A nurse is reinforcing teaching about diagnostic tests with the parents of a child who has suspected cystic fibrosis. Which of the following diagnostic tests should the nurse include as the most definitive when diagnosing cystic fibrosis?

Pulmonary function test

Sweat chloride test

Stool fat content analysis

Sputum culture

Answer and Explanation

The Correct Answer is B

A. Pulmonary function test:

Pulmonary function tests (PFTs) assess lung function by measuring airflow, lung volume, and gas exchange. While PFTs can provide valuable information about respiratory function, they are not specific to cystic fibrosis and may show abnormalities consistent with various respiratory conditions. However, PFTs are often performed in individuals with cystic fibrosis to monitor lung function over time and assess response to treatment. They are not considered the most definitive test for diagnosing cystic fibrosis.

B. Sweat chloride test:

This option is correct. The sweat chloride test is considered the most definitive diagnostic test for cystic fibrosis. It measures the concentration of chloride in sweat, which is typically elevated in individuals with cystic fibrosis due to defective chloride transport in sweat glands. A sweat chloride concentration above a certain threshold (usually ≥60 mmol/L) is diagnostic of cystic fibrosis, particularly when confirmed with repeat testing.

C. Stool fat content analysis:

Stool fat content analysis evaluates fat absorption and fecal fat excretion, which may be impaired in individuals with cystic fibrosis due to pancreatic insufficiency. However, while stool fat content analysis can provide supportive evidence of malabsorption in cystic fibrosis, it is not considered the most definitive test for diagnosing the condition. Stool fat content analysis is often used in conjunction with other diagnostic tests to assess pancreatic function and nutritional status in individuals with cystic fibrosis.

D. Sputum culture:

Sputum culture involves culturing respiratory secretions to identify bacterial pathogens, which can be useful for diagnosing respiratory infections in individuals with cystic fibrosis. However, sputum culture is not specific to cystic fibrosis and may show similar findings in other respiratory conditions. While respiratory cultures are important for guiding treatment in cystic fibrosis, they are not considered the most definitive test for diagnosing the condition.

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Correct Answer is ["C","D"]

Explanation

A. Keep the infant in a side-lying position.

This intervention is not appropriate following cleft palate repair surgery. Placing the infant in a side-lying position may increase the risk of trauma to the surgical site and disrupt the healing process. It's important to follow the surgeon's recommendations regarding positioning, which typically involves keeping the infant in an upright position to minimize strain on the surgical site.

B. Remove elbow restraints while the infant is sleeping.

Elbow restraints are often used postoperatively to prevent the infant from accidentally touching or rubbing the surgical site, which could disrupt wound healing or cause discomfort. Removing the restraints while the infant is sleeping may increase the risk of unintended movement or injury to the surgical site. Therefore, it is not appropriate to remove the restraints while the infant is sleeping.

C. Administer pain medication around the clock for the first 72 hours.

This intervention is appropriate. Pain management is an essential component of postoperative care following cleft palate repair surgery. Administering pain medication around the clock helps to maintain consistent pain relief and prevent spikes in discomfort. Pain management should be tailored to the individual needs of the infant and may include both non-pharmacological measures and analgesic medications.

D. Feed the infant half-strength formula for the first 48 hours.

This intervention is appropriate. Following cleft palate repair surgery, feeding may need to be adjusted to accommodate the infant's comfort and ensure adequate nutrition while minimizing the risk of aspiration. Feeding the infant half-strength formula or other appropriate feeding methods as recommended by the healthcare provider can help prevent stress on the surgical site and reduce the risk of complications such as aspiration pneumonia.

A. Lethargy B. Urine output 70 mL in 2 hr C. Lying flat on the unaffected side D. Respiratory rate 20/min

Correct Answer is A

Explanation

A. Lethargy: Lethargy can be a concerning sign in a postoperative child, especially following a procedure involving the central nervous system like VP shunt insertion. It could indicate increased intracranial pressure or other neurological complications, which require immediate attention. Therefore, this is a priority finding.

B. Urine output 70 mL in 2 hr: While monitoring urine output is important for assessing hydration and renal function, a urine output of 70 mL in 2 hours may not be immediately concerning in a 4-year-old child. However, if this pattern continues or if there are signs of dehydration, it should be addressed. It's not as urgent as assessing for neurological changes.

C. Lying flat on the unaffected side: The positioning of the child, lying flat on the unaffected side, may or may not be concerning depending on the specific instructions provided postoperatively. While positioning can affect the function of the VP shunt, it may not necessarily indicate an immediate complication.

D. Respiratory rate 20/min: A respiratory rate of 20 breaths per minute is within the normal range for a 4-year-old child. While changes in respiratory rate can indicate respiratory distress, this respiratory rate alone is not immediately concerning.

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A nurse is reinforcing teaching about diagnostic tests with the parents of a child who has suspected cystic fibrosis. Which of the following diagnostic tests should the nurse include as the most definitive when diagnosing cystic fibrosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["C","D"]

Explanation

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Correct Answer is A

Explanation

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