A nurse is reviewing the medical record of a client who has AIDS and is malnourished. The client has been receiving total parenteral nutrition (TPN). Which of the following findings should the nurse identify as a therapeutic response to the TPN?
Hgb 10 g/dL
Temperature 38.4° C (101.1 F)
BUN 25 mg/dL
BMI 18.5
The Correct Answer is D
BMI (body mass index) of 18.5: BMI is a measure of body fat based on an individual's weight and height. A BMI of 18.5 is within the normal range and indicates that the client's nutritional status has improved. An increase in BMI suggests successful repletion of body stores and improved overall health.
Hgb (hemoglobin) of 10 g/dL: Hemoglobin level is an indicator of the oxygen-carrying capacity of the blood. While a hemoglobin level of 10 g/dL is within the normal range for an adult, it does not specifically indicate a therapeutic response to TPN. However, it can be associated with improved nutritional status.
Temperature of 38.4° C (101.1 F): An elevated temperature indicates the presence of a fever, which is not a direct therapeutic response to TPN but may be associated with an underlying infection or inflammation.
BUN (blood urea nitrogen) of 25 mg/dL: BUN is a measure of kidney function and protein metabolism. An elevated BUN may indicate dehydration, impaired kidney function, or increased protein breakdown. It is not a specific therapeutic response to TPN.
While other factors, such as hemoglobin level, temperature, and BUN, can provide additional information about the client's overall health, the most specific indicator of a therapeutic response to TPN in a malnourished client is an improvement in BMI.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Place the client in a semi-Fowler's position when eating. The semi-Fowler's position involves elevating the head of the bed to an angle of 30 to 45 degrees. This position helps prevent aspiration by facilitating proper swallowing and reducing the risk of food or liquid entering the airway.

Initiating a calorie count of daily food intake is not a specific action for dysphagia. Calorie counting is generally used for monitoring caloric intake in clients with specific dietary needs or conditions, but it is not directly related to dysphagia management. The focus for dysphagia management is on ensuring safe swallowing and preventing complications such as aspiration.
Instructing the client to keep their chin up when swallowing is not appropriate for dysphagia management. This action can actually increase the risk of aspiration. The proper technique for swallowing with dysphagia typically involves tucking the chin slightly down towards the chest to help close off the airway and direct the food or liquid down the esophagus.
Providing food in a thin liquid consistency is not appropriate for dysphagia unless specifically recommended by a healthcare professional. Dysphagia diets typically involve modifying the consistency of food and liquids based on the client's swallowing abilities and recommendations from a speech-language pathologist or dietitian. Different levels of texture modifications (such as pureed, minced, or mechanically soft) may be prescribed to ensure safe swallowing and reduce the risk of aspiration.
Correct Answer is B
Explanation
"My baby will receive the most milk within the first 10 minutes of the feeding": This statement is correct. During the first few minutes of breastfeeding, the baby receives the foremilk, which is more watery and quenches their thirst. The hindmilk, which is higher in fat and provides more calories, is obtained as the feeding progresses.
"I need to supplement feedings with water once my baby is 4 months old": Breast milk provides all the necessary fluids for the baby, and additional water supplementation is generally not needed for exclusively breastfed infants.
"The purpose of alternating breasts during feedings is to promote comfort": The purpose of alternating breasts during feedings is to ensure that the baby receives both foremilk and hindmilk from each breast and to stimulate milk production in both breasts. It is not primarily for promoting comfort.
"During the first few weeks, I should nurse my baby every 4 hours": Breastfed newborns typically feed more frequently than every 4 hours, especially during the early weeks.
On-demand feeding is recommended, which means feeding the baby whenever they show hunger cues, which can be more frequent than every 4 hours.

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