, known as hypokalemia, can be a significant concern in individuals with bulimia nervosa due to the frequent purging behaviors associated with the condition. Purging, such as self-induced vomiting or misuse of laxatives or diuretics, can lead to excessive loss of potassium from the body. Hypokalemia can have serious consequences, including cardiac arrhythmias, muscle weakness, fatigue, and even life-threatening complications.
The normal range for potassium is typically around 3.5-5.0 mEq/L. With a potassium level of 3.2 mEq/L falling below the normal range, it indicates a low potassium level and requires prompt attention.
The other laboratory results mentioned in the question are within normal ranges:
● A WBC (white blood cell) count of 5,200/mm3 falls within the normal range (typically between 4,500 and 11,000/mm3) and indicates a normal white blood cell count.
● An Hgb (hemoglobin) level of 14 g/dL falls within the normal range (typically between 12 and 16 g/dL) and indicates a normal hemoglobin level.
● A magnesium level of 1.6 mEq/L, although slightly low, is still within the normal range (typically between 1.5 and 2.5 mEq/L). The nurse should monitor it closely and assess for symptoms associated with hypomagnesemia. If the client's symptoms or other clinical indications suggest a significant magnesium imbalance, the healthcare provider should be notified.

Correct Answer is A
Explanation
"Eat protein at each meal": This is an important instruction for a client with dumping syndrome. Including protein at each meal can help slow down the digestion process and reduce the rapid emptying of the stomach contents into the small intestine, which is characteristic of dumping syndrome. Protein takes longer to digest and can help stabilize blood sugar levels, promote satiety, and minimize the symptoms of dumping syndrome.
"Consume three large meals daily": Consuming three large meals daily is not recommended for clients with dumping syndrome. Large meals can exacerbate the symptoms by overloading the digestive system. Instead, it is generally advised to consume smaller, more frequent meals throughout the day to help manage dumping syndrome symptoms.
"Drink beverages with meals": It is not recommended to drink beverages with meals for clients with dumping syndrome. Consuming liquids with meals can further contribute to the rapid emptying of the stomach contents and worsen symptoms. It is preferable to drink fluids between meals to maintain hydration without affecting the digestion process.
"Sit up in bed after meals": This instruction is relevant for clients with gastroesophageal reflux disease (GERD) but may not be specifically related to dumping syndrome. In the case of dumping syndrome, it is generally recommended to remain in an upright position after meals to aid digestion and reduce symptoms, such as bloating, cramping, and diarrhea.
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