A nurse is assisting in the care of a child in the pediatrician's office.

Exhibits
Which of the following symptoms is the child at risk of developing?

bone marrow failure

hypernatremia

malabsorption

chronic respiratory infections

excessive weight gain

Answer and Explanation

Correct Answer : C,D

Rationale:

• Chronic respiratory infections: A positive sweat chloride test confirms cystic fibrosis, a condition characterized by thick mucus that obstructs airways, leading to persistent cough, wheezing, and a high risk of recurrent lung infections due to impaired mucus clearance.

• Malabsorption: Cystic fibrosis affects the pancreas by blocking enzyme flow needed for digestion. This results in poor nutrient absorption, causing symptoms like excessive hunger, weight loss despite eating well, and abdominal distension, all of which are evident in this child.

• Bone marrow failure: There are no signs of pancytopenia, anemia, or infection susceptibility that would suggest bone marrow dysfunction. Cystic fibrosis does not typically impact hematopoietic function directly.

• Hypernatremia: Although cystic fibrosis can lead to salt imbalances due to abnormal chloride transport, hypernatremia is not commonly a presenting concern unless there's severe dehydration, which is not evident here.

• Excessive weight gain: The child is losing weight despite increased appetite. Malabsorption from pancreatic insufficiency prevents weight gain in cystic fibrosis, making excessive weight gain an unlikely risk.

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Correct Answer is A

Explanation

Rationale:

A. "You should have a sputum examination every 4 weeks.": Monthly sputum samples are necessary to monitor treatment effectiveness and determine when the client is no longer infectious. Clients typically need three consecutive negative sputum cultures to be considered non-contagious.

B. "You should obtain a chest x-ray every 3 months.": Chest x-rays are not routinely used for frequent follow-up during treatment. They may be used at diagnosis or treatment completion, but monthly sputum cultures are more reliable for monitoring active infection.

C. "You should schedule a tuberculin skin test every 6 months.": A tuberculin skin test is not useful for clients with active TB or for monitoring treatment response. Once a person has tested positive, repeat testing is not recommended due to persistent reactivity.

D. "You should stop taking your antituberculin medication after 2 weeks.": TB treatment requires a prolonged course typically 6 to 12 months. Stopping medication after 2 weeks increases the risk of treatment failure, relapse, and drug resistance, even if symptoms improve.

A. Don sterile gloves prior to the procedure. B. Hold the finger in an upright position prior to the procedure. C. Use the lateral tip of the finger to obtain specimen. D. Discard the lancet in the trash container.

Correct Answer is C

Explanation

Rationale:

A. Don sterile gloves prior to the procedure: Clean gloves, not sterile gloves, are required for a capillary blood glucose test since it is a clean, not sterile, procedure. Sterile technique is unnecessary and not cost-effective for this type of routine testing.

B. Hold the finger in an upright position prior to the procedure: The finger should be held in a dependent (downward) position to promote blood flow to the puncture site. Holding it upright may reduce perfusion and make obtaining an adequate sample more difficult.

C. Use the lateral tip of the finger to obtain specimen: The lateral sides of the fingertip have fewer nerve endings than the center and are more vascular, making them ideal for obtaining an adequate blood sample with minimal discomfort to the client.

D. Discard the lancet in the trash container: Lancets are sharp instruments and must be discarded in an approved sharps container to prevent needle-stick injuries and ensure proper infection control. Disposing of them in regular trash poses a safety hazard.

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A nurse is assisting in the care of a child in the pediatrician's office. Exhibits Which of the following symptoms is the child at risk of developing?

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A nurse is assisting in the care of a child in the pediatrician's office.

Exhibits
Which of the following symptoms is the child at risk of developing?