The nurse is assessing an older female adult client’s nutritional status. Which finding indicates that the client has a nutritional deficiency?

Reference Ranges: Hemoglobin [12 to 16 g/dL (120 to 160 g/L)] Hematocrit [37% to 47% (0.37 to 0.47 volume fraction)] Albumin [3.5 to 5.0 g/dL (35 to 50 g/L)] Serum transferrin [250 to 380 mg/dL (2.5 to 3.80 g/L)]

Low weight as determined from a height/weight comparison chart.

Hemoglobin (Hgb) of 11.8 g/dL (118 g/L) and hematocrit (Hct) of 34% (0.34).

Decreased lean body mass compared to results of 10 years ago.

Serum albumin of 3 g/dL (30 g/L) and serum transferrin of 180 mg/dL (18 g/L).

Answer and Explanation

The Correct Answer is D

A. Low weight as determined from a height/weight comparison chart can indicate malnutrition, but it is not as specific as biochemical markers. Weight alone does not provide a complete picture of nutritional status, as it can be influenced by various factors such as fluid retention or loss of muscle mass.

B. Hemoglobin (Hgb) of 11.8 g/dL (118 g/L) and hematocrit (Hct) of 34% (0.34) are below the normal reference ranges, indicating anemia. Anemia can result from various nutritional deficiencies, including iron, vitamin B12, or folate deficiencies. However, it does not provide a comprehensive assessment of overall nutritional status.

C. Decreased lean body mass compared to results of 10 years ago suggests muscle wasting, which can be a sign of malnutrition. However, it is not as specific as biochemical markers like serum albumin and transferrin levels, which provide more direct evidence of protein-energy malnutrition.

D. Serum albumin of 3 g/dL (30 g/L) and serum transferrin of 180 mg/dL (18 g/L) are below the normal reference ranges, indicating protein-energy malnutrition. Low levels of these proteins are strong indicators of poor nutritional status and are commonly used to assess malnutrition in clinical settings.

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Correct Answer is ["A","B","C","D","E"]

Explanation

A. A client undergoing peritoneal dialysis is at an increased risk for malnutrition due to the loss of protein and other nutrients during the dialysis process. This can lead to deficiencies if not properly managed with dietary adjustments and supplementation.

B. A client recovering from a severe burn injury has increased metabolic demands and nutrient needs for wound healing and recovery. Without adequate nutrition, these clients are at high risk for malnutrition and related complications.

C. A client living with progressing dementia may experience difficulties with eating and maintaining proper nutrition due to cognitive decline. This can lead to unintentional weight loss and malnutrition if not addressed with appropriate interventions.

D. A client experiencing severe depression may have a reduced appetite and lack of interest in food, leading to inadequate nutrient intake and potential malnutrition. Depression can significantly impact dietary habits and overall nutritional status.

E. A client receiving intravenous fluids for diarrhea is at risk for malnutrition due to the loss of fluids and electrolytes. Diarrhea can lead to dehydration and nutrient deficiencies, making it essential to monitor and address the nutritional needs of these clients.

A. High protein soft diet. B. Low residue diet. C. Pureed regular diet. D. Mechanical soft diet.

Correct Answer is A

Explanation

A. High protein soft diet is recommended for clients undergoing chemotherapy, especially those with stomatitis. This diet includes soft foods that are easy to chew and swallow, and it provides the necessary protein to help maintain muscle mass and support healing. Foods such as scrambled eggs, yogurt, and smoothies are good options.

B. Low residue diet is designed to reduce the amount of fiber and residue in the digestive tract, which can be helpful for certain gastrointestinal conditions. However, it is not specifically tailored to address the needs of a client with stomatitis and significant weight loss due to chemotherapy.

C. Pureed regular diet involves blending foods to a smooth consistency, which can be helpful for clients with severe swallowing difficulties. However, it may not provide the necessary protein and nutrients required for a client undergoing chemotherapy and experiencing significant weight loss.

D. Mechanical soft diet includes foods that are easy to chew and swallow but may not be as high in protein as a high protein soft diet. While it can be beneficial for clients with chewing difficulties, it may not fully meet the nutritional needs of a client with significant weight loss and stomatitis.

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Naxlex Comprehensive Predictor Exams

A nurse is planning care for several clients. Which client(s) are at an increased risk for malnutrition? Select all that apply.

Correct Answer is ["A","B","C","D","E"]

Explanation

A client who is receiving antineoplastic chemotherapy has lost 25% of total body weight and is having difficulty eating because of stomatitis. In planning care for this client, which diet should the nurse recommend?

Correct Answer is A

Explanation

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A client has a serum sodium level of 155 mEq/L (155 mmol/L). The nurse should encourage the client to make which selection from the lunch menu? Reference Range: Sodium [136 to 145 mEq/L (136 to 145 mmol/L)]

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The nurse is caring for an older adult client that is exhibiting signs of confusion. Which intervention should the nurse implement?

The nurse is preparing to review nutritional guidelines with older adult clients. Which action should the nurse recommend to this age group?

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