Final Test Review (Qns & Ans)
2025
1. Case Study 1
A 55-year-old male inmate with hypertension, diabetes, and
hyperlipidemia presents with acute chest pain radiating to his left
arm, accompanied by shortness of breath and diaphoresis. What is
the most appropriate immediate management step?
A) Administer sublingual nitroglycerin immediately without
further evaluation.
B) Perform a 12-lead ECG and assess cardiac enzymes.
C) Provide antacids and monitor for 15 minutes.
D) Request a psychiatric evaluation for anxiety-related chest
pain.
ANS: B
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, Rationale: Given his risk factors and clinical presentation,
rapid cardiac evaluation (ECG and cardiac enzymes) is essential
to diagnose a potential acute coronary syndrome accurately.
2. Case Study 2
An inmate with poorly controlled diabetes is found to have a
foot ulcer with redness, swelling, and purulent discharge. What is
the next best step in management?
A) Use topical antibiotics and perform wound dressings only.
B) Initiate systemic antibiotic therapy after evaluating vascular
supply.
C) Proceed with immediate surgical debridement without
further workup.
D) Opt for observation and a delayed treatment approach.
ANS: B
Rationale: For a diabetic patient, systemic antibiotics
together with an evaluation for peripheral vascular disease help
prevent serious complications such as osteomyelitis.
3. Case Study 3
A 40-year-old female inmate with a history of substance abuse
presents following a suspected benzodiazepine overdose. Which
priority action should be taken?
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, A) Administer flumazenil immediately to reverse the effects.
B) Ensure airway protection and closely monitor respiratory
function.
C) Discharge the patient after collecting the medications.
D) Administer a higher dose of benzodiazepine to mitigate
withdrawal symptoms.
ANS: B
Rationale: In benzodiazepine overdose, securing the airway
and monitoring breathing is paramount. Flumazenil is used
cautiously due to risk of precipitating seizures or severe
withdrawal.
4. Case Study 4
An inmate undergoing psychiatric treatment on multiple
psychotropic medications develops fever, confusion, and muscle
rigidity. What is the correct immediate intervention?
A) Continue the current medication regimen and reassess after
24 hours.
B) Immediately discontinue antipsychotics and initiate
supportive care for neuroleptic malignant syndrome (NMS).
C) Increase the dosage of current medications to overcome
symptoms.
D) Begin high-dose steroids as the first-line therapy.
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, ANS: B
Rationale: NMS is life-threatening. The first step is to
discontinue the antipsychotic medications and begin supportive
measures such as hydration and temperature control.
5. Case Study 5
An inmate with a history of alcohol dependency presents with
tremors, agitation, and tachycardia indicative of alcohol
withdrawal. What is the most appropriate management?
A) Observe the patient with no immediate intervention.
B) Initiate a benzodiazepine protocol for alcohol withdrawal
management.
C) Treat agitation with antipsychotics only.
D) Rely solely on physical restraints for safety.
ANS: B
Rationale: Benzodiazepines are the first-line treatment for
alcohol withdrawal symptoms and help prevent complications
such as seizures and delirium tremens.
6. Case Study 6
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