The nurse monitors the laboratory results of the patient with protein-calorie malnutrition during treatment. Which result is an indication of improvement in the patient's condition?

Correct Answer: B

Rationale: The correct answer is B because an increase in serum transferrin levels indicates improvement in protein-calorie malnutrition as transferrin is a protein that binds and transports iron, which is essential for various body functions. When protein intake increases, transferrin levels also increase to support iron transport. A: Decreased lymphocytes do not directly reflect improvement in protein-calorie malnutrition. C: Increased serum potassium is not specific to improvement in protein-calorie malnutrition. D: Decreased serum prealbumin levels indicate ongoing malnutrition, not improvement.

Correct Answer: D

Rationale: Step 1: Peptic ulcers are mainly caused by H. pylori infection or NSAIDs use, not directly related to acid injury. Step 2: Ammonia formation in the mucosal wall neutralizes acid, protecting mucosal cells. Step 3: Ammonia is produced by H. pylori urease enzyme, contributing to ulcer formation. Step 4: Acid back diffusion (B) and histamine release (C) are consequences, not direct causes of ulcers. Summary: Ammonia formation (D) is the correct answer as it directly contributes to mucosal injury in peptic ulcers. Acid back diffusion (B) and histamine release (C) are secondary effects of ulcer formation, not the primary cause.

Correct Answer: A

Rationale: Rationale for Correct Answer (A): Ambulating the patient more frequently helps to stimulate GI motility, reduce abdominal distention, and promote passage of flatus. Movement aids in peristalsis, which can alleviate postoperative GI issues. Summary of Incorrect Choices: B: Assessing bowel sounds is important but does not directly address the issue of stimulating GI motility or addressing the patient's pain and distention. C: Placing the patient in a high Fowler's position may improve respiratory function but does not specifically target GI motility or pain relief. D: Withholding opioids may be necessary in some cases, but pain management is crucial for postoperative care. There are other ways to address decreased GI motility without completely withholding pain medications.

Correct Answer: C

Rationale: Rationale: 1. Choice C is correct because it acknowledges the patient's concerns about sexuality post-surgery. 2. Reminding the patient that affection can be expressed in non-sexual ways validates his feelings. 3. It promotes open communication and offers alternative ways to maintain intimacy during the healing process. Summary of Incorrect Choices: A. Involving the sexual partner may add pressure and may not address the patient's personal insecurities. B. Promising a return to normal sexual function may create false expectations and overlook emotional aspects. D. Focusing on physical and emotional factors may downplay the patient's specific concerns about his sexuality.

Correct Answer: C

Rationale: The correct answer is C: HCV genotyping. Before prescribing treatment for a patient with positive HCV testing, genotyping is essential to determine the specific strain of HCV present. This information guides treatment decisions as different HCV genotypes respond differently to antiviral medications. Anti-HCV (choice A) is used for initial screening but does not provide genotype information. HCV RNA quantitation (choice B) measures viral load but does not identify the genotype. Recombinant immunoblot assay (RIBA) (choice D) is an older confirmatory test and is not typically used for initial treatment decision-making.