Exam question troubleling me.....

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I just took my 4th exam for Medsurg 2 and there's a question that keeps lingering on my mind.

The question is something about which patient has a higher risk for CAD?

These were the choices:

A patient w/ high cholesterol

A patient w/ DM

A patient who's a smoker

Aren't they all at risk for CAD????:smackingf

Which would you have picked?

Specializes in Nursing Professional Development.
But that is my point. Diabetes is the biggest risk factor because it can lead to CAD by several mechanisms. High LDL is one of them. There are also issues with hypertension coagulation, circulation, etc. The thing with nursing exams is there are often more than a single "correct" answer.

Not so sure what was extraneous, or what "core idea" we are supposed to be comparing that we are all missing? Can you elaborate?

~Mel'

If we assume that it is a good test question, then we must assume that 1 of the possible answers has a level of risk that is higher than the others -- making it the one and only 1 correct answer to the question, "Which has the greatest risk?" We must also assume that the students were given the information needed to answer the question (or else it is a bad question and not worth discussing).

Presumably, either the amount of increased risk for each choice was given to them or else they were told that "xxxx is the single biggest risk factor." Another possibilty is that the students have been taught how to weigh and/or rank different types of risk with certain types of risk being more significant that other types of risks. You are assuming that because DM can increase the risk through more than 1 mechanism, it must therefore be responisible for the greatest amount of risk.

So, the structure of the question is either:

A. A straightforward recall question that asks the student to recall the information provided in the readings or in class about the relative risks of each.

or

B. A question asking the student to apply a method of ranking the risk (by amount or type of risk) that they were taught in the course.

As I was not in the course, I do not know whether or not the students were taught a method to use to rank different types or amount of risk. Nor do I know what specific information they were given about the amount of risk for each choice. So, I can't pretend to know the answer that the teacher is looking for. However, I do know that simply knowing the sequence of events through which DM increases the risk is not sufficient to answer the question because that knowledge by itself does not give us the ability to rank the amount or type of risk with DM to the amount and type of risk from the other two. To make the comparison, you need to know the amount and/or type of risk from all three.

Specializes in med/surg, telemetry, IV therapy, mgmt.

llg. . .I agree with you. That's why I thought from the beginning that this question had the air of something coming out of a lecture. I have a current instructor that this this kind of thing on tests all the time.

Specializes in med-surg.
Nili I am feeling your pain.. I keep telling myself 4 MORE WEEKS and then 3 months away.. it can not come fast enough!! :) Good luck with your exam.. and finals..!!

Amen to that Jessie!!!

18 more months and I will be an RN. 18 more months and I will be an RN.

18 more months and I will be an RN. 18 more months and I will be an RN.

18 more months and I will be an RN. 18 more months and I will be an RN.

18 more months and I will be an RN. 18 more months and I will be an RN.

18 more months and I will be an RN. 18 more months and I will be an RN.

18 more months and I will be an RN. 18 more months and I will be an RN.

18 more months and I will be an RN. 18 more months and I will be an RN.:trout:

Specializes in med-surg.

:trout: There are probably no wrong answers, just the most right answer:smiley_ab

Specializes in OB.
Amen to that Jessie!!!

18 more months and I will be an RN. 18 more months and I will be an RN.

18 more months and I will be an RN. 18 more months and I will be an RN.

18 more months and I will be an RN. 18 more months and I will be an RN.

18 more months and I will be an RN. 18 more months and I will be an RN.

18 more months and I will be an RN. 18 more months and I will be an RN.

18 more months and I will be an RN. 18 more months and I will be an RN.

18 more months and I will be an RN. 18 more months and I will be an RN.:trout:

right on!

in 18 DAYS I graduate !!!!!!!!!!!!!!!!!!!

Specializes in PCU/Hospice/Oncology.
right on!

in 18 DAYS I graduate !!!!!!!!!!!!!!!!!!!

Well, I can say I will learn a lot from questions/answers/debates, like this and the links are great.. Thanks guys.

This exact question was on my 2nd exam in 4th semester (getting ready for my final) -- and the answer was DM due to the disease process and to the fact that having DM significantly increases your risk for CAD.

So... does the OP have the official answer to the question and the rationale?

Specializes in Geriatrics, Hospice, Palliative Care.

I would have chosen DM as well, since you can lower the cholesterol and stop smoking...but you cannot overcome DM, so your risk is higher with that. Of course, my reasoning has been wrong before for this type of question!

I've got 4 more months...and sometime I wonder if I will make it. My grades are fine, but our school is closing after our class graduates in August, and frankly we're all getting a little nutty. The teachers, naturally, are concerned about their next move once the school closes, so we all have cabin fever. Oye.

e

Specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.

Absolutely--Diabetes--and for all the reasons stated by Melina.

I feel the answer is cholesterol, because smoking has more of a effect on your lungs, d.m. more on the kidneys, but cholesterol can encompass hdl and ldl and as we know they are a direct link to cad. I know d.m. can also lead to that, but not a strongly as high cholesterol levels. You are not supposed to look so deap into a question. This is my humble opinion. P.S.... if you ask me the real answer is missing...genetics!

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