What is the pathophysiologic mechanism of cystic fibrosis leading to obstructive lung disease?

Correct Answer: C

Rationale: Cystic fibrosis (CF) is caused by mutations in the CFTR gene, leading to altered transport of sodium and chloride ions in and out of epithelial cells. This results in the production of secretions that are low in sodium chloride, leading to thickened mucus. The abnormally thick, abundant secretions from mucous glands in the respiratory tract can obstruct the airways, leading to chronic, diffuse obstructive pulmonary disease in almost all patients with CF. This process impairs mucociliary clearance, predisposing individuals to recurrent lung infections, inflammation, and ultimately bronchiectasis. This mechanism is a key factor in the pathophysiology of cystic fibrosis-associated obstructive lung disease.

Correct Answer: A

Rationale: Chemotherapy can cause fluid and electrolyte imbalances in the body, leading to potential kidney damage and altered urinary output. A low urine output of 400 ml in 8 hours could indicate dehydration or impaired renal function, both of which can be induced by chemotherapy. Monitoring urine output is crucial in assessing the patient's fluid balance and kidney function during chemotherapy. It is essential to identify and address such imbalances promptly to prevent complications.

Correct Answer: C

Rationale: Reducing evening fluids and using positive reinforcement (reward system) are effective and developmentally appropriate strategies.

Correct Answer: B

Rationale: Acute glomerulonephritis is commonly associated with a preceding streptococcal infection, particularly Group A beta-hemolytic streptococcal infection such as strep throat or impetigo. The infection triggers an abnormal immune response leading to inflammation of the glomeruli in the kidneys. This inflammation impairs the kidneys' ability to filter waste and excess fluids from the blood, resulting in symptoms such as hematuria (blood in urine), proteinuria (protein in urine), hypertension, and edema. Other causes such as renal vascular disorders, structural anomalies of the genitourinary tract, or urinary tract infections are not typically linked to acute glomerulonephritis.

Correct Answer: C

Rationale: When setting up supplies for a client who requires a blood transfusion, the appropriate nursing intervention is to prime the tubing of the blood administration set with 0.9% NS solution completely, filling the filter. This is essential to ensure that the blood components flow smoothly through the tubing and any potential air bubbles are removed in order to prevent air embolism and ensure the safety of the blood transfusion process. Option A is not correct because adding IV medication in the blood bag is not a standard practice and can compromise the integrity of the blood product. Option B is also incorrect as blood products should be stored and maintained at specific temperatures to prevent spoilage or contamination; leaving it at room temperature is not advised. Option D is unrelated to setting up supplies for a blood transfusion and addresses inadequate dietary intake, which is a different nursing concern than the preparation of blood transfusion supplies.