Pathophysiology Final Exam Questions with Complete Solutions, Exams of Pathophysiology

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Pathophysiology Final exam Questions with Complete

Solutions

1. The nurse is caring for a patient who has a disease caused by the mother's use of

alcohol during pregnancy. How would you classify this disease?: Con- genital environmental

2. A nursing student is explaining the differece between sign and symptom; which of

the following is best explanation?: A sign is a manifestation that is noted by the observer; while a symptom is what the patient describes (not visible to observer)

3. The nurse is caring for a client in remission. The client asks what "remis- sion"

means? Which of the following is the best statement for the nurse to state?: Remission is when there is a period of time where the manifestation of the disease subside.

4. The client is under going a diagnostic procedure; the client asks what they are

having this procedure completed? The nurse knows that a diagnostic procedure is needed to:: To identify the disease which could include testing

5. The nursing students are holding an event for the student nurses asso- ciation

on campus. The student nurses have been tasked with educating the community on secondary prevention. Which of the following could the students include: SELECT ALL THAT APPLY: 1. BMI, Body mass index Check

2.Blood Pressure Check

3.Smoking History Check

6. A patient is visiting the primary care doctor's office to follow up on diabetes

management. The client has their labs drawn and brings their blood sugar readings. This is known as what type of prevention check?: Tertiary prevention

7. A client is in receiving their prognosis of the diagnosis of cancer. The client asks the

student nurse what prognosis means. Which is the best response to the client?: The

prognosis is the likelihood of making a full recovery after treatment.

8. The study nurse is looking at the study of disease occurrence in the human

population as well as patterns in age, race, dietary habits, and lifestyles. This is known as:: Epidemiology

9. A woman is in the primary care physician's office following a broken left leg, 3 weeks

later, the nurse finds the following. Match the assessment findings with the correct terminology.: 1. The left leg is smaller than the right leg. Atrophy

2.The circumference of the right calf has increased by 2 cm Hypertrophy

3.There are some noted new calluses on the right foot. Metaplasia

10.Which of the following is an increase in the number of cells in an organ or tissue

due to excessive hormonal stimulation?: Endometrial hyperplasia

11. The nurse is admitting a 35-year-old male welder complaining of persistent

abdominal pain and vomiting. He was brought in by a co-worker who stated that he became more confused as the day went on. Which assessment finding indicates that a serum lead level is needed?: Dark line at the gum margins

12.Mrs. Turner is considered to be at increased risk for developing breast can- cer.

Which of the following factors is most positively related to this high-risk profile?: History of breast cancer in family members

13.Mrs. Turner's tumor was staged at stage III using the TNM staging system. A

pathological exam of the surgically removed tissue sample placed Mrs. Turner's tumor in category type II. Characterizing and classifying tumors is important for which of the following reasons?: 1. Tumor staging is useful for studying the number of researchable factors, from survival to treatment response.

2.Treatment is based on the knowledge of tumor size, extent, and tissue type.

3. A consistent classification system provides a way to catalogue individuals

with breast tumors for statistical analysis.

14. Mr. and Mrs. Kim, a couple in their late 50s, are concerned about their son, John,

who is 14 years old. John is a tall, outgoing, cheerful-appearing adolescent, who is nevertheless nervous about having his parents accompany him as they seek advice about his possible problems. Mr. and Mrs. Kim have no other children. John's penis and testicles are small for a 14-year-old. His testicles have not matured with puberty, and retain the appearance of those of a child. Mr. Kim says that John has gotten into trouble with school authorities over fighting with other boys in gym class and in the school hallways. This is a new problem during the current school year, but there have been other behavioral difficulties earlier in John's school career. "People make fun of me," John says. "I'm getting tired of it." On examination, it is noted that John's legs are exceptionally long in propor- tion to his trunk, which is s: What is the likely diagnosis for John? Klinefelter's syndrome What recommendations would be made for John and his parents? Male hormone treatment

15.Which of the following are the effects of stress? Select all that apply: Fa- tigue

Increased respirations Hypertension Overeating

16. The class is discussing the effects of stress on the cardiovascular system. Which

of the following will be included in this discussion. Select all that apply: Hypertension Stroke Elevated heart rate

17.Which of the following is a function of the immune system?: Destroy bac-

terial/cancer cells

18.The nurse is caring for a patient who is having a Type III immune com- plex-

mediated hypersensitivity that is causing glomerulonephritis. Which of the following nursing findings indicate a complication from this disorder?: In- adequate hourly urinary output

19.A diagnosis of systemic lupus erythematosus is strongly suggested when a person

has developed more than how many of the 11 criteria?: 4

20. A 22-year-old obese female patient comes into the clinic complaining of an

earache and hearing loss in the right ear. Assessment reveals a temperature of 101.2, low-set ears, a wide neck, and droopy eyelids. The patient reports a history of "kidney and heart problems" as well as "being born different." Based on these findings, what chromosomal disorder does this patient likely have?: Turner's syndrome

21.A 17-year-old college-bound student receives a vaccine against an organ- ism that

causes meningitis. This is an example of:: Primary prevention

22.The nurse conducts group education for patients with seasonal allergies and

teaches about the role of histamine. The nurse evaluates that the educa- tion has been effective when the patients make which response?: "Histamine dilates the vessels in the nose, so it is congested and stuffy."

23.Which of the following is not a part of the inflammation process?: Contrac- tion of

vascular smooth muscle

24.Which statement made by the student during a discussion about the plasma

membrane correctly describes cell lysis?: Cell rupture occurs due to the movement of too much water into the cell during osmosis

25.Warning signs of possible cancer would include which of the following?: 1. A

change in bowel habits

2.A change in the size, shape, and color of skin lesion

3.Persistent unusual bleeding

26.A metastatic tumor is one that:: has spread to a location away from its site of

origin

27.The activities of the cell are directed by which cell structure?: Nucleus

28.Which of the following is defined as injurious, unstable agents that can cause

cell death?: Free Radicals

29.A routine ultrasound of a 42-year-old woman at 26 weeks gestation reveals a male

fetus with a small square head, upward slanting eye shape, and low set ears. The nurse recognizes that these are findings are consistent with which of the following?: Trisomy 21 (Down's syndrome)

30.The majority of white blood cells are which destroy invaders by

phagocytosis and enzymatic digestion.: Neutrophils

31.Which action by the nurse is most effective to prevent becoming exposed to the

human immune deficiency virus (HIV)?: Always use standard precautions with all patients

32.Which type of immunity is developed following injection of antibodies

developed by another human or animal?: Passive

33.The nurse assesses patients for the cardinal signs of inflammation. Which

signs/symptoms does this include?: Warmth Edema and swelling Loss of function Redness

34. immunity provides immediate protection and is not specific,

therefore it provides protection against all invaders. (Example: Skin, Mucus membranes..): Innate

35.The nurse is assessing a patient that has been diagnosed with lead toxicity. The

nurse knows that the cardinal sign of this condition is:: Anemia

36.What is the name of the syndrome that occurs in males when there is an extra X

chromosome?: Klinefelter's

37. Which of the following will the nurse document as symptoms of a disease

process? Select all that apply: Fatigue Pain Nausea

38.Metaplasia of normal squamous epithelium cell in gastric esophageal reflux

disease (GERD) is caused by which of the following?: Chronic irritation and inflammation

39.Which statement indicates that the student has a good understanding about the

role of pyrogens during innate immunity?: Pyrogens can cause mild fevers that cause the spleen and liver to remove iron from the blood that is needed for bacterial growth

40.Which type of immunity is provided by a vaccination?: active artificial

41. infections are caused by pathogens that do not usually cause

disease in health individuals.: Opportunistic

42.Building a strong immune system is the key to preventing what type of

diseases?: Infectious Diseases

43. transplants use tissue from the same person, but a different area of

the body. An example is donating blood before a procedure to use in the procedure (host and donor are the same).: Autologous

44.Which of the following refers to loss of blood supply due to decreased tissue

perfusion, and a cause of atrophy?: ischemia

45.The physician has ordered a colonoscopy on a patient admitted with lower

abdominal discomfort. What level of prevention is this procedure?: Secondary

46.Which of the following mechanisms demonstrates the bodies attempt to maintain

homeostasis?: The patient's insulin level increases after eating a candy bar in order to lower increased glucose levels.

47.A lung biopsy and magnetic resonance imaging have confirmed the pres- ence of a

benign lung tumor in a patient. Which of the following characteristics is associated with this patient's tumor?: The tumor will grow by expansion and is likely encapsulated, but it is unlikely to metastasize.

48.The patient is having an altered immune response called hypersensitivity; the

nurse knows that this is:: Increased reaction to an antigen that will lead to inflammation, which destroys healthy cells

49.The patient needs a kidney transplant- where the kidney will come from another

human. The nurse understands that which type of transplant is nec- essary?: Allogenic

50. Sodium has an inverse relationship with which of the following elec-

trolytes? Example: Sodium is excreted ---> is retained: Potassium

51.The blood levels of are regulated by parathyroid hormone

(PTH) and calcitonin.: Calcium

52. The nurse is caring for a client with iron-deficiency anemia and wants to teach the

client which foods are high in iron. The nurse should include which foods in the discussion? SELECT ALL THAT APPLY: Spinach Liver Steak

53.While monitoring a patient who has fluid overload, the nurse would be most

concerned about which assessment finding?: Presence of Crackles in the Lungs

54.The type of Leukemia that primarily affects children is:: Acute lymphoblastic

leukemia (ALL)

55.Which of the following patients is most likely to have a respiratory alkalo- sis?: A

patient having a panic attack and breathing rapidly

56.Hodgkin's Lymphoma is characterized by solid tumors with presence of::

Reed-Sternberg cells

57.Which of the following lab results would be tested by a complete blood count

(CBC)?: Red Blood Cells and Platelets

58.True or False. The respiratory system responds to acid/base imbalances faster

than the kidneys, but the response of the kidneys lasts longer.: True

59.The nurse observes a flattened T-wave and a prominent U-wave on the ECG of a

patient admitted with vomiting and muscle weakness. Which of the following lab results does the nurse expect find on this patient?: Serum potassium level of 2. mEq/L

60.Your patient's ABG results are: pH -7.50, PaCO2 37, HCO3 36. Which acid-

base balance does this patient have?: Metabolic Alkalosis

61.Sodium is primarily excreted through the:: Kidneys

62.Your patient's sodium level is low at 119 mEq/L. What manifestation might you

see?: muscle cramps and weakness

63. The most significant extra cellular fluid buffering system which involves carbonic

acid (H2CO3), and bicarbonate (HCO3) reacting with H2O, is called:- : Bicarbonate - carbonic acid system

64.Which of the following is an example of insensible water losses?: Sweating

65. Manifestations of fluid, volume excess include:

select all that apply: Anasarca Periorbital edema Peripheral edema

66.Kussmaul's respirations are most likely to be seen in which acid/base

imbalance?: Metabolic acidosis

67.A patient presented with an elevated magnesium level of 2.7. Which disor- der is

the most likely calls for this electrolyte imbalance?: Renal failure

68.A nurse is caring for a client who is postoperative, and whose respirations are

shallow at 6/MIN. Hint: he's holding onto CO2. Which of the following acid-base imbalances should the nurse identify the client as being at higher risk for developing?: Respiratory acidosis

69.Which of the following discharge instructions is essential to include for the patient

with infectious mononucleosis?: Avoid contact sports to prevent rupture of the spleen

70.True or false. Hypertonic solutions have an osmolality greater than intra- cellular

fluids (ICF). Therefore, water moves out of the cells.: True

71. A patient who recently had a thyroidectomy reports, bruising and petechi- ae since

her surgery. The nurse also notes that she has a positive trousseau's sign when her blood pressure is taken. It is most likely that this patient is experiencing which electrolyte imbalance?: Hypocalcemia

72.A diet high in can potentially lead to fluid volume excess.: Sodi- um

73.The patient with a low calcium level has been placed on seizure precau- tions.

Which of the following are interventions that will be included in this patient's care? select all that apply: Dim the lights Bed in low position Ensure three side rails are up while the patient is in bed

74.True or faults: non-Hodgkin's lymphoma tends to spread throughout the body in

an unorganized pattern and has a poor prognosis.: True

75.A nurse is caring for a client who has the following Archero blood gas results:

HCO3 mEq, PaCO2 37mmHg, and pH 7.30. The nurse recognizes the client is experiencing which of the following acid-base imbalances.: Metabolic acidosis

76.Red blood cells or erythrocytes are made in the and destroyed in

the .: Bone marrow, spleen

77.2/3 of the body's water in healthy adults is located in the:: Intracellular fluid

compartment, or ICF

78.One treatment for metabolic alkalosis is which increases excre-

tion of bicarbonate.: Diamox

79. Your patient has the below ABG results. Which acid base in balance is the patient

experiencing? pH 7. PaCO2 25 HCO3 19: Respiratory alkalosis

80.Significant fluid increases in the transcellular compartment are often re- ferred to

as which of the following because fluid is not easily exchanged among the other extracellular fluids?: Third spacing

81.The three systems in the body that work to maintain acid base balance are: select

all that apply: Buffer, lungs, and kidneys

82.During a discussion about hematologic disorders, the topic of having an appetite

for non-nutrient substances such as ice and soil was discussed. Which statement by the student indicates that there is an understanding about this disorder?: The patient is experiencing pica that is a manifestation of iron-deficiency anemia.

83. Which of the following IV solutions is an example of an isotonic solution?-

: 0.9% sodium chloride.

84.A 14 year old high school freshman presents to her pediatricians office with severe

fatigue, swollen, lymph nodes, and a low-grade fever. Which blood test would confirm her diagnosis of infectious mononucleosis?: An elevated total white blood cell count

85. A nurse is reviewing the arterial blood gas values for a client below. The nurse

should recognize that these indicate which of the following acid-base imbalances. ADD: Respiratory acidosis

86. The CBC, results of a patient admitted to the ER indicates leukocytosis. The

patient should be further evaluated for which of the following disorders?- : Presence of inflammation, or infection

87.The most common hereditary bleeding disorder is and it is

caused by a deficit of a factor with the same name that results in decreased platelet adhesion and aggregation. There are multiple types.: Von Willebrand's disease

88.True or false. Carbon dioxide is not able to diffuse across the blood brain barrier.:

False

89.A nurse is reviewing the laboratory values of a client who is in respiratory acidosis.

Which of the following findings should the nurse expect?: PaCO2 of 50

90.A nurse is reviewing the medical records of four clients who have an acid base and

balance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?: A client who has diarrhea

91.Which statement made by the student during a discussion about the plasma

membrane correctly describes cell lysis?: Bleeding precautions

92. A nurse is creating a teaching plan for a client who has thrombocytopenia. Which

of the following instruction should the nurse include? Select all that apply: Use an electric razor to shave Blow nose gently Brush teeth with a soft toothbrush

93.A nurse is assessing a client who has end-stage kidney disease and is receiving

hemodialysis. Which of the following findings should the nurse identify as an indication the client is experiencing fluid overload?: The client has a 5 pound weight gain since yesterday

94.Production of red blood cells is regulated by , which is produced

in the kidneys and stimulates the bone marrow stem cells.: Erythropoietin

95.A nurse is reviewing a client CBC findings and discovers that the clients plate

light count is low at 9000. The nurse knows this Client is an increased risk for which condition?: Spontaneous bleeding

96. A nurse is assessing a client who has fluid overload. Which of the following

findings should the nurse expect? Select all that apply: Moist crackles in the lungs Distended, neck veins Increased blood pressure

97.The nurse is providing teaching to a client who has neutropenia. Which of the

following information should the nurse include in the teaching?: Avoid large crowds, or gatherings

98. A nurse is teaching a client who has a new diagnosis of aplastic anemia. Which of

the following information should the nurse include in the teaching?- : Aplastic anemia results from decreased bone marrow production of all blood cells

99.A nurse is caring for a client who has in stage kidney disease, or ESKD, and reports

having shortness of breath and swelling in his lower extremities. Upon assessment, the nurse notes that the client has crackles in his lungs and an elevated blood pressure. The nurse should expect which of the following based on the clients manifestations?: Hypervolemia

100. A nurse is teaching a client about dietary recommendations who has iron

deficiency anemia. The nurse suggest that the client take their iron tablet with

to increase absorption.: Orange juice

101. A nurse is caring for a client who has sustained significant blood loss. Which

of the following is a manifestation of hypovolemia?: Weak, thready pulse

102. A nurse is assessing a client who is postoperative and has anemia due to

excessive blood loss following surgery. Which of the following symptoms should the nurse expect from a patient with anemia?: fatigue

103. A nurse is assigned to care for a patient diagnosed with autoimmune or

idiopathic thrombocytopenic purpura or ITP. When reviewing the clients plan of care prior to caring for the client, the nurse should recognize that the priority concern and caring for the client is to monitor for what?: Bleeding

104. A nurse is caring for a child who has acute gastroenteritis, but is able to

tolerate world fluids. Which of the following fluids is best for a client with gastroenteritis?: Oral rehydration solution such as Pedialyte

105. When reviewing coagulation lab results, the

prothrombin time, or PT, assesses the effects of , while the partial thromboplastin time or PTT, assesses the effects of : Coumadin, heparin

106. A nurse is discharging a child who has sickle cell anemia after an acute

crisis episode. Which of the following instruction should the nurse include in the teaching?: To prevent dehydration, offer fluids to your child multiple times a day

107. A nurse is assessing a client who has chronic kidney disease for fluid

volume increase. Which of the following provides the most reliable measure of fluid retention?: Daily weight

108. pH: Indicates acid-base status

109. HCO3: Indicates the activity in the kidneys to retain or excrete

bicarbonate

110. PaO2: Indicates serum oxygen concentration

111. PaCO2: Indicates adequacy of pulmonary ventilation

112. Initial treatment for a myocardial infarction includes: (hint: Mona): Mor-

phine, oxygen, nitroglycerin, & aspirin

113. What part of the heart is the most susceptible to ischemic damage because

more arteries supply it to meet its increased need for oxygen?: Left ventricle

114. The layer of the blood vessel responsible for the vessels ability to change

diameter is the:: Tunica media

115. A female patient has been experiencing episodes of color changes of her

fingertips, especially when she experiences cold temperatures. She states that the tips become pale, turn a bluish color, and then become very painful. Which of the following is the most likely diagnosis?: Raynaud phenomenon

116. Narrowing and hardening of the arteries is known as: Atherosclerosis

117. A nurse is reviewing the laboratory results for a client who has a history of

atherosclerosis and notes elevated cholesterol levels. Which of the following statements by the client indicates the nurse should plan follow up teaching on a low cholesterol diet?: I will eat two eggs and bacon for breakfast every day

118. The nurse recognizes, which of the following is the most critical assess-

ment, finding when caring for the patient at risk for hypovolemic shock?: De- creased urine output

119. The patient has all of the following clinical manifestations. Which assess-

ment finding alerts the nurse, to the probability of anaphylactic shock, as opposed to other types of shock?: Difficulty breathing

120. True or false: blood flows in the following sequence in the heart.

Superior vena cava/inferior, vena cava, right atrium, bicuspid valve, right, ven- tricle, pulmonic valve, pulmonary artery, lungs, pulmonary veins, left atrium, tricuspid valve, left, ventricle, aortic valve, and aorta: False

121. The lymphatic system works to return, excess interstitial fluid (lymph) to

circulation, plays a role in immunity, and includes the lymph nodes, tonsils and .:

Spleen

122. occurs with insufficient valve closure and causes decreased

cardiac output, increase, cardiac workload, hypertrophy, and dilation.: Regur- gitation

123. True or false: restrictive cardiomyopathy is the least common type of

cardiomyopathy, but it is endemic in parts of south and Central America, India, Asia, and Africa.: True

124. The ability of the heart to generate in impulse to contract with no external

nerve stimulus is called the property of:: Automaticity

125. When diagnosed with heart failure, which of the following lifestyle modi-

fications may help improve a patient's condition? Select all that apply.: Fluid restriction Weight reduction Tobacco cessation

126. What type of aneurysm affects the entire circumference of the vessel?: -

Fusiform aneurysm

127. An thrombi, that forms in the venous circulation, for example, a DVT, is most

likely to travel to which location of the body and cause severe damage?- : Lungs

128. The nurse is providing group education about lipids to patients who have

been diagnosed with hyper lipidemia. What does the best instruction include?: High density lipoprotein is called good cholesterol because it removes the bad cholesterol or LDL from your body

129. Cardiac output is used to measure the effectiveness of the heart as a

pump. What is the equation used to express cardiac output?: CO = stroke volume X heart rate

130. What type of cardiomyopathy is characterized by progressive, cardiac

hypertrophy, dilation, and impaired, pumping with heart, enlargement and thinning

walls?: Dilated

131. The patient is immobilized following a hip injury and has begun demon-

strating right, lower leg, discoloration with edema, pain, tenderness, and increased warmth in the mid calf area. The patient has many of these mani- festations, which of the following could this be?: Deep vein thrombosis

132. A nurse in an emergency department is assessing a client who is having a

suspected acute myocardial infarction. Which of the following manifestations should the nurse expect to find for a client experiencing an acute MI? Select all that apply.: Tachycardia Nausea Diaphoresis

133. A nurse is caring for a client who has hypovolemic shock. Which of the

following should the nurse recognize as expected finding?: Oliguria

134. Aortic stenosis is most likely to result in which of the following cardio-

vascular manifestations?: Left ventricular hypertrophy

135. Which of the following vessels delivers deoxygenated blood from the

heart to the lungs?: Pulmonary artery

136. A patient comes to the emergency department, complaining of coughing and

difficulty breathing. The patient's diagnosis is left heart failure. He ask you how difficulty breathing could be a heart problem. What is the nurses best response?: The left side of your heart has weakened and blood has backed up into your lungs

137. When teaching a patient with new onset right sided heart failure, the nurse

should teach the patient that the best way to monitor for fluid accumulation is to perform which of the following?: Weighing every day at the same time with the same type of clothing

138. A patient has just been told that he has an infection of the inner surface of

the heart. He has also told that the bacteria has invaded his heart valves. What term is

used for this disease process?: Infective endocarditis

139. In the heart, inotropic

affect controls : Strength of contraction

140. Considering the PQRST complex of an electrocardiogram, which of the

following letter designations represents atrial depolarization?: P-wave

141. Which of the following statements relating to heart failure is not correct?-

: It leads to excretion of excessive amounts of salt and water by the kidneys

142. And especially intense form of hypertension that develops rapidly and

usually results from noncompliance with prescribed antihypertensive med- ication is called what?: Malignant, hypertension

143. The node is the primary pacemaker of the heart, and has an

intrinsic rate of 60 to 100 bpm.: Sinoatrial or SA

144. The node is the gatekeeper of the heart.: AV or atrioventricular

145. Which type of cardiomyopathy is frequently caused by treatment with

chemotherapy agents such as doxorubicin?: Dilated cardiomyopathy

146. Conditions that promote thrombus formation, Virchow's triad, include

which of the following? Select all the apply.: Endothelial injury Increased coagulopathy Sluggish blood flow

147. A nurse is caring for a client who has infective endocarditis. Which of the

following manifestations is the priority for the nurse to monitor?: Dyspnea

148. Which statement made by a patient with alert the nurse to the possibility of

right sided heart failure?: My legs are swollen and my shoes are getting really tight.

149. Your patient has hypertension and ask you how this can lead to heart failure.

What is the best response?: Hypertension causes resistance in your blood vessels, or afterload, so your heart works harder, and weakens.

150. The most likely place for a thrombosis to form postoperatively is:: The

legs

151. A nurse is caring for a client who has a valvular heart disease and is at risk

for developing left sided heart failure. Which of the following manifestations should alert the nurse the client is developing left sided heart failure?: Lung crackles

152. The cardiac cycle describes the pumping action of the heart. Which

statement is correct about systole?: Ventricles contract, and blood is ejected from the heart

153. Which of the following is most likely to contribute to thrombus develop-

ment?: Immobility

154. Which is the most serious complication of an aortic aneurysm?: Rupture

and massive bleeding

155. Which delivers richly oxygenated blood to the body after leaving the left

ventricle?: Aorta

156. Why do cardiac enzymes such as troponins rise after an acute myocardial

infarction?: Cardiac enzymes leak from the damage muscle fibers into the blood- stream

157. A nurse is assessing a female client and notes that her left arm is swollen

from the shoulder down to the fingers, with nonpitting edema. The right arm is normal. The patient had a left-sided mastectomy one year ago. Which of the following does the nurse suspect is the problem?: Lymphedema

158. Pericardial effusion can eventually progress to which life-threatening

medical condition?: Cardiac tamponade

159. The force opposing the blood, and the peripheral circulation is called:: -

Peripheral vascular resistance

160. The electrical activity of the heart is recorded on an electrocardiogram.

What does the T-wave on the ECG represent?: Repolarization of the ventricles

161. A nurse is preparing a community health program for adults at risk for

cardiovascular disease. Which of the following should the nurse includes as a modifiable risk factor?: Cigarette Smoking