Cystic fibrosis most often affects multiple systems of the body. The primary factor responsible for possible multiple clinical manifestations is which of the following?

Correct Answer: D

Rationale: Cystic fibrosis (CF) is an inherited genetic disorder caused by mutations in the CFTR gene, leading to the production of thick, sticky mucus. This increased viscosity affects various organs and systems in the body, causing multiple clinical manifestations. The abnormal secretions block the airways in the lungs, leading to recurrent lung infections, breathing difficulties, and ultimately respiratory failure. In the digestive system, the thick mucus blocks the pancreatic ducts, impairing the release of digestive enzymes, which can result in malabsorption and malnutrition. Additionally, the thick secretions can affect the liver, leading to complications like liver disease. Therefore, the primary factor responsible for the multiple clinical manifestations in cystic fibrosis is the increased viscosity of the mucous gland secretions, which impacts various systems in the body.

Correct Answer: A

Rationale: Congenital clubfoot is best treated when started immediately after diagnosis. Early intervention and treatment are crucial for better outcomes in correcting clubfoot deformities. Tendons and ligaments are more flexible in infants, making it easier to manipulate and correct the foot. Starting treatment as early as possible can help prevent long-term complications and improve the child's ability to walk normally. Therapy may involve stretching exercises, casting, or surgery, depending on the severity of the condition. Therefore, early intervention is key in the successful management of congenital clubfoot in infants.

Correct Answer: D

Rationale: Type I DM, also known as insulin-dependent diabetes mellitus, is characterized mainly by insulin deficiency. In this type of diabetes, the pancreas produces little to no insulin, which is essential for regulating blood glucose levels. Therefore, individuals with type I DM require lifelong insulin therapy to manage their condition. Unlike type II DM, which is associated with insulin resistance, type I DM is not preventable through lifestyle modifications like diet and exercise alone. It is crucial for the nurse to educate the family about the importance of insulin therapy, monitoring blood glucose levels, carbohydrate counting, and responding to hypoglycemic episodes in caring for their 7-year-old with type I DM.

Correct Answer: B

Rationale: Erythrocyte Sedimentation Rate (ESR) is a non-specific marker for inflammation and can be elevated in conditions like rheumatic fever. A decrease in ESR suggests a reduction in the inflammatory response in the body, indicating an improvement in the condition. While the other parameters (WBC count, ASOT, and hemoglobin level) may be affected in rheumatic fever, a decrease in ESR is a more direct indicator of improvement in the inflammatory process associated with the disease.

Correct Answer: C

Rationale: The diagnosis of congenital heart disease is most commonly done through an echocardiogram, which is a non-invasive test that uses sound waves to create images of the heart's structure and function. This imaging technique allows healthcare providers to visualize any abnormalities in the heart's structure and how it is functioning. While cardiac catheterization and chest x-ray with ECG can also provide valuable information, an echocardiogram is the primary diagnostic tool for identifying congenital heart defects due to its accuracy, safety, and non-invasiveness.