As part of the treatment for congestive heart failure, the child takes the diuretic furosemide. As part of teaching home care, the nurse encourages the family to give the child foods such as bananas, oranges, and leafy vegetables. These foods are recommended because they are high in what electrolyte?

The correct answer is choice A: Administer pancreatic enzymes between meals if at all possible.

Choice A rationale:

Administer pancreatic enzymes between meals if at all possible. This is the correct choice. When educating the parents and child with cystic fibrosis about the administration of pancreatic enzymes, it's important to emphasize that these enzymes should be given between meals whenever feasible. Administering them between meals, when the stomach is less acidic and less likely to release the enzymes prematurely, ensures optimal digestion of food and absorption of nutrients. This approach aligns with the physiological need to supplement pancreatic enzyme function due to the inadequate natural enzyme production in cystic fibrosis.

Choice B rationale:

Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal. This choice is a valid option for administering pancreatic enzymes. While it's true that the enzymes can be taken either by swallowing the capsules whole or by opening them and sprinkling the contents on a small amount of food at the start of a meal, this method can vary based on individual preferences and abilities. However, the primary focus should be on timing (between meals) to achieve the best enzymatic action.

Choice C rationale:

Do not administer pancreatic enzymes if the child is receiving antibiotics. This statement is not accurate. There is no general contraindication to administering pancreatic enzymes while a child is on antibiotics. However, it's important for the healthcare provider to be aware of all the medications the child is taking to ensure there are no potential drug interactions or effects on absorption. Always consult with the healthcare team before adjusting the administration of any medication.

Choice D rationale:

Decrease the dose of pancreatic enzymes if the child is having frequent, bulky stools. This statement is not consistent with typical practice. If a child is experiencing frequent, bulky stools, it may actually indicate that the pancreatic enzyme dosage needs adjustment (increasing the dose rather than decreasing). Bulky stools can suggest poor digestion and absorption, which might require more enzymes to properly break down nutrients. Dosage adjustments should always be made under the guidance of the healthcare provider based on factors such as stool consistency, weight gain, and nutritional status.

The correct answer is choice C: Concrete operations stage.

Choice A rationale:

The preoperational stage, which occurs roughly between ages 2 and 7, is characterized by egocentrism, animism, and a lack of conservation. Children in this stage struggle with understanding that quantities can remain the same even if their appearance changes. For instance, they might think that pouring water from a tall glass into a short, wide glass somehow changes the amount of water. This stage does not demonstrate the mental understanding required for the examples given in the question.

Choice B rationale:

The intuitive thought stage, which typically spans from ages 4 to 7, is marked by increased symbolic thinking but still lacks the capacity for logical and systematic reasoning. Children in this stage might be able to count and perform basic arithmetic, but they struggle with more complex operations and understanding the underlying principles of mathematical operations. This stage is not where the ability to understand the given math operations is firmly established.

Choice C rationale:

The concrete operations stage, which encompasses ages 7 to 11, is characterized by the development of logical and systematic thinking. Children in this stage are capable of understanding basic mathematical principles and operations, such as conservation of quantity and simple arithmetic. They can mentally manipulate numbers and understand that reversing an operation will yield the original quantity. Therefore, this stage is when the ability to understand that 1 + 3 = 4 and 4 - 3 = 1 occurs.

Choice D rationale:

The formal operations stage, typically beginning around age 11, is characterized by abstract and hypothetical thinking. This is when adolescents and adults can engage in complex reasoning and consider multiple possibilities and outcomes. The given math operations are not the focus of this stage; rather, it pertains to more advanced cognitive abilities like hypothetical problem-solving and deductive reasoning.