The client is a male who states his wife complains that his snoring awakens her at night.
The spouse is present.
To obtain further data, the nurse asks the spouse:

Choice A rationale

While cultural sensitivity is important, respecting the client's desire to have her uncle make decisions would undermine her legal and ethical right to self-determination, which is a fundamental principle in healthcare. This right ensures individuals make their own healthcare decisions free from coercion.

Choice B rationale

Revisiting the decision without the uncle present might pressure the client and still not directly address her right to make her own informed choices. It doesn't empower the client to exercise her autonomy.

Choice C rationale

Holding a family meeting and encouraging the client to speak on her own behalf is a supportive approach, but it doesn't guarantee the client will feel empowered to make her own decision, especially if cultural norms strongly favor the uncle's authority.

Choice D rationale

Educating the client about her right to autonomy directly addresses the ethical principle of self-determination. By understanding her rights, the client is empowered to make her own informed decisions about her treatment, regardless of cultural influences or family dynamics.

Choice A rationale

High blood urea nitrogen (BUN) levels primarily indicate impaired kidney function or dehydration, as urea is a waste product of protein metabolism filtered by the kidneys. While severe protein catabolism can elevate BUN, it is not the most direct or sensitive indicator of inadequate protein intake. Normal BUN ranges typically fall between 7 to 20 mg/dL.

Choice B rationale

Low specific gravity of urine suggests that the kidneys are excreting dilute urine, which can be caused by various factors such as excessive fluid intake, diabetes insipidus, or kidney dysfunction. It is not a reliable indicator of protein nutritional status. Normal urine specific gravity ranges from 1.005 to 1.030.

Choice C rationale

Serum albumin is a protein synthesized by the liver and is a key indicator of long-term protein status. Inadequate protein intake leads to decreased albumin synthesis, resulting in low serum albumin levels. Albumin has a relatively long half-life (around 20 days), making it a reflection of chronic protein deficiency. Normal serum albumin levels typically range from 3.5 to 5.0 g/dL.

Choice D rationale

Hemoglobin is the protein in red blood cells responsible for oxygen transport. While severe protein deficiency can eventually affect hemoglobin levels due to the protein component, it is not the most direct or immediate indicator of inadequate protein intake. Other factors like iron deficiency are more commonly associated with low hemoglobin. Normal hemoglobin ranges for adults are typically 13.5 to 17.5 g/dL for males and 12.0 to 15.5 g/dL for females.