CCHP Patient Care and Treatment 2 — Questions and Answers
Question 1: A correctional nurse encounters a patient who refuses insulin for their diabetes, citing personal reasons. What is the most appropriate first action?
- Document the refusal and administer insulin anyway
- Assess the patient's understanding of the consequences and document informed refusal (Correct answer)
- Notify the court immediately
- Discontinue the diabetes care plan
Correct answer: Assess the patient's understanding of the consequences and document informed refusal
Patients retain the right to refuse treatment; the nurse must ensure informed refusal by assessing understanding and documenting thoroughly.
Question 2: Which chronic disease management strategy is most effective in a correctional setting with high patient turnover?
- Relying solely on specialist referrals
- Standardized chronic care clinics with structured follow-up protocols (Correct answer)
- Treating chronic conditions only during acute episodes
- Delegating all chronic care to custody staff
Correct answer: Standardized chronic care clinics with structured follow-up protocols
Structured chronic care clinics with standardized protocols ensure continuity even with frequent patient transfers.
Question 3: A patient with hypertension reports headache and blurred vision. Blood pressure reads 190/120 mmHg. What is the priority action?
- Schedule a follow-up appointment for the next week
- Administer the scheduled antihypertensive and recheck in 4 hours
- Treat as a hypertensive emergency and arrange immediate medical evaluation (Correct answer)
- Reassure the patient and document findings
Correct answer: Treat as a hypertensive emergency and arrange immediate medical evaluation
Blood pressure at this level with end-organ symptoms (headache, blurred vision) constitutes a hypertensive emergency requiring immediate evaluation.
Question 4: When developing a treatment plan for a patient with both a substance use disorder and a serious mental illness, the most effective approach is:
- Treat the mental illness first, then address substance use
- Treat the substance use disorder only until stable
- Use an integrated co-occurring disorder treatment model (Correct answer)
- Refer exclusively to an outside psychiatric facility
Correct answer: Use an integrated co-occurring disorder treatment model
Integrated co-occurring disorder treatment addresses both conditions simultaneously, which yields better outcomes than sequential treatment.
Question 5: A patient on opioid agonist therapy (OAT) is transferred from another facility. The receiving facility does not have OAT in its formulary. What should occur?
- Discontinue OAT immediately upon arrival
- Continue OAT and initiate a formulary exception process (Correct answer)
- Switch the patient to a benzodiazepine for withdrawal management
- Reduce the dose by 50% as a precaution
Correct answer: Continue OAT and initiate a formulary exception process
Abrupt discontinuation of OAT is dangerous; the patient's therapy should continue while a formulary exception is pursued.
Question 6: Which of the following best describes the standard of care for wound management in a correctional facility?
- Wounds should only be treated in outside hospital settings
- Wound care should follow evidence-based protocols consistent with community standards (Correct answer)
- Custody staff should perform routine wound dressing changes
- Wound care is optional for minor injuries
Correct answer: Wound care should follow evidence-based protocols consistent with community standards
Correctional health facilities are required to provide care equivalent to community standards, including evidence-based wound management.
Question 7: A patient with HIV is prescribed antiretroviral therapy (ART). Which monitoring parameter is most critical for assessing treatment efficacy?
- Complete blood count monthly
- Viral load and CD4 count at scheduled intervals (Correct answer)
- Daily blood pressure measurement
- Weekly liver function tests
Correct answer: Viral load and CD4 count at scheduled intervals
Viral load measures treatment suppression and CD4 count reflects immune status, making them the primary efficacy markers for ART.
CCHP Patient Care and Treatment 2
A correctional nurse encounters a patient who refuses insulin for their diabetes, citing personal reasons.
What is the most appropriate first action?