A nurse assesses a client with chronic obstructive pulmonary disease.
Which Questions would the nurse ask to determine the client's activity tolerance? (Select all that apply.)

Choice A rationale

Adherence to the prescribed treatment regimen is paramount for successful tuberculosis (TB) therapy due to the long duration of treatment and the risk of developing drug-resistant strains if medication is taken inconsistently. Scientific principles dictate that maintaining therapeutic drug levels continuously is essential to effectively kill Mycobacterium tuberculosis and prevent the emergence of mutations that confer resistance, ensuring complete eradication of the infection and preventing relapse.

Choice B rationale

While a well-balanced diet supports overall health and immune function, it is secondary to medication adherence in the acute management of tuberculosis. Nutritional support can aid recovery by replenishing energy stores and supporting the immune system, which is crucial for combating chronic infection. However, without consistent pharmacological intervention, dietary factors alone cannot eradicate the Mycobacterium tuberculosis bacilli or prevent disease progression.

Choice C rationale

Follow-up sputum cultures are vital for monitoring treatment effectiveness and confirming cure, but educating on adherence takes precedence. Sputum cultures are a diagnostic tool to assess bacterial load and viability, providing objective evidence of treatment success or failure. They guide decisions regarding treatment duration and drug susceptibility, but their value is contingent upon the client consistently taking their medication to achieve bacterial clearance in the first place.

Choice D rationale

Balancing rest with activity is important for managing fatigue and promoting recovery, but it is less critical than adherence to the medication regimen. Rest allows the body to conserve energy and focus resources on healing, reducing metabolic demands on the already stressed physiological systems during an active infection. Activity, when tolerated, can prevent deconditioning. However, neither directly targets the elimination of the causative organism like antimicrobial therapy.

Choice A rationale

Black and tarry stools (melena) typically indicate upper gastrointestinal bleeding, where digested blood causes the dark color. This is not a characteristic of steatorrhea, which is caused by the presence of undigested fat. Steatorrhea results from pancreatic enzyme insufficiency, a common feature of cystic fibrosis.

Choice B rationale

Steatorrheaic stools are classically described as frothy, foul-smelling, and fatty due to the malabsorption of fats. The lack of pancreatic lipase, a characteristic of cystic fibrosis, prevents proper fat digestion. This undigested fat is then excreted, leading to stools that are bulky, pale, and often float due to their high fat content.

Choice C rationale

Clay-colored stools are indicative of a lack of bile pigment, suggesting an obstruction of the bile ducts or liver dysfunction. While liver involvement can occur in cystic fibrosis, clay-colored stools are not the primary descriptor for steatorrhea resulting from pancreatic insufficiency.

Choice D rationale

Orange or green stools are not typical descriptions for steatorrhea. Orange stools can sometimes be due to certain medications or foods, while green stools can result from rapid transit through the digestive system, where bile has not had time to be fully broken down. Neither describes the characteristic appearance of fatty stools.