Question: A 4-year-old child with cystic fibrosis is admitted to the pediatric unit. The nurse understands that the primary goal of treatment is to prevent complications. Which of the following interventions is most important for the nurse to implement?
A. Encourage a high-fat diet.
B. Administer bronchodilators as ordered.
C. Provide genetic counseling.
D. Encourage participation in physical activities.
E. Perform chest physiotherapy regularly.
Rationale: Chest physiotherapy is a critical component in the management of cystic fibrosis as it helps to loosen and clear mucus from the lungs, preventing pulmonary complications. This intervention is more immediately vital to the patient’s well-being than dietary modifications, genetic counseling, or physical activities. While bronchodilators are important, they are part of a broader approach to airway clearance and not as directly impactful as chest physiotherapy.
Question: A nurse is teaching a family about the digestive complications associated with cystic fibrosis. Which statement by the family indicates an understanding of the teaching?
A. “We should limit fluid intake to prevent fluid overload.”
B. “Our child should consume a low-protein diet.”
C. “Pancreatic enzymes should be taken with each meal and snack.”
D. “It’s best to avoid high-fiber foods.”
E. “We’ll need to increase carbohydrate intake significantly.”
Rationale: Pancreatic enzyme replacement therapy is essential in managing cystic fibrosis as it helps with the digestion and absorption of nutrients, particularly fats and proteins, due to the pancreas’s inability to produce sufficient enzymes naturally. This understanding is crucial for maintaining nutritional status and preventing malnutrition. Fluids, proteins, and carbohydrates play a role in overall health, but the correct administration of pancreatic enzymes directly addresses the malabsorption issues characteristic of cystic fibrosis.
Question: During a home health visit, a nurse assesses a teenager with cystic fibrosis. The nurse notices the patient exhibiting signs of depression. Which of the following actions should the nurse take first?
A. Encourage more vigorous physical activity.
B. Discuss the importance of adhering to the treatment regimen.
C. Suggest increasing social activities with peers.
D. Refer the patient to a mental health professional.
E. Teach the patient relaxation techniques.
Rationale: While all the options might benefit the patient in various ways, addressing mental health by referring the patient to a mental health professional is the most immediate and appropriate action. Patients with cystic fibrosis may experience chronic stress, anxiety, and depression due to the demanding nature of the disease and its treatments. Early intervention by mental health professionals can provide the necessary support and treatment to improve the patient’s mental health and overall quality of life.
Question: A nurse is planning care for a child with cystic fibrosis. Which of the following goals is a priority?
A. Increase body weight to within normal range.
B. Eliminate all bacteria from the respiratory tract.
C. Prevent transmission of the disease to siblings.
D. Ensure 100% adherence to pulmonary rehabilitation.
E. Maintain patency of the airways.
Rationale: Maintaining airway patency is a critical goal in the management of cystic fibrosis, as the disease primarily affects the lungs and leads to thick, sticky mucus buildup. This goal is fundamental to preventing respiratory complications, facilitating breathing, and improving quality of life. While weight management, infection control, adherence to treatment, and prevention of disease transmission are important, ensuring airway patency directly impacts the patient’s immediate respiratory function and overall health.
Question: A nurse is discussing respiratory therapies with the parents of a child with cystic fibrosis. The nurse explains the benefits of hypertonic saline nebulization. Which of the following is a primary benefit of this therapy?
A. It eliminates the need for antibiotics.
B. It reduces the frequency of hospitalizations.
C. It improves oxygenation by thinning mucus.
D. It increases appetite and nutritional intake.
E. It serves as a substitute for chest physiotherapy.
Rationale: Hypertonic saline nebulization is a therapy used in cystic fibrosis management to hydrate the airway surface and thin the thick, sticky mucus characteristic of the condition. This action facilitates mucus clearance, improves lung function, and enhances oxygenation by allowing better air flow. While it does not eliminate the need for antibiotics, substitute for chest physiotherapy, directly increase appetite, or guarantee reduced hospitalizations, its role in improving mucus clearance directly impacts respiratory health and can contribute to better overall outcomes for patients with cystic fibrosis.
Question: A nurse is teaching a group of nursing students about the importance of high-calorie diets in patients with cystic fibrosis. Which of the following reasons best explains this dietary recommendation?
A. To promote rapid growth spurts.
B. To compensate for increased caloric expenditure due to chronic lung infections.
C. To enhance the effect of fat-soluble vitamins.
D. To prevent the development of diabetes mellitus.
E. To increase muscle mass and reduce fat content.
Rationale: Patients with cystic fibrosis often experience increased caloric expenditure due to the effort required to breathe and fight chronic lung infections. A high-calorie diet is recommended to meet these increased energy needs, support growth and development, maintain optimal nutritional status, and help prevent malnutrition. While promoting growth, enhancing vitamin absorption, managing diabetes, and altering body composition are relevant concerns, the primary rationale for a high-calorie diet is to compensate for the elevated energy expenditure.
Question: The parents of a child newly diagnosed with cystic fibrosis ask the nurse how they can best prevent pulmonary infections. Which of the following is the most effective strategy?
A. Administer prophylactic antibiotics continuously.
B. Ensure the child receives all recommended vaccines.
C. Isolate the child from others with respiratory infections.
D. Use air purifiers throughout the home.
E. Regularly perform hand hygiene and encourage it in the child.
Rationale: Regular hand hygiene is a fundamental and effective strategy for preventing the spread of infections, particularly in patients with cystic fibrosis who are at increased risk for pulmonary infections. While vaccines are important for preventing specific infections, isolation and air purifiers can help reduce exposure to pathogens, and prophylactic antibiotics might be used in certain circumstances, consistent hand hygiene is a universally applicable and critically important practice for infection control.
Question: A nurse is planning care for an adolescent with cystic fibrosis. The patient expresses frustration with the daily treatment regimen. Which of the following approaches should the nurse prioritize to support treatment adherence?
A. Recommend reducing the number of treatments to ease the burden.
B. Involve the patient in decision-making regarding treatment options.
C. Insist on strict adherence without deviation to ensure effectiveness.
D. Schedule treatments at times that interfere least with the patient’s social activities.
E. Provide detailed explanations of the consequences of non-adherence.
Rationale: Involving the patient in decision-making empowers them, fosters a sense of control, and can enhance adherence to the treatment regimen. Adolescents, in particular, benefit from being active participants in their care as it respects their growing independence and individual preferences. While it’s important to understand the consequences of non-adherence and to schedule treatments conveniently, actively engaging the patient in discussions about their care is more likely to result in a positive attitude towards treatment and better overall adherence.
Question: A nurse is evaluating a child with cystic fibrosis for potential complications. Which of the following symptoms would most urgently warrant further investigation for pulmonary hypertension?
A. Increased appetite
B. Frequent headaches
C. Clubbing of the fingers
D. Bright red blood in stool
E. Sudden weight gain
Rationale: Clubbing of the fingers, characterized by the broadening and thickening of the tips of the fingers or toes, is a sign of chronic hypoxia and can indicate the development of pulmonary hypertension, a serious complication in cystic fibrosis. While headaches could have various causes, blood in the stool may indicate gastrointestinal complications, and sudden weight gain could relate to nutritional issues, clubbing is a specific physical sign that warrants immediate attention to assess lung function and potential pulmonary complications.