Chronic Illness NCLEX Questions

Chronic Illness NCLEX Questions Related

Review Chronic Illness NCLEX Questions related questions and content

Which of the following findings would be most indicative of retinoblastoma for an 18-month old child?

  • A. Orbital inflammation of the right eye and head tilt when standing.
  • B. Cat's eye reflex and yellow discharge from the left eye.
  • C. Leukokoria and hyphema noted for the right eye.
  • D. Strabismus in the left eye and light sensitivity in the opposite eye.
Correct Answer: C

Rationale: Retinoblastoma, a retinal cancer in young children, commonly presents with leukokoria (white pupil reflection) and hyphema (blood in the anterior eye chamber), making these findings most indicative due to tumor effects on retinal light reflection and vascular fragility. Orbital inflammation and head tilt suggest brain tumors or orbital cellulitis, not retinoblastoma's typical intraocular focus. Cat's eye reflex (leukokoria) fits, but yellow discharge points to infection (e.g., conjunctivitis), not cancer. Strabismus and light sensitivity may occur in retinoblastoma but are less specific strabismus from muscle imbalance and sensitivity from inflammation lacking hyphema's diagnostic weight. Nurses spotting leukokoria and hyphema trigger urgent ophthalmology referral, critical in pediatric oncology for early detection and vision-saving or life-saving intervention in this age group.

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The nurse educates the client that besides an echocardiogram, which of the following tests is the best tool for diagnosing heart failure?

  • A. Pulmonary artery catheter
  • B. Mitigated angiographic (MUGA) scan
  • C. B-type natriuretic peptide (BNP)
  • D. Radionuclide studies
Correct Answer: C

Rationale: BNP, a blood test, spikes with heart stretch heart failure's calling card, outshining invasive tools for diagnosis. Pulmonary catheters measure pressures, not routine. MUGA scans ejection fraction, less direct. Radionuclide's vague here. Nurses teach BNP's ease and accuracy, a biomarker gold standard, syncing with echo to nail heart failure's fluid tale.

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.

With regards to starting drug therapy for arterial hypertension, at which level of diastolic pressure should treatment be considered?

  • A. 60 to 69 mmHg
  • B. 70 to 79 mmHg
  • C. 80 to 89 mmHg
  • D. 90 to 95 mmHg
Correct Answer: D

Rationale: Arterial hypertension management follows guidelines like those from the American College of Cardiology, where drug therapy is typically considered when blood pressure exceeds certain thresholds. Diastolic pressure of 90 mmHg or higher is a widely accepted level for initiating treatment in adults, especially if sustained or accompanied by risk factors like diabetes or organ damage, as it indicates stage 1 hypertension needing intervention to prevent cardiovascular complications. Levels below 90 mmHg (60-69, 70-79, 80-89 mmHg) may warrant lifestyle changes but not immediate drug therapy unless systolic pressure or other risks elevate the profile. The 90-95 mmHg range aligns with clinical practice to start antihypertensives, balancing benefit and risk, particularly in primary care settings where family physicians aim to reduce stroke and heart disease incidence effectively.

Fatty liver disease is more common in people with metabolic syndrome or type 2 diabetes. The pathogenesis of fatty liver disease is not yet completely known. Question: What does current research suggest with respect to the pathogenesis?

  • A. Steatosis correlates with inflammation
  • B. Inflammation correlates with fibrosis
  • C. Steatosis correlates with liver damage
  • D. Steatosis correlates with insulin resistance
Correct Answer: D

Rationale: Fatty liver's tale steatosis ties to insulin resistance, a metabolic syndrome root, not just inflammation, fibrosis, or vague damage. Nurses see this, a chronic fat-glucose knot.

What does the abbreviation DALY stand for?

  • A. Definition of anticipated life years
  • B. Diabetes-affected life years
  • C. Disability-adjusted life years
  • D. Disease-affected life years
Correct Answer: C

Rationale: DALY disability-adjusted life years tallies lost health, not diabetes alone or vague terms. Nurses use this, a chronic burden metric.

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