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Chapter 16. Cystic Fibrosis

Student Questions

Airway clearance therapy in patients with cystic fibrosis (CF) should be performed by the patient or patient's caregiver:

A. Twice daily for maintenance therapy

B. At least three times per day during acute exacerbations

C. Twice daily for maintenance therapy and at least three times per day during acute exacerbations

D. Only under the direct supervision of a respiratory therapist

Answer: C

Option A: Incorrect. This answer does not address frequency changes in airway clearance therapy based on whether the patient is healthy or having an acute exacerbation.

Option B: Incorrect. This answer does not address frequency changes in airway clearance therapy based on whether the patient is healthy or having an acute exacerbation.

Option C: Correct. Airway clearance therapy is the cornerstone of maintenance therapy in CF, and frequency is increased in the setting of acute exacerbations.

Option D: Incorrect. Patients and/or caregivers perform airway clearance therapy independently in the home environment. Respiratory therapists supervise therapies while inpatient and provide education to patients and caregivers so therapies can be administered independently at home.

Dornase alfa is used in CF for which of the following reasons:

A. Chronic Pseudomonas aeruginosa suppression

B. Mucolytic activity

C. Sputum induction

D. Mucolytic activity and sputum induction

Answer: B

Option A: Incorrect. Dornase alfa is not an antibiotic.

Option B: Correct. Dornase alfa is a mucolytic therapy.

Option C: Incorrect. Hypertonic saline is another mucolytic agent that is also used for sputum induction.

Option D: Incorrect. Hypertonic saline is another mucolytic agent that is also used for sputum induction.

Patients with a history of anaphylactic reaction to piperacillin-tazobactam and cefepime can most safely be treated with which antibiotic?

A. Dicloxacillin

B. Meropenem

C. Loracarbef

D. Aztreonam

Answer: D

Option A: Incorrect. The patient has a life-threatening allergy to an agent in the penicillin drug classes and should avoid those agents.

Option B: Incorrect. Carbapenems may be tolerated with a low incidence of cross-reactivity with penicillin and cephalosporin drug classes; however, aztreonam has the lowest risk and would ...

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