Inmate Health Assessment & Chronic Care Management Flashcards

During a chronic care clinic visit for an inmate with hypertension, the nurse notes a blood pressure of 178/112 mmHg despite reported medication adherence. What is the most appropriate immediate action?

Answer: Assess for medication nonadherence and perform a focused cardiovascular assessment

A significantly elevated BP requires immediate assessment for nonadherence, secondary causes, and cardiovascular risk before any medication changes.

When screening a newly incarcerated individual for tuberculosis, which test is preferred for someone who has a history of BCG vaccination?

Answer: QuantiFERON-TB Gold Plus (IGRA)

Interferon-gamma release assays (IGRAs) are preferred over TST in BCG-vaccinated individuals because they are not affected by BCG vaccination.

An inmate with type 2 diabetes reports frequent hypoglycemic episodes occurring after meals. The nurse should first assess for which condition?

Answer: Postprandial hypoglycemia related to insulin secretagogues

Postprandial hypoglycemia is commonly caused by insulin secretagogues (sulfonylureas) stimulating excess insulin release after meals.

A correctional nurse is conducting a chronic care review for a patient with hepatitis C. Which lab value most directly reflects current liver fibrosis progression?

Answer: FIB-4 index or liver biopsy/elastography

The FIB-4 index and liver elastography are validated noninvasive tools for staging hepatic fibrosis in hepatitis C patients.

During an intake health screening, an inmate discloses a history of opioid use disorder (OUD). Which action best aligns with evidence-based correctional health standards?

Answer: Initiate or continue medications for opioid use disorder (MOUD) if clinically indicated

NCCHC and evidence-based guidelines support continuation or initiation of MOUD (e.g., methadone, buprenorphine) in correctional settings.

A nurse notes that an inmate with asthma has been requesting his rescue inhaler more than twice a week. According to NAEPP guidelines, how should asthma control be classified?

Answer: Not well-controlled

Rescue inhaler use more than twice per week indicates asthma that is not well-controlled per NAEPP classification.

When reviewing an inmate's medication list, the nurse finds that the patient with chronic kidney disease stage 3 is prescribed metformin. What is the most appropriate nursing action?

Answer: Flag for provider review, as metformin is generally contraindicated below eGFR 30 and requires dose adjustment below 45

Metformin requires dose adjustment when eGFR falls below 45 mL/min/1.73m² and is contraindicated below 30, requiring provider review.