An older adult is brought to the emergency department by a family member, who reports a moderate change in mental status and mild cough.

The client is afebrile.

The primary healthcare provider orders a chest x-ray.

The family member asks why this is needed since the symptoms seem so vague.

What response by the nurse is best?

Choice A rationale

Cystic fibrosis primarily affects exocrine glands, leading to thick, viscous secretions that obstruct the pancreatic ducts. This obstruction prevents the release of pancreatic enzymes (e.g., lipase, amylase, protease) into the small intestine, impairing the digestion of fats, carbohydrates, and proteins, thus requiring exogenous enzyme supplementation.

Choice B rationale

Water-soluble minerals like sodium, potassium, and chloride are generally absorbed through active transport or diffusion in the intestines. While fluid and electrolyte imbalances can occur in CF, the primary digestive issue is enzyme deficiency, not a direct lack of water-soluble mineral absorption, although some may be affected indirectly.

Choice C rationale

Fat-soluble vitamins (A, D, E, K) require pancreatic lipase for their absorption, as they are dissolved in dietary fats. Due to the impaired fat digestion in CF, malabsorption of these vitamins is common, necessitating supplementation, but the fundamental issue addressed by enzymes is overall nutrient digestion, not just vitamins.

Choice D rationale

Salt supplements are often required in cystic fibrosis due to excessive sodium and chloride loss in sweat, particularly during hot weather or exercise. However, salt supplements do not directly facilitate the digestion and absorption of macronutrients; their role is to maintain electrolyte balance and prevent dehydration.

Choice A rationale

Long-acting beta agonists (LABAs) are not rescue medications and should not be carried for immediate use during an asthma attack. Their onset of action is too slow to provide rapid relief, and their use for acute symptoms could mask worsening asthma, delaying appropriate treatment with a short-acting beta agonist.

Choice B rationale

LABAs are designed for maintenance therapy to prevent asthma symptoms over an extended period. Taking them only when an asthma attack begins is an inappropriate use, as they are not meant for acute symptom relief and will not provide immediate bronchodilation required during an exacerbation.

Choice C rationale

LABAs are prescribed as a daily maintenance medication to provide sustained bronchodilation and help prevent acute asthma attacks. Consistent daily use, typically in the morning, helps to control airway inflammation and reactivity, reducing the frequency and severity of future exacerbations by maintaining open airways.

Choice D rationale

Weaning off LABA medication should only be done under the direct supervision of a healthcare provider. Abrupt discontinuation can lead to a rebound in asthma symptoms. The decision to discontinue or adjust medication is based on a comprehensive assessment of asthma control and lung function, not just symptom absence.