Nokea
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.
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A nurse assesses a client who is prescribed fluticasone (Flovent) and notes oral lesions. Which action should the nurse take?
- A. Encourage rinsing the mouth after fluticasone administration.
- B. Obtain an oral specimen for culture and sensitivity.
- C. Start the client on a broad-spectrum antibiotic.
- D. Document the finding as a known side effect.
Correct Answer: A
Rationale: Fluticasone reduces local immunity, increasing the risk of oral infections like Candida albicans. Rinsing the mouth after inhaler use decreases this risk. Obtaining a culture, starting antibiotics, or only documenting the finding do not address prevention or immediate management.
After teaching a client who is prescribed a long-acting beta2 agonist medication, a nurse assesses the client's understanding. Which statement indicates the client comprehends the teaching?
- A. I will carry this medication with me at all times in case I need it.
- B. I will take this medication when I start to experience an asthma attack.
- C. I will take this medication every morning to help prevent an acute attack.
- D. I will be weaned off this medication when I no longer need it.
Correct Answer: C
Rationale: Long-acting beta2 agonist medications are used to prevent asthma attacks due to their long-acting nature. The client should take this medication daily for best effect. It is not a rescue medication, so it does not need to be carried at all times or used during an attack. Clients are not typically weaned off this medication as it is likely a daily maintenance therapy.
A nurse cares for a female client who has a family history of cystic fibrosis. The client asks, 'Will my children have cystic fibrosis?' How should the nurse respond?
- A. Your children will have cystic fibrosis and will also be carriers of the gene.
- B. Cystic fibrosis is an autosomal recessive disorder. If you are a carrier, your children will have the disorder.
- C. Since you have a family history of cystic fibrosis, I would encourage you and your partner to be tested.
- D. Cystic fibrosis is caused by a protein that controls the movement of chloride. Adjusting your diet will decrease the spread of this disorder.
Correct Answer: C
Rationale: Cystic fibrosis is an autosomal recessive disorder, requiring both parents to be carriers for a child to have the disease. Testing the client and her partner is the most appropriate recommendation to assess risk. The other options are incorrect or irrelevant to the question.
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.
A nurse cares for a client who has developed esophagitis after undergoing radiation therapy for lung cancer. Which diet selection should the nurse provide for this client?
- A. Spaghetti with meat sauce, ice cream
- B. Grilled cheese sandwich with whole wheat bread
- C. Oatmeal with skim milk, custard
- D. Pasta salad, custard, orange juice
Correct Answer: C
Rationale: Side effects of radiation therapy may include esophagitis. Oatmeal with skim milk and custard are soft, non-irritating foods suitable for a client with esophagitis. Spaghetti with meat sauce may be too spicy, grilled cheese sandwiches are too difficult to swallow, and orange juice is too caustic due to its citric acid content.