Exam question troubleling me.....

Esther2007 · Apr 26, 2007

Hi everyone I want to thank everyone for responding. I have to say that I've learned alot just be reading everyone's post! We didn't have an exam review for the last exam due to the teacher having a family emergency and having to travel last minute..... which is really frustrating. I did look it up in my textbook, If any of you have the Medical Surgical Nursing book by Lewis (MOSBY) 6th edition, starting on page 802-804 under modifiable risk factors for CAD the book talks about high cholesterol first then hypertension as 2nd major risk factor, smoking as 3rd, Physical inactivity 4th. Then the book goes on to talk about the incidence of CAD being greater among patients with DM than the general public. According to the book DM is classified as a modifiable contributing risk factor but cholesterol, HTN, and smoking are classified as modifiable MAJOR risk factors.
I answered cholesterol on the exam and feel better about that answer after reading that section in the book.
What do you think???

That is what my textbook Brunner and Suddarth has also.

As far as for diabetes, CAD is a longterm complications, does not happen automatic . If you have a patient who is compliant with the insulin regimen, exercise and follow their diets, the chances of them develop CAD will less likely.

I would not select smoking because it is a modifiable factor. Whereas someone with high cholesterol, there is not much they can do because their bodies just over producing cholesterol. I know patients who eat well and exercise, but because of family history, their LDL was still high. That is a nonmodifiable factor.

VieraGrl1030 · Apr 27, 2007

i needed to change the question i was trying to recite it from memory;

verbatim:

Why is it important to know the isotonic point of human cells when administering an IV?

BoonersmomRN · Apr 27, 2007

I'm going to go with....to make sure the type of IV fluids you are giving ( ordered) are correct ( if you are talking IV fluids here). Ie...if the cells are in a shrunken state..you wouldn't want to give a hypertonic IV- that would just exacerbate the problem. Just a guess here...

LaceyRN · Apr 29, 2007

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?

This seems to be a tough one, but it's exactly like the exam q's I have been getting in med-surg I. I would answer high cholesterol and here's why... CAD develops from excess cholesterol in the blood which leads to arteriosclerosis. DM and smoking can both damage vessel walls leading to arteriosclerosis but excess cholesterol must be present to develop CAD. That's my rationale and I'm sticking to it! :)

jade-athyst · Apr 29, 2007

I would have picked DM. The cholesterol answer doesn't give you enough info. HDL cholesterol actually helps combat CAD, and the question doesn't mention which type. Also, high LDL is more easilly treated with meds tha the cardiovascular effects of DM. Good blood sugar control can decrease the risk, but even people with perfect DM control are at a high risk of developing CAD.

A word of warning: This question is just like many of the questions I faced on the NCLEX, where all the answers seem right. I think the best way to study for the NCLEX is to master critical thinking and prioritizing.

Best of luck to you, and let us know how you did on the test!

Nili927 · Apr 30, 2007

Hey everyone! I have news on the exam! The question was disputed by most of the class, it seemed that a large majority of the class was between DM and cholesterol... according to the teacher the correct answer was high cholesterol because of the reference in our textbook. But I'mhappy to say the question was given to us! I got a 90 on the exam and an 85 on the final! I passed the class with a B+!!

:yelclap:

cherokeesummer · May 1, 2007

I would go with DM.

ARRR10 · May 1, 2007

The answer is in the textbook, right?!? or do you have to use your critical thinking skills to know what the answer is? Sorry to ask, because I'll be in med/surg. in the fall and I heard it was really hard...

JoniL&DRN · May 6, 2007

I did look it up in my textbook, If any of you have the Medical Surgical Nursing book by Lewis (MOSBY) 6th edition, starting on page 802-804 under modifiable risk factors for CAD the book talks about high cholesterol first then hypertension as 2nd major risk factor, smoking as 3rd, Physical inactivity 4th. Then the book goes on to talk about the incidence of CAD being greater among patients with DM than the general public. According to the book DM is classified as a modifiable contributing risk factor but cholesterol, HTN, and smoking are classified as modifiable MAJOR risk factors.
I answered cholesterol on the exam and feel better about that answer after reading that section in the book.
What do you think???

Based on my lecture and my book (same as yours ;o) I would have answered cholesterol as well. But then those are "modifiable" right?