A nurse is assessing a child with coarctation of the aorta.

The nurse expects to find weaker pulses in the lower extremities compared to the upper extremities.

Choice A rationale

The sweat chloride test is the gold standard diagnostic test for cystic fibrosis (CF). CF is caused by a mutation in the CFTR gene, which impairs chloride ion transport across epithelial cells. This defect leads to abnormally high chloride concentration in sweat, typically >60 mEq/L in children, which provides biochemical confirmation of the disease.

Choice B rationale

Pulmonary function tests (PFTs) measure lung volumes and airflow, typically revealing an obstructive pattern in CF due to chronic infection and inflammation. While they monitor disease progression and severity, PFTs are not diagnostic for the underlying genetic disorder that defines cystic fibrosis.

Choice C rationale

A Chest X-ray (CXR) may show characteristic findings of chronic lung disease in CF, such as bronchiectasis, hyperinflation, or atelectasis, reflecting the disease's pulmonary complications. However, the CXR is an imaging tool for assessing lung structure, not a diagnostic test for the systemic genetic condition itself.

Choice D rationale

Sputum cultures are used to identify the specific bacterial pathogens, such as Pseudomonas aeruginosa or Staphylococcus aureus, colonizing the airways of CF patients. While essential for guiding antibiotic therapy, a sputum culture only detects secondary infection and does not confirm the diagnosis of cystic fibrosis.

Choice A rationale

Restricting fluids is generally contraindicated in meningitis unless there is documented syndrome of inappropriate antidiuretic hormone (SIADH) or severe, life-threatening cerebral edema. Maintaining adequate hydration is crucial to prevent dehydration and support systemic circulation, especially since fever can increase fluid loss.

Choice B rationale

Monitoring for signs of increased intracranial pressure (ICP) is paramount because meningeal inflammation can lead to cerebral edema and impaired CSF reabsorption. Signs like changes in level of consciousness, bradycardia, and hypertension (Cushing's triad) require immediate intervention to prevent brain herniation.

Choice C rationale

Administering acetaminophen (or ibuprofen) is appropriate for controlling the systemic symptoms of fever (pyrexia) and managing headache/body pain associated with meningeal irritation. Effective fever control reduces metabolic demands and can decrease the risk of febrile seizures.

Choice D rationale

Administering IV antibiotics immediately is the standard for bacterial meningitis to prevent morbidity and mortality, but viral meningitis is typically self-limiting and managed with supportive care; thus, empirical antibiotics are not indicated if the viral etiology is confirmed or highly suspected.

Choice E rationale

Encouraging rest and hydration is the cornerstone of supportive care for viral meningitis. Rest reduces cerebral metabolic demand and prevents overexertion, while hydration helps combat fluid losses from fever and vomiting and supports overall recovery.

Choice F rationale

Providing a quiet, dimly lit environment helps reduce noxious stimuli that can exacerbate common symptoms like headache and photophobia (light sensitivity), which are caused by meningeal inflammation and irritation of cranial nerves, thus promoting comfort and rest.