Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is reviewing the medical record of a client who has AIDS and is malnourished. The client has been receiving total parenteral nutrition (TPN). Which of the following findings should the nurse identify as a therapeutic response to the TPN?
A. Hgb 10 g/dL
Hgb (hemoglobin) of 10 g/dL: Hemoglobin level is an indicator of the oxygen-carrying capacity of the blood. While a hemoglobin level of 10 g/dL is within the normal range for an adult, it does not specifically indicate a therapeutic response to TPN. However, it can be associated with improved nutritional status.
B. Temperature 38.4° C (101.1 F)
Temperature of 38.4° C (101.1 F): An elevated temperature indicates the presence of a fever, which is not a direct therapeutic response to TPN but may be associated with an underlying infection or inflammation.
C. BUN 25 mg/dL
BUN (blood urea nitrogen) of 25 mg/dL: BUN is a measure of kidney function and protein metabolism. An elevated BUN may indicate dehydration, impaired kidney function, or increased protein breakdown. It is not a specific therapeutic response to TPN.
D. BMI 18.5
BMI (body mass index) of 18.5: BMI is a measure of body fat based on an individual's weight and height. A BMI of 18.5 is within the normal range and indicates that the client's nutritional status has improved. An increase in BMI suggests successful repletion of body stores and improved overall health.
This question is an excerpt from Nurse Dive's nursing test bank - ATI RN Nutrition 2019 Proctored Exam. Take the full exam now
Full Explanation
BMI (body mass index) of 18.5: BMI is a measure of body fat based on an individual's weight and height. A BMI of 18.5 is within the normal range and indicates that the client's nutritional status has improved. An increase in BMI suggests successful repletion of body stores and improved overall health.
Hgb (hemoglobin) of 10 g/dL: Hemoglobin level is an indicator of the oxygen-carrying capacity of the blood. While a hemoglobin level of 10 g/dL is within the normal range for an adult, it does not specifically indicate a therapeutic response to TPN. However, it can be associated with improved nutritional status.
Temperature of 38.4° C (101.1 F): An elevated temperature indicates the presence of a fever, which is not a direct therapeutic response to TPN but may be associated with an underlying infection or inflammation.
BUN (blood urea nitrogen) of 25 mg/dL: BUN is a measure of kidney function and protein metabolism. An elevated BUN may indicate dehydration, impaired kidney function, or increased protein breakdown. It is not a specific therapeutic response to TPN.
While other factors, such as hemoglobin level, temperature, and BUN, can provide additional information about the client's overall health, the most specific indicator of a therapeutic response to TPN in a malnourished client is an improvement in BMI.
Similar Questions
A nurse is providing teaching about a gluten-free diet to a client who has celiac disease. Which of the following foods should the nurse recommend the client include in his diet?
A. Wheat germ
Wheat germ: Wheat germ is derived from wheat and contains gluten. Therefore, it should be avoided by individuals with celiac disease.
B. Corn
Corn: Corn is a gluten-free grain and can be included in a gluten-free diet for individuals with celiac disease.
C. Salami
Salami: Salami is a processed meat product that may contain gluten-containing additives or fillers. Therefore, it is important for individuals with celiac disease to carefully read the ingredient labels of processed meat products or opt for certified gluten-free alternatives.
D. Barley
Barley: Barley is a gluten-containing grain and should be strictly avoided by individuals with celiac disease.
Full Explanation
Corn: Corn is a gluten-free grain and can be included in a gluten-free diet for individuals with celiac disease.
Wheat germ: Wheat germ is derived from wheat and contains gluten. Therefore, it should be avoided by individuals with celiac disease.
Salami: Salami is a processed meat product that may contain gluten-containing additives or fillers. Therefore, it is important for individuals with celiac disease to carefully read the ingredient labels of processed meat products or opt for certified gluten-free alternatives.
Barley: Barley is a gluten-containing grain and should be strictly avoided by individuals with celiac disease.
It is important for individuals with celiac disease to carefully read food labels and select gluten-free alternatives. Gluten-containing grains and their derivatives, such as wheat, barley, and wheat germ, should be avoided. Safe alternatives, such as corn, rice, quinoa, and Gluten-free oats, can be included in the diet.
A nurse is assessing a client who is postoperative and has an indwelling urinary catheter. Which of the following findings indicates that the client is experiencing dehydration?
A. BUN 15 mg/dL
BUN 15 mg/dL: Blood urea nitrogen (BUN) is a laboratory value that reflects the amount of urea nitrogen in the blood and can be used to assess kidney function and hydration status. A BUN level of 15 mg/dL falls within the normal range, indicating that the client's kidneys are adequately removing urea from the blood. However, it does not provide definitive information about hydration status on its own.
B. Blood pressure 150/82 mm Hg
Blood pressure 150/82 mm Hg: The blood pressure reading of 150/82 mm Hg does not provide specific information about hydration status. It is important to consider the client's baseline blood pressure, medical history, and other factors when interpreting blood pressure readings.
C. Urine specific gravity 1.010
Urine specific gravity 1.010: A urine specific gravity of 1.010 falls within the normal range and does not indicate dehydration. It suggests that the concentration of solutes in the urine is within the expected range.
D. Urine output of 20 mL/hr
A urine output of 20 mL/hr is considered to be low and suggests decreased fluid intake or fluid loss. In a postoperative client with an indwelling urinary catheter, a low urine output may indicate dehydration, especially if the client is not receiving adequate fluids or experiencing excessive fluid loss.
Full Explanation
A urine output of 20 mL/hr is considered to be low and suggests decreased fluid intake or fluid loss. In a postoperative client with an indwelling urinary catheter, a low urine output may indicate dehydration, especially if the client is not receiving adequate fluids or experiencing excessive fluid loss.
BUN 15 mg/dL: Blood urea nitrogen (BUN) is a laboratory value that reflects the amount of urea nitrogen in the blood and can be used to assess kidney function and hydration status. A BUN level of 15 mg/dL falls within the normal range, indicating that the client's kidneys are adequately removing urea from the blood. However, it does not provide definitive information about hydration status on its own.
Blood pressure 150/82 mm Hg: The blood pressure reading of 150/82 mm Hg does not provide specific information about hydration status. It is important to consider the client's baseline blood pressure, medical history, and other factors when interpreting blood pressure readings.
Urine specific gravity 1.010: A urine specific gravity of 1.010 falls within the normal range and does not indicate dehydration. It suggests that the concentration of solutes in the urine is within the expected range.
A nurse is caring for a client who reports manifestations of gastroesophageal reflux disease (GERD). Which of the following client statements should the nurse identify as a contributing factor to GERD?
A. "I like to drink a glass of warm milk before bed to help me sleep."
The nurse should identify the statement "I like to drink a glass of warm milk before bed to help me sleep" as a contributing factor to gastroesophageal reflux disease (GERD). Consuming a glass of warm milk before bed can worsen GERD symptoms due to its high-fat content. High-fat foods, including dairy products, can relax the lower esophageal sphincter (LES) and delay gastric emptying, allowing stomach acid to flow back into the esophagus, leading to symptoms of GERD.
B. "I try to follow a low-fat, high-protein diet to help me maintain my weight."
"I try to follow a low-fat, high-protein diet to help me maintain my weight": Following a low-fat, high-protein diet is actually beneficial for managing GERD. High-fat foods can worsen GERD symptoms by relaxing the LES and delaying gastric emptying, while a low-fat diet can help reduce symptoms.
C. "I stopped drinking caffeinated beverages several weeks ago."
"I stopped drinking caffeinated beverages several weeks ago": Avoiding caffeinated beverages is a positive step in managing GERD. Caffeine can stimulate acid production in the stomach and relax the LES, contributing to GERD symptoms.
D. "I have recently stopped drinking alcohol."
"I have recently stopped drinking alcohol": Stopping alcohol consumption is also beneficial for managing GERD. Alcohol can relax the LES and increase acid production in the stomach, leading to GERD symptoms.
Full Explanation
The nurse should identify the statement "I like to drink a glass of warm milk before bed to help me sleep" as a contributing factor to gastroesophageal reflux disease (GERD). Consuming a glass of warm milk before bed can worsen GERD symptoms due to its high-fat content. High-fat foods, including dairy products, can relax the lower esophageal sphincter (LES) and delay gastric emptying, allowing stomach acid to flow back into the esophagus, leading to symptoms of GERD.
"I try to follow a low-fat, high-protein diet to help me maintain my weight": Following a low-fat, high-protein diet is actually beneficial for managing GERD. High-fat foods can worsen GERD symptoms by relaxing the LES and delaying gastric emptying, while a low-fat diet can help reduce symptoms.
"I stopped drinking caffeinated beverages several weeks ago": Avoiding caffeinated beverages is a positive step in managing GERD. Caffeine can stimulate acid production in the stomach and relax the LES, contributing to GERD symptoms.
"I have recently stopped drinking alcohol": Stopping alcohol consumption is also beneficial for managing GERD. Alcohol can relax the LES and increase acid production in the stomach, leading to GERD symptoms.
