NCLEX-RN practice question 20 of 35

In evaluating the laboratory results of a client with severe pressure ulcers, the nurse finds that her albumin level is low. A decrease in serum…

Choose your answer, then check it against the explanation.

Domain Physiological Adaptation

In evaluating the laboratory results of a client with severe pressure ulcers, the nurse finds that her albumin level is low. A decrease in serum albumin would contribute to the formation of pressure ulcers because:

Answer options

Correct Answer:

Explanation

Serum albumin is a primary protein in the blood plasma and a key indicator of nutritional status, specifically protein levels. Proteins are essential for all phases of wound healing, including cell migration, proliferation, and the synthesis of collagen, which provides structural integrity to tissues. A low serum albumin level (hypoalbuminemia) signifies a deficit in the protein required for maintaining skin integrity and repairing damaged tissue, thereby increasing the risk of pressure ulcer formation and impairing the healing of existing ulcers.

Why Incorrect

B. Low albumin is a marker of protein status, not a direct indicator of iron stores. While both can be low in general malnutrition, they are distinct nutritional deficiencies.

C. While severe kidney disease can cause low albumin, this option states a potential cause of the lab finding, not the mechanism by which it contributes to pressure ulcers.

D. This statement is physiologically incorrect. Low serum albumin decreases colloid osmotic pressure, causing fluid to shift from the blood vessels into the interstitial space, leading to edema, not dehydration.

References

1. Guo, S., & DiPietro, L. A. (2010). Factors affecting wound healing. Journal of dental research, 89(3), 219–229. (See section "Nutrition," paragraph 1, which details the critical role of proteins and amino acids in cell proliferation and collagen synthesis for wound repair). https://doi.org/10.1177/0022034509359125

2. Wisconsin Technical College System. (2021). Nursing Fundamentals. Open RN. (Chapter 13, "Skin Integrity and Wounds," section "Promoting Skin Integrity," subsection "Nutrition," paragraph 1). This text states, "Protein is the building block of cells, and a deficiency of protein can lead to impaired skin healing." It also identifies a serum albumin level less than 3.5 g/dL as a significant risk factor for pressure injury development.

3. Cox, J. (2019). Wound care 101. Nursing2019, 49(10), 32-39. (See section "Nutrition," p. 37). This article emphasizes that inadequate protein intake, often reflected by low albumin levels, leads to decreased collagen synthesis and impaired wound healing. https://doi.org/10.1097/01.NURSE.0000580628.58239.36

Question 20 of 35

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