RPN Care of Chronic Illness 5 — Questions and Answers
Question 1: A patient with chronic pancreatitis is most at risk for which nutritional deficiency?
- Vitamin C deficiency
- Fat-soluble vitamin deficiencies (A, D, E, K) (Correct answer)
- Iron deficiency anemia
- Vitamin B12 deficiency only
Correct answer: Fat-soluble vitamin deficiencies (A, D, E, K)
Chronic pancreatitis impairs lipase production, reducing fat absorption and causing fat-soluble vitamin deficiencies.
Question 2: A patient with COPD is receiving oxygen therapy at 2 L/min. The nurse notes the patient's respirations have decreased to 8 breaths/min. What should the nurse do first?
- Increase the oxygen flow rate to 6 L/min
- Reduce or discontinue the oxygen and notify the physician (Correct answer)
- Continue monitoring because this is an expected response
- Administer a bronchodilator immediately
Correct answer: Reduce or discontinue the oxygen and notify the physician
Some COPD patients rely on hypoxic drive; excessive oxygen can suppress respirations, requiring prompt reduction and physician notification.
Question 3: A patient with hypothyroidism is started on levothyroxine. Which finding indicates the medication is effective?
- Increased fatigue and weight gain
- Return of normal energy levels and resolution of cold intolerance (Correct answer)
- Elevated TSH level on follow-up lab work
- Development of tremors and palpitations
Correct answer: Return of normal energy levels and resolution of cold intolerance
Resolution of hypothyroid symptoms such as fatigue and cold intolerance indicates therapeutic levothyroxine levels.
Question 4: A patient with chronic heart failure is prescribed furosemide. Which electrolyte imbalance is the most common adverse effect?
- Hypernatremia
- Hyperkalemia
- Hypokalemia (Correct answer)
- Hypercalcemia
Correct answer: Hypokalemia
Furosemide is a loop diuretic that promotes potassium excretion, frequently causing hypokalemia.
Question 5: A patient with Type 2 diabetes asks about the purpose of HbA1c testing. The nurse explains it reflects blood glucose control over:
- The past 24 hours
- The past week
- The past 2-3 months (Correct answer)
- The past year
Correct answer: The past 2-3 months
HbA1c reflects average blood glucose levels over the preceding 2-3 months based on the lifespan of red blood cells.
Question 6: A nurse is educating a patient with chronic obstructive pulmonary disease about pursed-lip breathing. What is the primary benefit of this technique?
- It increases the respiratory rate to improve oxygenation
- It slows exhalation and prevents airway collapse (Correct answer)
- It strengthens inspiratory muscles over time
- It eliminates the need for bronchodilator medications
Correct answer: It slows exhalation and prevents airway collapse
Pursed-lip breathing creates back-pressure that slows exhalation and keeps airways open longer, improving gas exchange.
Question 7: A patient with chronic venous insufficiency develops leg ulcers. Which intervention is the priority in ulcer management?
- Elevate the legs below heart level during rest
- Apply compression bandaging to improve venous return (Correct answer)
- Massage the affected leg to stimulate circulation
- Encourage the patient to remain on bed rest until healed
Correct answer: Apply compression bandaging to improve venous return
Compression therapy is the cornerstone of venous ulcer management as it reduces venous hypertension and promotes healing.
RPN Care of Chronic Illness 5
A patient with chronic pancreatitis is most at risk for which nutritional deficiency?