A patient with cystic fibrosis has blood glucose levels that are consistently between 180 to 250 mg/dL. Which action will the nurse expect to implement?

Teach the patient about administration of insulin.

Give oral hypoglycemic medications before meals.

Discuss the role of diet in blood glucose control.

Evaluate the patient’s use of pancreatic enzymes.

Answer and Explanation

The Correct Answer is A

Choice A reason: CF-related diabetes (CFRD) from pancreatic damage requires insulin, as glucose of 180-250 mg/dL indicates insulin deficiency. Teaching administration addresses this directly, aligning with standard CFRD management for glycemic control.

Choice B reason: Oral hypoglycemics aren’t effective in CFRD, which stems from insulin lack, not resistance. Glucose levels of 180-250 mg/dL need insulin, making this inappropriate for CF’s unique endocrine pathology.

Choice C reason: Diet impacts glucose, but CFRD requires insulin first, not just dietary control. Levels of 180-250 mg/dL exceed dietary management alone, so this is secondary to initiating insulin therapy in CF.

Choice D reason: Pancreatic enzymes aid digestion in CF, not glucose control directly. Evaluating use is routine, but hyperglycemia of 180-250 mg/dL points to CFRD, necessitating insulin over enzyme adjustment.

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Correct Answer is ["A","B","C","E"]

Explanation

Choice A reason: Mild left ventricular hypertrophy indicates cardiac strain from chronic hypertension, increasing risk for heart failure or infarction. It reflects structural change, elevating cardiovascular morbidity as pressure overload progresses, a known precursor to serious events.

Choice B reason: Total cholesterol of 210 mg/dL exceeds optimal (<200 mg/dL), promoting atherosclerosis. Lipid plaques narrow arteries, raising risks for coronary artery disease and stroke, a well-established cardiovascular risk factor needing intervention.

Choice C reason: Hemoglobin A1C of 7.5% shows poor glycemic control (>6.5% is diabetes), damaging vessels via glycation. This accelerates atherosclerosis and microvascular complications, significantly increasing cardiovascular event risk in uncontrolled diabetes.

Choice D reason: Sodium of 138 mEq/L is normal (135-145 mEq/L), not impacting cardiovascular risk directly. It influences fluid balance, but this value doesn’t suggest hypertension or heart strain, making it irrelevant here.

Choice E reason: Creatinine of 1.6 mg/dL (>1.2 mg/dL) signals renal impairment, often from hypertension or diabetes. Kidney dysfunction raises cardiovascular risk by disrupting fluid and pressure regulation, contributing to heart disease progression.

Choice F reason: Oxygen saturation of 95% on room air is normal (95-100%), indicating adequate lung function. It doesn’t suggest hypoxia or cardiovascular compromise, so it’s not a risk factor in this context.

A. Respiratory rate decreases to 18 breaths per minute. B. Oxygen saturation increases to 90% on 2 L oxygen via nasal cannula. C. Increased use of accessory muscles for breathing. D. Productive cough with yellowish sputum.

Correct Answer is C

Explanation

Choice A reason: Respiratory rate dropping to 18 breaths/min may suggest improvement or fatigue, not worsening, in respiratory status. Normal range (12-20) makes this less alarming than signs of increased breathing effort.

Choice B reason: Oxygen saturation rising to 90% on 2 L indicates better oxygenation, not worsening. It reflects treatment response, improving gas exchange, so this finding contradicts a decline in respiratory status.

Choice C reason: Increased accessory muscle use signals worsening respiratory distress, as it compensates for airway resistance or fatigue. It reflects higher work of breathing, a critical sign of decompensation needing intervention.

Choice D reason: Productive cough with yellowish sputum suggests infection, not immediate worsening of respiratory mechanics. It’s a chronic sign, less urgent than accessory muscle use indicating acute respiratory effort escalation.

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A patient with cystic fibrosis has blood glucose levels that are consistently between 180 to 250 mg/dL. Which action will the nurse expect to implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","B","C","E"]

Explanation

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Correct Answer is C

Explanation

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