A nurse is caring for a child who has cystic fibrosis and is taking dornase alfa. Which of the following actions should the nurse take to evaluate the effectiveness of the medication?

Determine the child's heart rate.

Weigh the child daily.

Auscultate the child's breath sounds.

Monitor the child's 180.

Answer and Explanation

The Correct Answer is C

Choice A reason:

Determining the child's heart rate is important for assessing overall cardiovascular health, but it is not specific to evaluating the effectiveness of dornase alfa.

Choice B reason:

Weighing the child daily is important for monitoring overall nutritional status and fluid balance, but it is not specific to evaluating the effectiveness of dornase alfa.

Choice C reason:

Dornase alfa is a medication used to help clear mucus from the airways in individuals with cystic fibrosis. Therefore, auscultating the child's breath sounds for improved air exchange and reduced adventitious lung sounds is a direct way to evaluate the effectiveness of the medication.

Choice D reason:

Monitoring the child's 180 (assuming this is a typo and referring to heart rate) is important, but it is not specific to evaluating the effectiveness of dornase alfa.

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Correct Answer is C

Explanation

Choice A reason:

Reducing fiber intake is not necessary for a client in skeletal traction. Maintaining a balanced diet, including fiber, is important for overall health.

Choice B reason:

The nurse should not lift the traction weights off the floor. The weights must hang freely to provide the necessary traction.

Choice C reason:

Performing passive range-of-motion exercises helps prevent stiffness and muscle atrophy in the affected extremity. This is an important nursing intervention for a client in skeletal traction.

Choice D reason:

Applying protective padding to the pin sites is essential to prevent pressure and irritation. However, this action alone does not address the need for range-of-motion exercises.

A. "You should not have anything to eat 4 hours prior to the procedure." B. "You should wash your hair prior to the procedure." C. "You will be given a mild sedative prior to the procedure." D. You should have a full bladder during the procedure."

Correct Answer is B

Explanation

Choice A reason:

Fasting is not typically required for an EEG, so this instruction is not necessary.

Choice B reason:

Washing the hair is important before an EEG, as it helps to remove any oils or substances that might interfere with the electrodes' ability to record brain activity.

Choice C reason:

A mild sedative is not a standard part of an EEG procedure.

Choice D reason:

Having a full bladder is not necessary for an EEG.

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A nurse is caring for a child who has cystic fibrosis and is taking dornase alfa. Which of the following actions should the nurse take to evaluate the effectiveness of the medication?

Nursing Test Bank

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A nurse is caring for a child who has cystic fibrosis and is taking dornase alfa. Which of the following actions should the nurse take to evaluate the effectiveness of the medication?