PNC Chronic Disease Management 1 — Questions and Answers
Question 1: Which first-line intervention is recommended for a congregant newly diagnosed with Type 2 diabetes before initiating pharmacotherapy?
- Insulin therapy
- Therapeutic lifestyle changes including diet and exercise (Correct answer)
- Metformin initiation only
- Bariatric surgery referral
Correct answer: Therapeutic lifestyle changes including diet and exercise
Therapeutic lifestyle changes—improved diet, increased physical activity, and weight management—are the recommended first-line treatment for Type 2 diabetes prior to or alongside medication initiation.
Question 2: A parish nurse is educating a congregant with hypertension. Which target blood pressure is recommended by current guidelines for most adults with hypertension?
- Less than 160/100 mmHg
- Less than 150/90 mmHg
- Less than 130/80 mmHg (Correct answer)
- Less than 140/90 mmHg
Correct answer: Less than 130/80 mmHg
Current AHA/ACC guidelines recommend a blood pressure target of less than 130/80 mmHg for most adults with hypertension to reduce cardiovascular risk.
Question 3: A congregant with chronic heart failure should be instructed to notify their provider if daily weight increases by how much over one to two days?
- 1 pound
- 2 pounds
- 3 pounds (Correct answer)
- 5 pounds
Correct answer: 3 pounds
A weight gain of 3 or more pounds in one to two days typically indicates fluid retention and possible heart failure decompensation, requiring prompt medical evaluation.
Question 4: Which breathing technique is most beneficial to teach a congregant with COPD to reduce air trapping and improve exhalation?
- Diaphragmatic breathing with rapid inhalation
- Pursed-lip breathing (Correct answer)
- Valsalva maneuver
- Chest breathing with shoulder elevation
Correct answer: Pursed-lip breathing
Pursed-lip breathing slows the respiratory rate, prolongs exhalation, and reduces air trapping in COPD by keeping airways open longer during exhalation.
Question 5: A fasting blood glucose level of which value is diagnostic for diabetes according to American Diabetes Association criteria?
- 100 mg/dL or higher
- 110 mg/dL or higher
- 126 mg/dL or higher (Correct answer)
- 140 mg/dL or higher
Correct answer: 126 mg/dL or higher
A fasting blood glucose of 126 mg/dL or higher on two separate occasions meets the ADA diagnostic criteria for diabetes mellitus.
Question 6: Which dietary restriction is most critical to teach a congregant with advanced chronic kidney disease (CKD stages 4-5)?
- Reduced vitamin C intake
- Reduced potassium intake (Correct answer)
- Increased phosphorus intake
- Increased sodium intake
Correct answer: Reduced potassium intake
Impaired kidneys cannot excrete potassium effectively, so dietary potassium restriction is essential in advanced CKD to prevent life-threatening hyperkalemia.
Question 7: When teaching a patient with asthma about trigger avoidance, which indoor environmental factor is most commonly associated with asthma exacerbations?
- High humidity alone
- Dust mites and allergens (Correct answer)
- Cold air from air conditioning
- Fluorescent lighting
Correct answer: Dust mites and allergens
Dust mites are among the most prevalent indoor allergens and are a leading trigger for asthma exacerbations, making allergen reduction strategies critical.
PNC Chronic Disease Management 1
Which first-line intervention is recommended for a congregant newly diagnosed with Type 2 diabetes before initiating pharmacotherapy?