A nurse is teaching the parents of a 5-year-old child admitted to the pediatric unit with cystic fibrosis.
Which teaching statement concerning steatorrheaic stools is most accurate?
They are black and tarry.
They are frothy, foul-smelling, and fatty.
They are clay-colored.
They are orange or green.
The Correct Answer is B
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Antitubercular medications are not typically taken for the rest of a client's life. The standard treatment duration for active pulmonary tuberculosis is a multi-drug regimen lasting typically 6 to 9 months. Prolonged unnecessary use can lead to increased side effects and antibiotic resistance without additional therapeutic benefit.
Choice B rationale
The Mantoux test, or tuberculin skin test, indicates exposure to Mycobacterium tuberculosis but does not confirm active disease or determine treatment effectiveness. A positive Mantoux test can persist for life even after successful treatment. Treatment efficacy is primarily monitored through symptom resolution and sputum smear/culture negativity.
Choice C rationale
A typical course of antitubercular treatment involves a multi-drug regimen administered consistently for 6 to 9 months. This prolonged duration is critical to eradicate the slow-growing Mycobacterium tuberculosis and prevent the development of drug resistance, ensuring complete cure and minimizing relapse. Inconsistent or premature cessation of therapy can lead to treatment failure and resistance.
Choice D rationale
Not all family members of a client with pulmonary tuberculosis will need to take medications. Prophylactic treatment (latent TB infection therapy) is typically recommended for close contacts, especially children and immunocompromised individuals, after they have been evaluated for latent TB infection (positive tuberculin skin test or interferon-gamma release assay) to prevent progression to active disease.
Correct Answer is A
Explanation
Choice A rationale
A sputum culture for acid-fast bacillus (AFB) is considered the gold standard for confirming the diagnosis of active pulmonary tuberculosis. This test directly identifies the presence of Mycobacterium tuberculosis in respiratory secretions, providing definitive evidence of infection and allowing for drug susceptibility testing, which is crucial for guiding treatment.
Choice B rationale
A chest X-ray can show abnormalities suggestive of pulmonary tuberculosis, such as infiltrates, cavitations, or effusions, but it is not definitive. Other respiratory conditions can present similarly, and a chest X-ray alone cannot confirm the presence of active Mycobacterium tuberculosis. It serves as a supportive diagnostic tool.
Choice C rationale
A sputum smear for acid-fast bacilli provides rapid presumptive evidence of active tuberculosis by visualizing AFB under a microscope. While helpful for early detection and isolation precautions, it does not confirm the species of mycobacteria and has lower sensitivity than culture. A positive smear needs confirmation with culture.
Choice D rationale
The Mantoux test, or tuberculin skin test, indicates exposure to Mycobacterium tuberculosis and the development of a cell-mediated immune response. A positive test signifies either latent TB infection or active disease but cannot differentiate between the two. It does not confirm active pulmonary tuberculosis and is not reliable for confirming active disease.
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