After diagnosis and initial treatment of a pre-school age child with cystic fibrosis, the nurse provides home care instructions to the parents. Which statement by the child's parents indicates that understanding of the home care treatment to promote pulmonary function?

"Chest physiotherapy should be performed twice a day before a meal.”

"Administer a cough suppressant every 8 hours."

"Energy should be conserved by scheduling minimally strenuous activities."

"Maintain supplemental oxygen at 4 to 6 L/minute."

Answer and Explanation

The Correct Answer is A

Rationale:
A. "Chest physiotherapy should be performed twice a day before a meal.” Chest physiotherapy helps clear mucus from the lungs and is most effective when done before meals to prevent vomiting and optimize lung function and oxygenation.

B. "Administer a cough suppressant every 8 hours." Cough suppressants are generally avoided in cystic fibrosis because coughing is necessary to mobilize and expel thick secretions from the airways.

C. "Energy should be conserved by scheduling minimally strenuous activities." Physical activity is encouraged to enhance lung expansion and mucus clearance. Energy conservation is not the priority unless the child is acutely ill.

D. "Maintain supplemental oxygen at 4 to 6 L/minute." High-flow oxygen is not routinely used and may suppress respiratory drive. Oxygen is used with caution and only as prescribed in advanced disease or during exacerbations.

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Correct Answer is A

Explanation

Rationale:

A. The client's need for pain medication should be determined: Ensuring comfort is the top priority in end-of-life care, especially for a client with a DNR order. Assessing and managing pain helps uphold dignity and minimize suffering during the dying process.

B. The impending signs of death should be documented: Documentation is essential for maintaining accurate medical records, but it is not the first priority. Ensuring the client is comfortable and free from pain takes precedence over recording observations.

C. The client's status should be conveyed to the chaplain: Spiritual support is important, but it should follow after the client’s physical needs—especially pain relief—are addressed. Involving the chaplain is helpful but not the most urgent intervention in this context.

D. The nurse manager should be updated on the client's status: Informing leadership may be necessary for planning purposes, but it does not directly benefit the client’s care in the moment. Addressing physical symptoms must come before administrative communication.

A. Red edematous stomal appearance. B. Stomal output of 40 mL in last hour. C. Liquid brown drainage from stoma. D. Mucous strings floating in the drainage.

Correct Answer is C

Explanation

Rationale:
A. Red edematous stomal appearance: A bright red, moist, and mildly edematous stoma is expected in the immediate postoperative period. These features indicate healthy perfusion and normal healing after surgery.

B. Stomal output of 40 mL in last hour: This is a normal output volume for a ureteroileostomy. Urine flows continuously in small amounts, and 30–60 mL per hour is considered within normal limits for adequate renal function.

C. Liquid brown drainage from stoma: Brown liquid drainage suggests fecal contamination or leakage from the bowel, which is abnormal in a urinary diversion and may indicate a serious complication such as bowel injury or fistula formation. This requires urgent evaluation.

D. Mucous strings floating in the drainage: Mucus production from the ileal segment is expected because intestinal mucosa continues to secrete mucus even after being repurposed as a urinary conduit. This finding is not concerning.

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After diagnosis and initial treatment of a pre-school age child with cystic fibrosis, the nurse provides home care instructions to the parents. Which statement by the child's parents indicates that understanding of the home care treatment to promote pulmonary function?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a prescription for "do not resuscitate" (DNR) begins to manifest signs of impending death. After notifying the family of the client's status, which priority action should the nurse implement?

Correct Answer is A

Explanation

A client with bladder cancer had surgical placement of a ureteroileostomy (ileal conduit) yesterday. Which postoperative assessment finding should the nurse report to the healthcare provider immediately?

Correct Answer is C

Explanation

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