Chronic Illness NCLEX Questions

Chronic Illness NCLEX Questions Related

Review Chronic Illness NCLEX Questions related questions and content

A 59-year-old lady with type 2 diabetes mellitus (T2DM), heart failure from coronary artery disease, and an ejection fraction of 60 percent attends your practice for a routine follow-up. She has mild dyspnea while climbing stairs but reports no other limitations in her usual activities. Her HbA1c was 7.2 percent. She is compliant to extended-release metformin 2,000 mg OD, Rosuvastatin 10 mg ON, Telmisartan 40 mg OD, carvedilol 25 mg BD, and aspirin 100 mg OD. Her vital signs reveal stable body weight at 88 kg, a blood pressure of 126/78 mmHg, a heart rate of 68 bpm and regular, and a respiratory rate of 18 breaths/min. Her examination is otherwise normal. What would be the most appropriate next step in management?

  • A. Increase carvedilol to 50 mg BD
  • B. Add an SGLT2-inhibitor to her regimen
  • C. Add basal insulin to her regimen
  • D. Add dipeptidyl peptidase-4 (DPP-4) inhibitor to her regimen
Correct Answer: B

Rationale: HFpEF (EF 60%) with T2DM and dyspnea SGLT2 inhibitors cut heart failure risk and aid sugar, a dual win over carvedilol's max-out, insulin's glucose-only hit, DPP-4's weak HF edge, or unneeded frusemide (no edema). Clinicians add this, boosting chronic outcomes, a smart next step.

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Post exposure prophylaxis against Human Immunodeficiency Virus (HIV):

  • A. is probably not effective when commenced 36 hours post exposure
  • B. is administered intramuscularly
  • C. is generally well-tolerated by patients
  • D. when given, precludes the need for follow up serology
Correct Answer: C

Rationale: HIV PEP tolerable pills, not IM, works past 36 hours, needs serology, safe in pregnancy. Nurses dose this chronic shield easy.

An HIV-positive patient presents to the ED complaining of shortness of breath and non-productive cough. Chest x-ray shows diffuse interstitial infiltrates, and O2 saturation is 85% on room air. All of the following statements regarding this patient's probable diagnosis are TRUE, EXCEPT

  • A. Pneumocystis carinii pneumonia (PCP) is the most common opportunistic infection in AIDS patients
  • B. Pentamidine isothionate is an effective alternate therapy to TMP-SMX
  • C. A normal chest x-ray rules out acute PCP infection
  • D. 65% of patients relapse within 18 months
Correct Answer: H

Rationale: PCP top AIDS bug, pentamidine swaps TMP-SMX, relapse hits, steroids for hypoxia; normal CXR misses 20%. Nurses nix this chronic x-ray lie.

A nurse in a hematology clinic is working with four clients who have polycythemia vera. Which client should the nurse see first?

  • A. A client with a swollen and painful left great toe
  • B. Client who reports dyspnea
  • C. Client with a blood pressure of 180/98 mm Hg
  • D. Client who reports calf tenderness and swelling
Correct Answer: B

Rationale: Polycythemia vera thickens blood, risking clots dyspnea signals possible pulmonary embolism, a life-threatening emergency needing instant assessment per ABCs. Toe pain suggests gout, common but less acute. Hypertension, a chronic issue here, waits behind respiratory distress. Calf tenderness hints at DVT, urgent but not immediately fatal like embolism. Nurses triage dyspnea first, ensuring airway and oxygenation, a critical call in this hyperviscous condition prone to thrombotic crises.

The glycaemic profiles of people living with diabetes is affected by the following EXCEPT:

  • A. Dietary intake
  • B. Exercise
  • C. Monitoring of blood glucose
  • D. Stress
Correct Answer: C

Rationale: Glycemic profiles in diabetes are influenced by dietary intake (carbohydrate amount/type), exercise (glucose uptake), stress (cortisol-driven hyperglycemia), and medications (dose/effect). Monitoring blood glucose, however, doesn't affect the profile it measures it. While vital for management, the act of checking doesn't alter underlying glucose levels, unlike the others, which directly impact metabolism. This distinction is key for physicians educating patients on factors driving glycemic control, ensuring focus on actionable influencers rather than tools in chronic diabetes care.

Which is the most common organism/s causing osteomyelitis in all age groups?

  • A. streptococci
  • B. staph aureus
  • C. gm negatives
  • D. hemophilus
Correct Answer: B

Rationale: Staph aureus reigns in osteomyelitis bone's bane across kids to geezers, sticking to marrow like glue. Streptococci hit less, gram-negatives tag trauma, hemophilus fades post-vaccine, fungi creep rare. Nurses bank on this staph stat, a chronic skeleton scourge needing targeted juice.

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