CCHP Managing Chronic and Infectious Diseases 2

Question 1

A correctional nurse discovers that a newly admitted inmate has an HbA1c of 10.2%. What is the most appropriate initial management step?

Accepted Answer

Conduct a comprehensive diabetes assessment including current medications, complications, and self-management history

Answer

Immediately start insulin therapy without further assessment

Answer

Defer diabetes management until after the 30-day intake period

Answer

Refer directly to an outside endocrinologist before initiating any treatment

Question 2

Which hepatitis C treatment consideration is MOST relevant in a correctional setting?

Accepted Answer

Sufficient sentence length to complete a full treatment course is an important eligibility factor

Answer

Treatment should be withheld until release to reduce costs

Answer

Direct-acting antivirals (DAAs) are contraindicated in incarcerated populations

Answer

Inmates must demonstrate sobriety for five years before treatment eligibility

Question 3

An inmate with HIV has a viral load of 2,500 copies/mL despite reporting adherence to ART. What is the most likely explanation?

Accepted Answer

Medication non-adherence, drug resistance, or drug-drug interactions should be evaluated

Answer

The inmate's HIV has naturally progressed beyond treatment

Answer

ART is ineffective for viral loads above 1,000 copies/mL

Answer

The viral load result is within acceptable limits and no action is needed

Question 4

What is the recommended tuberculin skin test (TST) reading timeframe in a correctional facility?

Accepted Answer

48–72 hours after placement

Answer

Immediately after placement

Answer

12–24 hours after placement

Answer

96–120 hours after placement

Question 5

Which of the following best describes the 'booster effect' in tuberculin skin testing and why it matters in correctional facilities?

Accepted Answer

A waning immune response that can make a truly positive TST appear negative on first testing, corrected by two-step testing

Answer

A false-positive caused by BCG vaccination that requires no follow-up

Answer

An allergic reaction that invalidates the TST result permanently

Answer

An enhanced immune response seen only in HIV-positive inmates

Question 6

An inmate with hypertension consistently has blood pressure readings above goal despite three antihypertensive medications. What correctional-specific factor should be prioritized in the assessment?

Accepted Answer

Pill-hoarding or medication diversion leading to inconsistent ingestion

Answer

Genetic predisposition to treatment-resistant hypertension

Answer

Laboratory error in blood pressure measurement equipment

Answer

Natural resistance to antihypertensives in incarcerated populations

Question 7

Which bloodborne pathogen transmission route is of GREATEST concern during a correctional facility outbreak investigation involving multiple cases of acute hepatitis B?

Accepted Answer

Sharing of contaminated tattooing or piercing equipment

Answer

Airborne droplet transmission via shared ventilation

Answer

Contaminated food service equipment

Answer

Mosquito vector transmission within the facility