RPN Care of Chronic Illness 2 — Questions and Answers
Question 1: A patient with COPD is prescribed long-acting bronchodilators. Which inhaler technique instruction is most important?
- Exhale fully before inhaling the medication (Correct answer)
- Inhale quickly and shallowly for best delivery
- Hold breath for 1-2 seconds after inhaling
- Rinse mouth only if using a corticosteroid inhaler
Correct answer: Exhale fully before inhaling the medication
Exhaling fully before inhaling maximizes medication delivery to the airways.
Question 2: A nurse is educating a patient with Type 2 diabetes about foot care. Which instruction is highest priority?
- Wear open-toed shoes to reduce pressure
- Inspect feet daily using a mirror if needed (Correct answer)
- Soak feet in hot water for 20 minutes daily
- Apply lotion between the toes to prevent dryness
Correct answer: Inspect feet daily using a mirror if needed
Daily foot inspection allows early detection of injuries that can lead to serious complications due to diabetic neuropathy.
Question 3: Which lab value is most important to monitor in a patient with chronic kidney disease (CKD)?
- Serum albumin
- Serum potassium (Correct answer)
- Fasting blood glucose
- White blood cell count
Correct answer: Serum potassium
Hyperkalemia is a life-threatening complication of CKD because impaired kidneys cannot excrete potassium adequately.
Question 4: A patient with heart failure reports waking up at night feeling short of breath. This symptom is called:
- Orthopnea
- Paroxysmal nocturnal dyspnea (Correct answer)
- Cheyne-Stokes respiration
- Dyspnea on exertion
Correct answer: Paroxysmal nocturnal dyspnea
Paroxysmal nocturnal dyspnea (PND) is sudden shortness of breath that awakens a patient from sleep, characteristic of left-sided heart failure.
Question 5: A patient with rheumatoid arthritis reports joint stiffness. When is this stiffness typically worst?
- In the evening after activity
- During periods of cold weather only
- In the morning upon waking (Correct answer)
- Immediately after eating
Correct answer: In the morning upon waking
Morning stiffness lasting more than one hour is a hallmark of rheumatoid arthritis.
Question 6: A nurse is caring for a patient with multiple sclerosis (MS) experiencing fatigue. Which intervention is most appropriate?
- Encourage exercising during the hottest part of the day
- Schedule activities during the patient's peak energy periods (Correct answer)
- Recommend complete bed rest until fatigue resolves
- Administer stimulant medications without physician order
Correct answer: Schedule activities during the patient's peak energy periods
Scheduling activities when energy levels are highest helps MS patients manage fatigue and maintain function.
Question 7: Which dietary modification is most important for a patient with chronic heart failure to prevent fluid retention?
- Limit sodium intake to 2,000 mg per day (Correct answer)
- Increase potassium intake to 5,000 mg per day
- Eliminate all protein from the diet
- Consume a high-fat diet to maintain caloric intake
Correct answer: Limit sodium intake to 2,000 mg per day
Restricting sodium reduces fluid retention and decreases the workload on the failing heart.
RPN Care of Chronic Illness 2
A patient with COPD is prescribed long-acting bronchodilators.
Which inhaler technique instruction is most important?