CPC Chronic Disease Management 3

Question 1

A community paramedic visits a patient with hypertension who reports persistent morning headaches and visual disturbances. Blood pressure is 196/118 mmHg. The patient is alert, oriented, and has no neurological deficits. This presentation is classified as:

Accepted Answer

Hypertensive urgency

Answer

Hypertensive urgency is a severe BP elevation (≥180/120 mmHg) without evidence of acute target organ damage. Hypertensive emergency involves the same BP level WITH acute end-organ damage (stroke, MI, aortic dissection, renal failure, encephalopathy).

Question 2

The GOLD ABCD assessment in COPD management combines spirometric grade with which two additional parameters?

Accepted Answer

Symptom burden (CAT/mMRC score) and exacerbation history

Answer

GOLD ABCD groups combine spirometric severity (1–4) with symptom burden (CAT ≥10 or mMRC ≥2 = high symptoms) and exacerbation history (0–1 vs ≥2 moderate or ≥1 severe) to guide pharmacological treatment selection.

Question 3

A patient with type 2 diabetes and CKD Stage 3 has an eGFR of 42 mL/min/1.73m². Which diabetes medication has been shown to provide both glycemic control AND renoprotection in this patient?

Accepted Answer

SGLT2 inhibitors (e.g., empagliflozin, dapagliflozin)

Answer

SGLT2 inhibitors provide glycemic control AND have proven renoprotective effects (reduce proteinuria, slow eGFR decline) through hemodynamic mechanisms in the glomerulus — now recommended as first-line add-on therapy in T2DM + CKD.

Question 4

During a CHF home visit, a patient's SpO2 is 91% and they report waking up unable to breathe at night unless they prop up with multiple pillows. This symptom is termed:

Accepted Answer

Orthopnea

Answer

Orthopnea is breathlessness that occurs in the recumbent position, relieved by sitting or elevation — quantified by the number of pillows required. It results from redistribution of fluid from dependent areas to the pulmonary circulation when supine.

Question 5

According to the ADA Standards of Medical Care, which intervention is recommended for preventing type 2 diabetes in patients diagnosed with prediabetes who are overweight?

Accepted Answer

Weight loss of 5–7% of body weight through structured lifestyle intervention

Answer

ADA recommends a 5–7% weight loss through structured lifestyle programs (150+ minutes/week of moderate activity and dietary changes) as the primary intervention for prediabetes. The landmark DPP trial demonstrated this reduces progression to T2DM by 58%.

(CPC) Community Paramedic Certification Practice Test

(CPC) Community Paramedic Certification Practice Test

CPC Chronic Disease Management 3