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A nurse is teaching a client who has cystic fibrosis (CF). Which statement should the nurse include in this client's teaching?
- A. Take an antibiotic each day.
- B. Contact your provider to obtain genetic screening.
- C. Eat a well-balanced, nutritious diet.
- D. Perform daily respiratory therapy exercises.
Correct Answer: C
Rationale: Clients with CF often experience malnourishment due to vitamin deficiency and pancreatic malfunction. A well-balanced, nutritious diet is essential for maintaining health. Daily antibiotics are not typically required, genetic screening is not relevant for management, and while respiratory therapy is important, it is not listed as an option.
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A nurse is teaching a client with cystic fibrosis (CF). Which statements should the nurse include in this client's teaching? (Select all that apply.)
- A. Drink fluids with meals to stay hydrated.
- B. Rest before meals to conserve energy.
- C. Eat six small meals a day.
- D. Eat high-fiber foods to promote gastric emptying.
- E. Increase carbohydrate intake for energy.
Correct Answer: A,B,C
Rationale: Fluids should be avoided with meals to prevent bloating, resting before meals conserves energy, and six small meals reduce bloating. High-fiber foods can cause gas, worsening shortness of breath, and excessive carbohydrates increase carbon dioxide production, risking acidosis.
A nurse cares for a client who is prescribed an intravenous prostacyclin agent. Which actions should the nurse take? (Select all that apply.)
- A. Keep an intravenous line dedicated strictly to the infusion.
- B. Teach the client that this medication increases pulmonary pressures.
- C. Ensure that there is always a backup drug cassette available.
- D. Start a large-bore peripheral intravenous line.
- E. Use strict aseptic technique when using the drug delivery system.
Correct Answer: A,C,E
Rationale: Prostacyclin should be administered via a dedicated central venous catheter with strict aseptic technique to prevent infection. A backup cassette is essential due to risks of interruption. The medication decreases pulmonary pressures, and a central line, not peripheral, is used.
The nurse is caring for a client with lung cancer who states, 'I don't want any pain medication because I am afraid to become addicted.' How should the nurse respond?
- A. I will ask the provider to change your medication to a drug that is less potent.
- B. I will ask the provider to prescribe a non-opioid analgesic.
- C. It is unlikely you will become addicted when taking medicine for pain.
- D. I will discuss alternative pain relief methods like acupuncture.
Correct Answer: C
Rationale: The risk of addiction is low when pain medications are used appropriately for pain management in clients with cancer. Changing to a less potent drug or non-opioid may not adequately address pain. Alternative methods like acupuncture may be considered but are not the priority response.
A nurse cares for a client who has a chest tube. When would this client be at highest risk for developing a pneumothorax?
- A. When the tube drainage increases and warms to the touch.
- B. When the tube drainage decreases and becomes sanguineous.
- C. When the client experiences pain at the insertion site.
- D. When the tube becomes disconnected from the drainage system.
Correct Answer: D
Rationale: A disconnected chest tube allows air to enter the pleural space due to negative intrathoracic pressure, causing a pneumothorax. Warm drainage, sanguineous drainage, or pain at the insertion site do not directly increase pneumothorax risk.
A pulmonary nurse cares for clients who have chronic obstructive pulmonary disease (COPD). Which client should the nurse assess first?
- A. A 46-year-old with a 30-year history of smoking.
- B. A 52-year-old in a tripod position using accessory muscles to breathe.
- C. A 50-year-old with dependent edema and clubbed fingers.
- D. A 74-year-old with a chronic cough and thick, tenacious secretions.
Correct Answer: B
Rationale: A client in a tripod position using accessory muscles is in acute respiratory distress and requires immediate assessment to prevent respiratory failure. The other clients' symptoms, while concerning, do not indicate immediate distress.