A nurse is caring for a client with a major burn injury and is receiving TPN. Which of the following lab tests is the priority for the nurse to use to confirm the client is receiving adequate nutrition?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Prealbumin. Prealbumin is a valuable marker for assessing a client's nutritional status because it has a shorter half-life compared to other lab values like albumin. Prealbumin levels reflect recent protein intake and can help determine if the TPN therapy is providing adequate nutrition to support wound healing and metabolic needs in a client with major burn injuries. Option A) Iron, is not the priority lab test in this case because iron levels are more indicative of anemia and not a direct marker of nutritional adequacy in this context. Option B) Magnesium is important for various metabolic functions, but it is not the most specific lab test to assess nutritional status in a client receiving TPN for major burn injuries. Option C) Folic acid is essential for cell division and growth, but its levels may not necessarily reflect the current nutritional status of a client receiving TPN for major burn injuries. Educationally, understanding the significance of monitoring prealbumin levels in critically ill patients, especially those with major burn injuries, is crucial for nurses to provide optimal care and ensure adequate nutritional support for healing and recovery. Regular monitoring of prealbumin levels can guide healthcare providers in adjusting TPN formulations and other nutritional interventions to meet the client's needs effectively.

Correct Answer: D

Rationale: In the case of a client with bulimia nervosa, electrolyte imbalances are a common concern due to purging behaviors. The correct answer is option D) Potassium 3.2. A potassium level of 3.2 is significantly below the normal range (3.5-5.0 mEq/L) and can lead to serious cardiac complications such as arrhythmias and cardiac arrest. Hypokalemia is a common finding in individuals with bulimia due to excessive vomiting or laxative abuse, which can lead to potassium depletion. Option A) White Blood Cells 5,200/mm3 is within the normal range (4,500-11,000/mm3) and is not typically affected by bulimia nervosa. Option B) Hemoglobin 14 is also within the normal range (12-16 g/dL) and is not a priority concern in this context. Option C) Magnesium 1.6 is low, but potassium is a more critical electrolyte to monitor in clients with bulimia nervosa. Hypomagnesemia is common in eating disorders but does not pose the same immediate risk as severe hypokalemia. Educationally, understanding the importance of monitoring electrolyte levels in clients with eating disorders is crucial for nurses. Recognizing the significance of abnormal laboratory values and their potential impact on the client's health allows for timely intervention and prevention of complications. By prioritizing potassium monitoring in this scenario, the nurse demonstrates clinical judgment and promotes patient safety.

Correct Answer: D

Rationale: In the context of managing anorexia while undergoing radiation therapy, the correct instruction of consuming nutrient-dense foods first (Option D) is crucial for several reasons. Nutrient-dense foods provide essential vitamins, minerals, and calories in a smaller volume, which is beneficial for individuals struggling with poor appetite. By prioritizing these foods, the client can ensure they are receiving adequate nutrition despite reduced intake. This instruction also helps in meeting the increased nutritional demands during radiation therapy, supporting the body's healing process and maintaining strength. Option A, limiting high kilo-calorie supplements to between meals, is incorrect as anorexic clients often struggle to consume enough calories, and limiting supplements may further reduce their overall caloric intake, leading to nutritional deficiencies. Option B, avoiding overeating during "good" days, is inappropriate as anorexic individuals often have distorted perceptions of hunger and fullness. Encouraging them to eat appropriately sized meals consistently is more beneficial than fluctuating intake based on perceived good or bad days. Option C, eating hot foods rather than cold foods, is not directly related to managing anorexia during radiation therapy. While temperature preferences can impact appetite, it is not as critical as prioritizing nutrient-dense foods for adequate nutrition. In an educational context, understanding the rationale behind selecting nutrient-dense foods first empowers nurses to provide evidence-based nutritional guidance to clients. By emphasizing the importance of nutrient density, healthcare professionals can support clients in optimizing their nutritional intake to promote healing and overall well-being during cancer treatment.

Correct Answer: D

Rationale: The correct answer is D) A low-protein diet should be followed for three months prior to conception. In Phenylketonuria (PKU), individuals have a deficiency in the enzyme needed to break down the amino acid phenylalanine. During pregnancy, high levels of phenylalanine can be harmful to the developing fetus. By following a low-protein diet three months before conception, the client can lower their phenylalanine levels, reducing the risk of complications for the baby. Option A is incorrect because the focus for PKU management is on restricting phenylalanine, not on diet sodas. Option B is incorrect as monitoring serum bilirubin is not directly related to managing PKU during pregnancy. Option C is incorrect because breastfeeding will not prevent a baby from developing PKU if they inherit the genetic mutation. Educationally, this question highlights the importance of preconception counseling for individuals with PKU. It underscores the need for strict dietary management to ensure the best outcomes for both the mother and the baby. Understanding the specific dietary recommendations for PKU is crucial in managing the condition and reducing the risk of complications during pregnancy.

Correct Answer: B

Rationale: In the context of caring for a client who practices Islam and is observing dietary restrictions for Ramadan, the correct intervention to include in the plan of care is to facilitate fasting during daylight hours (Option B). This is because Ramadan is a holy month during which Muslims fast from dawn to sunset. By respecting and supporting the client's religious practices, the nurse promotes cultural competence and patient-centered care. Option A, removing beef products from the dietary plan, is incorrect because it does not specifically address the client's religious observance during Ramadan. Option C, serving meat and dairy items separately, and Option D, providing a strictly vegetarian diet on Fridays, are also incorrect as they do not align with the specific dietary restrictions observed during Ramadan. Educationally, it is crucial for healthcare providers to understand and respect the cultural and religious beliefs of their patients to provide holistic and individualized care. By incorporating cultural competence into nursing practice, nurses can establish trust, improve communication, and enhance patient outcomes.Understanding the significance of religious practices like fasting during Ramadan can help nurses tailor care plans to meet the unique needs of diverse patient populations.