An older adult client is admitted to the medical unit because of a loss of appetite and generalized malaise. To analyze the client's general nutritional status, which laboratory value is most important for the nurse to review?

Hematocrit.

Serum calcium.

Hemoglobin.

Serum prealbumin.

Answer and Explanation

The Correct Answer is D

Rationale:
A. Hematocrit: Hematocrit measures the proportion of red blood cells in the blood and helps assess for anemia or dehydration, but it does not directly reflect short-term changes in nutritional status or protein stores.

B. Serum calcium: Serum calcium levels assess electrolyte balance and bone health but are not specific indicators of overall nutritional status. Calcium levels can be maintained even when nutritional intake is poor.

C. Hemoglobin: Hemoglobin evaluates oxygen-carrying capacity and can suggest anemia, which may indirectly reflect poor nutrition, but it is not as sensitive a marker for acute or current nutritional status as prealbumin.

D. Serum prealbumin: Serum prealbumin is a sensitive marker of recent nutritional intake and protein status, reflecting short-term changes in nutrition. It is the most important laboratory value to assess when evaluating a client for malnutrition, especially in the setting of appetite loss and generalized malaise.

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Correct Answer is B

Explanation

Rationale:
A. Pain: Pain elicited during percussion is abnormal and suggests underlying pathology, such as peritonitis, inflammation, or an organ-related issue. A healthy abdomen should not be painful during percussion.

B. Musical and drum like: A tympanic, musical, drum-like sound is the expected normal finding when percussing most areas of the abdomen. Tympany reflects the presence of air within the stomach and intestines, which is typical in a healthy gastrointestinal tract.

C. Absent sounds: Absent sounds are assessed during auscultation, not percussion. Silence during auscultation may indicate a bowel obstruction or ileus, but it is unrelated to the expected percussion findings.

D. Absolute dullness: Dullness can be a normal finding over solid organs like the liver or full bladder, but absolute or widespread dullness across the abdomen is abnormal and may suggest fluid accumulation (ascites) or masses.

A. Localized sternal border pain intensified by palpation. B. Chest pain that intensifies upon chest excursion. C. Anterior thorax pain that radiates between the scapulae. D. Pain in the neck, jaw, or medial side of the left arm.

Correct Answer is D

Explanation

Rationale:
A. Localized sternal border pain intensified by palpation: Pain that worsens with palpation suggests musculoskeletal causes such as costochondritis rather than cardiac ischemia. Cardiac chest pain is usually deep, pressure-like, and not reproducible with touch.

B. Chest pain that intensifies upon chest excursion: Pain that worsens with breathing movements often points to pleuritic causes such as pulmonary embolism or pleurisy, not myocardial infarction. Cardiac chest pain is generally constant and unaffected by breathing patterns.

C. Anterior thorax pain that radiates between the scapulae: Pain radiating between the scapulae is more characteristic of aortic dissection rather than a typical acute myocardial infarction, though some cardiac conditions can cause atypical pain patterns.

D. Pain in the neck, jaw, or medial side of the left arm: Referred pain to the neck, jaw, or inner left arm is classic for an acute myocardial infarction. This pattern reflects nerve pathways from the heart and is a hallmark symptom that strongly indicates myocardial ischemia.

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An older adult client is admitted to the medical unit because of a loss of appetite and generalized malaise. To analyze the client's general nutritional status, which laboratory value is most important for the nurse to review?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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