COMPREHENSIVE PROFESSIONAL NURSING
EXAMINATION
Pediatric Nursing: Cystic Fibrosis, Pancreatic Enzyme Replacement
Therapy, and Multidisciplinary Clinical Management
200 Rigorous Clinical Questions with Comprehensive Rationales
Question 1: A nurse is providing discharge instructions to the
parents of a school-age child who has a new diagnosis of cystic
fibrosis. Which of the following enzyme replacement instructions
should the nurse include?
A. Administer enzymes 2 hours after meals
B. Give prescribed pancrelipase capsules with all meals and
snacks
C. Crush enteric-coated tablets before feeding
D. Mix enzymes with boiling water or formula
Correct Answer: B. Rationale: Pancreatic enzymes must be taken
with all meals and snacks to assist in digesting fats, proteins, and
carbohydrates.
Question 2: A parent asks why their child with cystic fibrosis must
take pancrelipase capsules. The nurse explains that this medication:
A. Replaces missing pancreatic enzymes to aid digestion
, B. Reduces airway inflammation and bronchospasm
C. Stimulates insulin production by islets of Langerhans
D. Prevents pulmonary bacterial infections
Correct Answer: A. Rationale: Pancrelipase replaces exocrine
pancreatic enzymes (lipase, protease, amylase) blocked by viscous
mucus.
Question 3: When should a child take pancreatic enzyme
replacement capsules in relation to food?
A. 30 minutes after eating
B. Immediately before or at the start of meals and snacks
C. Only at bedtime
D. Once daily in the morning on an empty stomach
Correct Answer: B. Rationale: Enzymes must be ingested with food
so they are present in the duodenum during digestion.
Question 4: A nurse teaches parents about administering pancreatic
enzymes to a child who cannot swallow pills. Which instruction is
correct?
A. Crush the capsules into a fine powder and mix with hot milk
, B. Open capsules and sprinkle microspheres on acidic, soft foods
like applesauce
C. Dissolve the capsules in carbonated soda
D. Break capsules in half and mix with water
Correct Answer: B. Rationale: Microspheres can be sprinkled on
acidic foods (pH <= 4.5) without chewing or crushing to preserve the
enteric coating.
Question 5: A nurse is providing discharge instructions to the
parents of a school-age child who has a new diagnosis of cystic
fibrosis. Which of the following enzyme replacement instructions
should the nurse include?
A. Administer enzymes 2 hours after meals
B. Give prescribed pancrelipase capsules with all meals and
snacks
C. Crush enteric-coated tablets before feeding
D. Mix enzymes with boiling water or formula
Correct Answer: B. Rationale: Pancreatic enzymes must be taken
with all meals and snacks to assist in digesting fats, proteins, and
carbohydrates.
, Question 6: A parent asks why their child with cystic fibrosis must
take pancrelipase capsules. The nurse explains that this medication:
A. Replaces missing pancreatic enzymes to aid digestion
B. Reduces airway inflammation and bronchospasm
C. Stimulates insulin production by islets of Langerhans
D. Prevents pulmonary bacterial infections
Correct Answer: A. Rationale: Pancrelipase replaces exocrine
pancreatic enzymes (lipase, protease, amylase) blocked by viscous
mucus.
Question 7: When should a child take pancreatic enzyme
replacement capsules in relation to food?
A. 30 minutes after eating
B. Immediately before or at the start of meals and snacks
C. Only at bedtime
D. Once daily in the morning on an empty stomach
Correct Answer: B. Rationale: Enzymes must be ingested with food
so they are present in the duodenum during digestion.
EXAMINATION
Pediatric Nursing: Cystic Fibrosis, Pancreatic Enzyme Replacement
Therapy, and Multidisciplinary Clinical Management
200 Rigorous Clinical Questions with Comprehensive Rationales
Question 1: A nurse is providing discharge instructions to the
parents of a school-age child who has a new diagnosis of cystic
fibrosis. Which of the following enzyme replacement instructions
should the nurse include?
A. Administer enzymes 2 hours after meals
B. Give prescribed pancrelipase capsules with all meals and
snacks
C. Crush enteric-coated tablets before feeding
D. Mix enzymes with boiling water or formula
Correct Answer: B. Rationale: Pancreatic enzymes must be taken
with all meals and snacks to assist in digesting fats, proteins, and
carbohydrates.
Question 2: A parent asks why their child with cystic fibrosis must
take pancrelipase capsules. The nurse explains that this medication:
A. Replaces missing pancreatic enzymes to aid digestion
, B. Reduces airway inflammation and bronchospasm
C. Stimulates insulin production by islets of Langerhans
D. Prevents pulmonary bacterial infections
Correct Answer: A. Rationale: Pancrelipase replaces exocrine
pancreatic enzymes (lipase, protease, amylase) blocked by viscous
mucus.
Question 3: When should a child take pancreatic enzyme
replacement capsules in relation to food?
A. 30 minutes after eating
B. Immediately before or at the start of meals and snacks
C. Only at bedtime
D. Once daily in the morning on an empty stomach
Correct Answer: B. Rationale: Enzymes must be ingested with food
so they are present in the duodenum during digestion.
Question 4: A nurse teaches parents about administering pancreatic
enzymes to a child who cannot swallow pills. Which instruction is
correct?
A. Crush the capsules into a fine powder and mix with hot milk
, B. Open capsules and sprinkle microspheres on acidic, soft foods
like applesauce
C. Dissolve the capsules in carbonated soda
D. Break capsules in half and mix with water
Correct Answer: B. Rationale: Microspheres can be sprinkled on
acidic foods (pH <= 4.5) without chewing or crushing to preserve the
enteric coating.
Question 5: A nurse is providing discharge instructions to the
parents of a school-age child who has a new diagnosis of cystic
fibrosis. Which of the following enzyme replacement instructions
should the nurse include?
A. Administer enzymes 2 hours after meals
B. Give prescribed pancrelipase capsules with all meals and
snacks
C. Crush enteric-coated tablets before feeding
D. Mix enzymes with boiling water or formula
Correct Answer: B. Rationale: Pancreatic enzymes must be taken
with all meals and snacks to assist in digesting fats, proteins, and
carbohydrates.
, Question 6: A parent asks why their child with cystic fibrosis must
take pancrelipase capsules. The nurse explains that this medication:
A. Replaces missing pancreatic enzymes to aid digestion
B. Reduces airway inflammation and bronchospasm
C. Stimulates insulin production by islets of Langerhans
D. Prevents pulmonary bacterial infections
Correct Answer: A. Rationale: Pancrelipase replaces exocrine
pancreatic enzymes (lipase, protease, amylase) blocked by viscous
mucus.
Question 7: When should a child take pancreatic enzyme
replacement capsules in relation to food?
A. 30 minutes after eating
B. Immediately before or at the start of meals and snacks
C. Only at bedtime
D. Once daily in the morning on an empty stomach
Correct Answer: B. Rationale: Enzymes must be ingested with food
so they are present in the duodenum during digestion.
