In performing health screening for a postmenopausal female client, which assessment data indicates the need for referral to a nutritionist?
Reference Range
Total Calcium [Reference Range: Adult 9 to 10.5 mg/dL or 2.25 to 2.62 mmol/L]
High Density Lipoproteins (HDL) [Reference Range: Female: greater than 55 mg/dL or greater than 0.91 mmol/L] Glycosylated haemoglobin (A1C) Reference Range: 4% to 5.9%]
Serum HDL (high-density lipoprotein) of 35 mg/dl (0.91 mmol/L).
Serum HbA1c (glycosylated haemoglobin) of 4.8% (0.05).
BMI (body mass index) of 22 kg/m2.
Total serum calcium of 10 mg/dl (2.5 mmol/L).
The Correct Answer is A
Choice A
Serum HDL (high-density lipoprotein) of 35 mg/dL (0.91 mmol/L). Among the options provided, a serum HDL level of 35 mg/dL (0.91 mmol/L) is the assessment data that indicates the need for referral to a nutritionist. HDL is often referred to as "good" cholesterol because it helps remove excess cholesterol from the bloodstream, reducing the risk of cardiovascular disease. In this case, the HDL level of 35 mg/dL is below the recommended reference range for females (greater than 55 mg/dL or greater than 0.91 mmol/L), which could suggest a potential need for dietary and lifestyle interventions to improve cardiovascular health.
Choice B
Serum HbA1c (glycosylated haemoglobin) of 4.8% (0.05) is incorrect. This HbA1c level is within the normal reference range (4% to 5.9%) and indicates good blood sugar control.
Choice C
BMI (body mass index) of 22 kg/m² is incorrect. A BMI of 22 is within the normal weight range and might not necessarily indicate the need for a nutritionist referral.
Choice D
Total serum calcium of 10 mg/dL (2.5 mmol/L) is incorrect. This calcium level is within the normal reference range and might not require a nutritionist referral, unless there are other specific concerns related to calcium intake.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A
Advising the client that too much fruit can irritate the colon is not the right choice. While it's true that excessive consumption of certain fruits can cause gastrointestinal discomfort, this information is not directly related to celiac disease or the selected meal.
Choice B
Informing the client that oatmeal contains gluten is the right choice. Celiac disease is an autoimmune disorder in which consuming gluten, a protein found in wheat, rye, and barley, triggers an immune response that damages the small intestine. Oatmeal itself is naturally gluten-free, but it is often processed in facilities that also process gluten-containing grains, which can lead to cross-contamination. Therefore, it's important for individuals with celiac disease to choose certified gluten-free oats to avoid adverse reactions.
Choice C
Commending the client for selecting fat-free milk is not the best choice. While choosing a healthier milk option is beneficial for overall health, it is not the most important action in this situation, considering the client's celiac disease.
Choice D reason;
Encouraging the client to choose decaffeinated coffee is not the right choice. The choice of caffeinated or decaffeinated coffee is a matter of preference and is not directly related to celiac disease or the potential for gluten exposure from the oatmeal.
Correct Answer is C
Explanation
Choice A
Urinary ketones are not most important. Monitoring urinary ketones can provide information about the utilization of glucose and fat as energy sources. However, it is not the primary lab value to monitor in TPN administration.
Choice B
Serum protein is not most important. Monitoring serum protein levels is important to assess nutritional status, but it might not be as immediate a concern as serum osmolarity.
Choice C
Serum osmolarity is the most important. When caring for a client receiving total parenteral nutrition (TPN), monitoring serum osmolarity is most important. TPN is a highly concentrated solution containing various nutrients, and it is infused directly into the bloodstream. Serum osmolarity reflects the concentration of particles (such as electrolytes, glucose, and other solutes) in the blood. Monitoring serum osmolarity is crucial to prevent complications related to fluid and electrolyte imbalances that can arise from the administration of TPN.
Choice D
Capillary glucose is not the most important. Monitoring capillary glucose levels is important, especially in clients receiving TPN with added glucose. Hyperglycaemia is a potential complication of TPN. While glucose monitoring is important, it is secondary to monitoring serum osmolarity, which encompasses a broader range of solute concentrations.
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