CCN Inmate Health Assessment & Chronic Care Management 3

Question 1

An inmate with HIV on antiretroviral therapy (ART) has a CD4 count of 185 cells/µL. Which prophylactic medication is indicated to prevent Pneumocystis jirovecii pneumonia (PCP)?

Accepted Answer

Trimethoprim-sulfamethoxazole (TMP-SMX) daily

Answer

TMP-SMX is the first-line prophylaxis for PCP when CD4 count falls below 200 cells/µL in HIV-positive patients.

Question 2

A correctional nurse is performing a health appraisal for a 55-year-old male inmate with a 30 pack-year smoking history. Which cancer screening is recommended per USPSTF guidelines?

Accepted Answer

Low-dose CT scan of the chest for lung cancer

Answer

USPSTF recommends annual low-dose CT lung cancer screening for adults aged 50–80 with a 20 pack-year history who currently smoke or quit within 15 years.

Question 3

An inmate with epilepsy misses several doses of phenytoin because of lockdowns. Upon assessment, the nurse finds the patient confused and shaking. What is the priority action?

Accepted Answer

Obtain a stat phenytoin level and notify the provider immediately

Answer

Obtaining a serum phenytoin level and notifying the provider allows for informed clinical decision-making to prevent status epilepticus.

Question 4

During chronic care follow-up, a nurse assesses an inmate with chronic obstructive pulmonary disease (COPD). Which finding indicates disease exacerbation requiring escalated care?

Accepted Answer

Increased dyspnea, change in sputum color, and decreased oxygen saturation

Answer

Increased dyspnea, purulent sputum, and decreased SpO2 are classic signs of a COPD exacerbation requiring prompt treatment.

Question 5

A nurse is reviewing an inmate's chronic care record and notices the patient's HbA1c has increased from 7.2% to 9.8% over 6 months despite no medication changes. What factor most commonly contributes to this change in a correctional setting?

Accepted Answer

Medication hoarding for trading or diversion

Answer

Medication diversion or hoarding is a significant cause of apparent treatment failure in correctional settings and must be assessed.

(CCN) Certified Corrections Nurse Practice Test

(CCN) Certified Corrections Nurse Practice Test

CCN Inmate Health Assessment & Chronic Care Management 3