What will the nurse teach the child with cystic fibrosis to take in order to facilitate digestion and absorption of nutrients?
Pancreatic enzymes.
Water-soluble minerals.
Fat-soluble vitamins.
Salt supplements.
The Correct Answer is A
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While nutrition is important, Meals on Wheels primarily addresses food insecurity and nutritional support for homebound individuals. For tuberculosis, the most critical long-term need is adherence to a complex medication regimen, which is not directly addressed by meal delivery services.
Choice B rationale
Occupational therapy focuses on helping individuals return to work or daily activities, and while long-term illness can impact this, it's not the immediate priority for ensuring effective treatment and preventing drug resistance in tuberculosis management.
Choice C rationale
Physical therapy is concerned with mobility and physical function. While a client with a chronic illness might experience deconditioning, it is not the primary or most critical referral for successful long-term tuberculosis therapy, which heavily relies on medication adherence.
Choice D rationale
Directly observed therapy (DOT) by visiting nurses is crucial for ensuring medication adherence in tuberculosis treatment. This strategy significantly improves treatment completion rates, reduces the development of drug-resistant strains, and prevents further transmission by directly observing clients taking their medications, which is vital for a successful outcome.
Correct Answer is A
Explanation
Choice A rationale
Taking bronchodilators after meals can reduce their effectiveness in bronchodilation during digestion, as blood flow is shunted to the gastrointestinal tract. Optimal bronchodilation is crucial before meals to improve breathing, reduce dyspnea, and enhance food intake. This timing ensures maximum therapeutic effect of the medication when respiratory demand might increase due to the physiological process of eating.
Choice B rationale
Eating five or six small meals daily helps reduce the volume of food in the stomach at any one time, minimizing pressure on the diaphragm. This prevents diaphragmatic splinting and allows for better lung expansion, reducing the feeling of fullness and breathlessness that can occur with large meals in individuals with chronic obstructive pulmonary disease.
Choice C rationale
Resting for at least 30 minutes before eating conserves energy and reduces oxygen demand, which is vital for clients with chronic obstructive pulmonary disease. Fatigue can exacerbate dyspnea, making it difficult to consume adequate nutrition. This rest period allows the respiratory muscles to recover, making the act of eating less strenuous.
Choice D rationale
Choosing foods that are not gas-forming helps prevent abdominal distension. A distended abdomen can elevate the diaphragm, restricting lung expansion and increasing respiratory effort. Avoiding gas-producing foods reduces intra-abdominal pressure, thereby facilitating more comfortable breathing during and after meals for individuals with chronic obstructive pulmonary disease.
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