RPN Care of Chronic Illness 3 — Questions and Answers
Question 1: A patient with asthma uses a peak flow meter. A reading in the red zone indicates:
- Good asthma control requiring no action
- Caution — the patient should use a rescue inhaler and contact the provider
- A medical emergency requiring immediate emergency care (Correct answer)
- Normal variation not requiring intervention
Correct answer: A medical emergency requiring immediate emergency care
A red zone reading (below 50% of personal best) signals a severe asthma episode requiring immediate emergency treatment.
Question 2: A patient with Parkinson's disease has difficulty swallowing. Which nursing intervention best reduces aspiration risk?
- Offer thin liquids frequently throughout the day
- Position the patient supine during meals
- Offer thickened liquids and small bite-sized foods (Correct answer)
- Encourage rapid eating to reduce fatigue
Correct answer: Offer thickened liquids and small bite-sized foods
Thickened liquids and small bites slow swallowing and reduce the risk of aspiration in patients with dysphagia.
Question 3: A patient with chronic liver disease develops asterixis. This finding is associated with which condition?
- Hepatic encephalopathy (Correct answer)
- Portal hypertension
- Esophageal varices
- Spontaneous bacterial peritonitis
Correct answer: Hepatic encephalopathy
Asterixis (flapping tremor) is a neurological sign indicating hepatic encephalopathy from ammonia accumulation.
Question 4: A nurse is teaching a patient with osteoporosis about fall prevention. Which instruction is most important?
- Avoid all weight-bearing activity to prevent fractures
- Remove throw rugs and ensure good lighting in the home (Correct answer)
- Wear socks without shoes to feel floor surfaces better
- Rely on furniture for balance instead of using a cane
Correct answer: Remove throw rugs and ensure good lighting in the home
Removing environmental hazards like throw rugs and improving lighting are key fall prevention strategies for osteoporosis patients.
Question 5: Which assessment finding in a patient with chronic obstructive pulmonary disease (COPD) indicates worsening respiratory status?
- SpO2 of 93%
- Use of accessory muscles for breathing (Correct answer)
- Mild expiratory wheezing
- Respiratory rate of 16 breaths per minute
Correct answer: Use of accessory muscles for breathing
Use of accessory muscles indicates significant respiratory distress and signals worsening airflow obstruction.
Question 6: A patient with Type 1 diabetes is found unresponsive with a blood glucose of 38 mg/dL. What is the nurse's first action?
- Administer oral glucose gel between the cheeks and gums
- Give the patient a glass of orange juice to drink
- Administer IV dextrose 50% as ordered (Correct answer)
- Call the physician before initiating any treatment
Correct answer: Administer IV dextrose 50% as ordered
An unresponsive patient cannot safely swallow, so IV dextrose is the appropriate treatment for severe hypoglycemia.
Question 7: A patient with chronic pain is started on a scheduled opioid regimen. Which bowel intervention should the nurse initiate proactively?
- Encourage reduced fluid intake to minimize bathroom trips
- Start a stimulant laxative regimen prophylactically (Correct answer)
- Administer an enema every other day
- Recommend a high-fat diet to coat the bowel
Correct answer: Start a stimulant laxative regimen prophylactically
Opioids cause constipation by slowing GI motility; a stimulant laxative should be started preventively when opioid therapy begins.
RPN Care of Chronic Illness 3
A patient with asthma uses a peak flow meter.
A reading in the red zone indicates: