CCHP Managing Chronic and Infectious Diseases 5

Question 1

An inmate with known opioid use disorder is admitted to a correctional facility.
According to current evidence-based guidelines, what is the recommended approach to medication-assisted treatment (MAT)?

Accepted Answer

Continue or initiate MAT with methadone, buprenorphine, or naltrexone as clinically indicated

Answer

Taper and discontinue all MAT medications within 72 hours of admission as facility policy

Answer

Offer only behavioral counseling, as MAT medications pose diversion risks in corrections

Answer

Administer naloxone daily to prevent opioid cravings without addressing dependence

Question 2

Which strategy is MOST effective for controlling methicillin-resistant Staphylococcus aureus (MRSA) outbreaks in correctional facilities?

Accepted Answer

Promoting hand hygiene, covering wounds, not sharing personal items, and laundering linens regularly

Answer

Administering prophylactic vancomycin to all inmates in the affected unit

Answer

Isolating all inmates in the affected unit indefinitely until MRSA is eradicated

Answer

Routinely decolonizing all inmates with intranasal mupirocin regardless of MRSA status

Question 3

When managing an inmate with sickle cell disease in a correctional facility, which situation requires the MOST urgent medical response?

Accepted Answer

Fever above 38.5°C (101.3°F), which can indicate life-threatening sepsis in this population

Answer

Mild joint aching without fever that the inmate rates as 3/10 pain

Answer

Mild fatigue following exercise that resolves with rest

Answer

A hemoglobin level of 8 g/dL in an asymptomatic inmate at baseline

Question 4

A correctional health provider is reviewing gonorrhea treatment guidelines. Which regimen reflects current CDC recommendations for uncomplicated urogenital gonorrhea?

Accepted Answer

Ceftriaxone 500 mg IM as a single dose (or 1g if weight ≥150 kg)

Answer

Oral ciprofloxacin 500 mg as a single dose

Answer

Oral azithromycin 1g plus oral doxycycline 100 mg twice daily for 7 days

Answer

Penicillin G benzathine 2.4 million units IM as a single dose

Question 5

An inmate with type 2 diabetes develops a foot ulcer. Which assessment component is MOST critical to determine the urgency of medical intervention?

Accepted Answer

Signs of infection including depth of wound, presence of cellulitis, exposed bone, and systemic signs of sepsis

Answer

The inmate's most recent HbA1c value from six months prior

Answer

The inmate's current housing assignment and proximity to the medical unit

Answer

Whether the inmate has previously refused diabetic foot care education

Question 6

Under which circumstance does the Americans with Disabilities Act (ADA) MOST directly apply to chronic disease management in correctional facilities?

Accepted Answer

When a correctional facility denies reasonable accommodations to an inmate whose chronic condition constitutes a disability

Answer

When an inmate requests cosmetic surgery to address a non-disabling condition

Answer

When an inmate seeks expedited release based on medical needs

Answer

When a facility sets a universal medication cap regardless of individual diagnosis

Question 7

Which approach BEST supports medication adherence for an HIV-positive inmate on ART in a correctional facility?

Accepted Answer

Implementing directly observed therapy (DOT) for ART administration to confirm ingestion and reduce diversion

Answer

Issuing a 90-day supply of ART medications for the inmate to self-administer without monitoring

Answer

Requiring the inmate to submit written requests for each dose to prevent overuse

Answer

Administering ART only during sick call to limit staff exposure to HIV-positive inmates