RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024, Exams of Nursing

Download RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 and more Exams Nursing in PDF only on Docsity! RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. A nurse is administering IV fluid to an older adult client. The nurse should perform which priority assessment to monitor for adverse effects? A) Auscultate lung sounds. B) Measure urine output. C) Monitor blood pressure readings. D) Monitor serum electrolyte levels. - CORRECT ANSWERS auscultate lung sounds Auscultate lung sounds.MY ANSWERThe priority assessment the nurse should make when using the airway, breathing, circulation approach to client care is auscultating lung sounds to monitor for fluid volume excess, a complication of IV therapy. Manifestations of fluid volume excess include moist crackles in lung fields, dyspnea, and shortness of breath. Measure urine output.The nurse should measure urine output to monitor the renal function of a client who is receiving IV fluid; however, it is not the priority assessment. Monitor blood pressure readings.The nurse should monitor blood pressure readings to evaluate the hemodynamic stability of a client who is receiving IV fluids; however, it is not the priority assessment. Monitor electrolyte levels.The nurse should monitor electrolyte levels, especially sodium, to guide the planning of interventions to correct any imbalances in a client who is receiving IV fluids; however, it is not the priority assessment. A charge nurse is discussing the responsibility of nurses caring for clients who have a Clostridium difficile infection. Which of the following information should the nurse include in the teaching? A) Assign the client to a room with a negative air-flow system. B) Use alcohol-based hand sanitizer when leaving the client's room. C) Clean contaminated surfaces in the client's room with a phenol solution. D) Have family members wear a gown and gloves when visiting. - CORRECT ANSWERS have family members wear a gown and gloves when visiting c.rational:The nurse should use a phenol solution to clean surfaces contaminated with bacteria and fungi. However, phenol does not kill Clostridium difficile spores. Chlorine bleach is an example of a disinfectant that kills spores. RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. a nurse is giving change-of-shift report about a client they admitted earlier that day who has pneumonia. which of the following pieces of information is the priority for the nurse to provide? a. admitting diagnosis b. breath sounds c. body temperature d. diagnostic test results - CORRECT ANSWERS breath sounds A nurse is planning teaching for a group of adolescents who each recently had surgical placement of an ostomy. Which of the following methods should the nurse use as a psychomotor approach to learning?A) Role play B) Group discussions C) Question-answer meetings D) Practice sessions - CORRECT ANSWERS practice sessions a nurse is caring for a client who reports difficulty falling asleep. which of the following recommendations should the nurse make? a. drink a cup of hot cocoa before bedtime b. maintain a consistent time to wake up each day c. exercise 1 hour before going to bed d. watch a television program in bed before going to sleep - CORRECT ANSWERS maintain a consistent time to wake up each day a nurse is admitting a client who has rubella. which of the following types of transmission- based precautions should the nurse initiate? a. droplet b. airborne c. contact d. protective environment - CORRECT ANSWERS droplet RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. a. Blowing sounds resulting from blood flowing through occluded or narrowed arteries are known as a bruit. b. Blood flowing through distended jugular veins does not produce a sound. c. Impaired ventricular function produces extra heart sounds, either S3 or S4. These sounds are best heard over the aortic area of the heart. d. Asynchronous closure of the aortic and pulmonic valves is known as "splitting" of S2, so the nurse should hear two "dub" sounds during auscultation. This sound is best heard over the aortic area of the heart. a nurse is caring for a group of clients on a medical-surgical unit. in which of the following situations does the nurse demonstrate the ethical principle of veracity? a. A client who is unaware of her recent cancer diagnosis asks the nurse if she has cancer, and the nurse responds affirmatively. b. A client who has a prescription for a nasogastric tube refuses it, and the nurse complies with the client's wishes. c. A client who has a do-not-resuscitate (DNR) order has a cardiac arrest, and the nurse does not perform CPR despite requests from the client's family. d. A client who is about to undergo a painful procedure receives pain medication 30 min before the procedure that the nurse previously promised to administer. - CORRECT ANSWERS a client who is unaware of her recent cancer diagnosis asks the nurse if she has cancer, and the nurse responds affirmatively A nurse in a clinic is caring for a middle adult client who states, "The doctor says that, since I am at an average risk for colon cancer, I should have a routine screening. What does that involve?" Which of the following responses should the nurse make? A) "I'll get a blood sample from you and send it for a screening test." B) "Beginning at age 60, you should have a colonoscopy." C) "You should have a fecal occult blood test every year." D) "The recommendation is to have a sigmoidoscopy every 10 years." - CORRECT ANSWERS you should have a fecal occult blood test every year a.Blood tests do not detect colorectal cancer. One option for screening is a double-contrast barium enema every 5 years. RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. b.Colorectal cancer screening for clients who are at average risk begins at age 50. One option for screening is a colonoscopy every 10 years. c.Colorectal cancer screening for clients who are at average risk begins at age 45. One option for screening is a fecal occult blood test annually. d. One option for screening is a flexible sigmoidoscopy every 5 years. a nurse is teaching a group of staff nurses about the use of essential oils for aromatherapy. the nurse should include in the teaching that this therapy might be contraindicated for which of the following clients? a. a client who has a history of physical abuse b. a client who has a permanent pacemaker c. a client who has ulcerative colitis d. a client who has asthma - CORRECT ANSWERS a client who has asthma a nurse is caring for a client who is receiving fluid through a peripheral IV catheter. which of the following findings at the IV site should the nurse identify as indicating infiltration? a. purulent exudate b. warmth c. skin blanching d. bleeding - CORRECT ANSWERS skin blanching Skin blanching, edema, and coolness at the IV site indicate infiltration. a nurse is discussing the use of herbal supplements for health promotion with a client. which of the following client statements indicates an understanding of herbal supplement use? a. I can take echinacea to improve my immune system b. I can take feverfew to reduce my level of anxiety c. I can take ginger to improve my memory d. I can take ginkgo blob to relieve nausea - CORRECT ANSWERS I can take echinacea to improve my immune system RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. - Echinacea is taken to promote immunity and reduce the risk of infection. - Feverfew is taken to promote wound healing and decrease inflammation associated with arthritis. Valerian and chamomile can be taken to reduce anxiety. - Ginger is taken to relieve nausea and vomiting and aid in digestion. Ginkgo biloba can be taken to improve memory and reduce stress. - Ginkgo biloba is taken to improve memory and reduce stress. Ginger can be taken to relieve nausea and vomiting and aid in digestion. A nurse is caring for a client who is refusing a blood transfusion for religious reasons. The client's partner wants the client to have the blood transfusion. Which of the following actions should the nurse take? A) Ask the client to consider a direct donation. B) Withhold the blood transfusion. C) Request a consultation with the ethics committee. D) Ask the client's family to intervene. - CORRECT ANSWERS withhold the blood transfusion a nurse has just inserted an NG tube for a client. which of the following findings should the nurse expect to confirm correct tube placement? a. the tube aspirate has a pH of 7 b. an x-ray shows the end of the tube above the pylorus c. bowel sounds are present on auscultation d. the client reports relief of nausea - CORRECT ANSWERS an x-ray shows the end of the tube above the pylorus A nurse is reviewing a client's medication prescription, which reads, "digoxin 0.25 by mouth every day." Which of the following components of the prescription should the nurse question? A) The medication name B) The route of administration RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. c. cleanse latex ports on IV tubing with chlorhexidine before injecting medication d. wear hypoallergenic latex gloves that contain powder - CORRECT ANSWERS wrap monitoring cords with stockinette and tape them in place a.Ethylene oxide can cause an allergic reaction in clients who have a latex allergy. The nurse should rinse any items that received this type of sterilization before use. b.Many monitoring devices and cords contain latex. The nurse should prevent any contact of these cords and devices with the client's skin by covering them with a nonlatex barrier material, such as stockinette, and using nonlatex tape to secure them. c.The nurse should use a stopcock for injecting medication. Cleansing a latex item will not remove the latex protein. a nurse is caring for a client who has decreased mobility. which of the following actions should the nurse take to decrease the clients risk of developing plantar flexion contractures? a. place a pillow under the clients knees b. position a trochanter roll under each of the clients hips c. advise the client to wear rubber-soled slippers d. apply an ankle-foot orthotic device to the clients feet - CORRECT ANSWERS apply an ankle-foot orthotic device to the clients feet The nurse should use a device to maintain dorsiflexion, such as an ankle-foot orthotic device or a foot board placed perpendicular to the mattress. a nurse manager is overseeing the care activities on a unit. for which of the following situations should the nurse manager intervene due to a violation of HIPAA guidelines? a. A nurse who is caring for a client reviews the client's medical chart with a nursing student who is working with the nurse. b. A nurse asks a nurse from another unit to assist with documentation for a client. c. A nurse who is caring for a client returns a call to the person appointed in the health care proxy to discuss the client's care. RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. d. A nurse discusses a client's status with the physical therapist who is caring for the client. - CORRECT ANSWERS A nurse asks a nurse from another unit to assist with documentation for a client. a nurse is caring for a client who is receiving pain medication through a patient-controlled analgesia (PCA) pump. which of the following actions should the nurse take? a. Instruct the family to refrain from pushing the button for the client while she is asleep. b. Inform the client that because she is on PCA, vital signs will be taken every 8 hr. c. Teach the client to avoid pushing the button until pain is above a 7 on a scale of 0 to 10. d. Increase the basal rate and shorten the lock-out interval time if the client's pain level is too high. - CORRECT ANSWERS Instruct the family to refrain from pushing the button for the client while she is asleep. a.The nurse should instruct family members not to activate the button for the client while they are sleeping. Even though PCA pumps minimize the risk of overdose, toxic effects could still occur if the client receives more medication than necessary to control pain. c.The nurse should instruct the client to activate the PCA pump when she needs it. It is inappropriate for the client to wait until pain escalates to any particular level of intensity before using the pump. a nurse is performing a Romberg test during the physical assessment of a client. which of the following techniques should the nurse use? a. touch the face with a cotton ball b. apply a vibrating tuning fork to the clients forehead c. have the client stand with their arms at their sides and their feet together d. perform direct percussion over the area of the kidneys - CORRECT ANSWERS have the client stand with their arms at their sides and their feet together A nurse is reviewing practice guidelines with a group of newly licensed nurses. Which of the following interventions should the nurse include that is within the RN scope of practice? A) Insert an implanted port. B) Close a laceration with sutures. RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. C) Place an endotracheal tube. D) Initiate an enteral feeding through a gastrostomy tube. - CORRECT ANSWERS initiate an enteral feeding through a gastrostomy tube A nurse is reviewing protocol in preparation for suctioning secretions from a client who has a new tracheostomy. Which of the following actions should the nurse plan to take? A) Use a resuscitation bag with 80% oxygen prior to the procedure. B) Select a suction catheter that is half the size of the lumen. C) Place the end of the suction catheter in water-soluble lubricant. D) Adjust the wall suction apparatus to a pressure of 170 mm Hg. - CORRECT ANSWERS select a suction catheter that is half the size of the lumen a. The nurse should preoxygenate the client with 100% oxygen before suctioning to prevent hypoxemia. b. The nurse should select a suction catheter that is half the size of the lumen to prevent hypoxemia and trauma to the mucosa. c. The nurse should lubricate the end of the suction catheter with sterile water or 0.9% sodium chloride irrigation solution to decrease trauma to the mucosa. d. The nurse should adjust the suction pressure to approximately 120 mm Hg and no higher than 150 mm Hg to prevent hypoxemia and trauma to the mucosa. A nurse is caring for a client who reports pain. When documenting the quality of the client's pain on an initial pain assessment, the nurse should record which of the following client statements? A) "I'm having mild pain." B) "The pain is like a dull ache in my stomach." C) "I notice that the pain gets worse after I eat." D) "The pain makes me feel nauseous." - CORRECT ANSWERS the pain is like a dull ache in my stomach RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. 1) Inject 5 units of air into the bottle of regular insulin 2) Withdraw the correct dose of NPH insulin from the bottle 3) Inject 10 units of air into the bottle of NPH insulin 4) Withdraw the correct dose of regular insulin from the bottle - CORRECT ANSWERS 1. Inject 10 units of air into the bottle of NPH insulin 2.Inject 5 units of air into the bottle of regular insulin 3.Withdraw the correct dose of regular insulin from the bottle 4) Withdraw the correct dose of NPH insulin from the bottle The nurse should first inject air into the vial of NPH insulin without touching the needle to the solution. Next, the nurse should inject air into the vial of regular insulin and withdraw the correct amount of the regular insulin. Finally, the nurse should insert the needle into the NPH insulin vial and withdraw the correct amount of NPH insulin. The nurse should follow these steps to prevent contaminating the regular insulin with NPH insulin. a middle adult client tells the nurse, "I feel so useless now that my children do not need me anymore." which of the following responses should the nurse make? a. "Most people are happy when their children grow up and leave home." b. "You should be proud that your children are becoming independent." c. "Maybe you should consider why you are feeling useless." d. "People in middle adulthood often find satisfaction in nurturing and guiding young people." - CORRECT ANSWERS "People in middle adulthood often find satisfaction in nurturing and guiding young people." a nurse is calculating a clients fluid intake over the past 8 hours. which of the following items should the nurse plan to document on the clients intake and output record as 120 ml of fluid? a. 2 cups of soup b. 1 quart of water c. 8 oz of ice chips RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. d. 6 oz of tea - CORRECT ANSWERS 8 oz of ice chips a.240ml b.960-1000ml c.ICE-> 120ml d.180ml a nurse on a medical unit is preparing to discharge a client to home. which of the following actions should the nurse take as part of the medication reconciliation process? a. seal unused medications from the facility in a plastic bag b. evaluate the clients ability to self administer medications c. report an identified discrepancy to the join commission d. compare prescriptions with medications the client received while at the facility - CORRECT ANSWERS compare prescriptions with medications the client received while at the facility A nurse is preparing to administer multiple medications to a client who has an enteral feeding tube. Which of the following actions should the nurse plan to take? A) Dissolve each medication in 5 mL of sterile water. B) Draw up medications together in the syringe. C) Push the syringe plunger gently when feeling resistance. D) Flush the tube with 15 mL of sterile water. - CORRECT ANSWERS flush the tube with 15mL of sterile water The nurse should flush the feeding tube with 15 to 30 mL of sterile water before administration and between each medication. The nurse should flush the feeding tube with 30 to 60 mL of sterile water following the administration of the last medication. a nurse is preparing to delegate client care tasks to an assistive personnel (AP). which of the following tasks should the nurse delegate? RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. a. ambulating a client who is postoperative b. inserting an indwelling urinary catheter for a client c. demonstrating the use of an incentive spirometer to a client d. confirming that a clients pain has decreased after receiving an analgesic - CORRECT ANSWERS ambulating a client who is postoperative The nurse should use a 35-mL syringe to irrigate the wound. Syringes that hold 30 to 60 mL of fluid create a safe but effective amount of pressure for wound irrigation. a nurse is caring for a client who has a terminal diagnosis and whose health is declining. the client request information about advanced directives. which of the following responses should the nurse make? a. "We can talk about advance directives, and I can also give you some brochures about them." b. "You should set up a time to talk with your provider about that." c. "Let's discuss how you are feeling today, and we'll save the planning for when you are feeling a little better." d. "Why do you want to discuss this without your partner here to plan this with you?" - CORRECT ANSWERS "We can talk about advance directives, and I can also give you some brochures about them." a nurse is providing discharge teaching for a client who has a new prescription for a home oxygen concentrator. which of the following instructions should the nurse provide to the client and his family? (select all that apply) a. check the cord routinely for frays or tearing b. keep the unit at least 1.2 m (4 ft) away from a gas stove c. Consider purchasing a generator for power backup. d. Observe for signs of hypoxia. e. Select synthetic clothing and bedding. - CORRECT ANSWERS a. check the cord routinely for frays or tearing c. Consider purchasing a generator for power backup. RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. b. a client who smokes one pack of cigarettes each day c. a client who walks for 30 minutes every day d. a client who drinks one glass of wine 3 times per week - CORRECT ANSWERS a client who smokes one pack of cigarettes each day a nurse is assessing a client who received an IV fluid bolus for dehydration. which of the following findings should the nurse identify as an indication of fluid volume excess? a. hypotension b. weak, thready pulse c. slow capillary refill d. distended neck veins - CORRECT ANSWERS distended neck veins HypotensionHypotension is an indication of fluid volume deficit. Other indications of fluid volume deficit, or dehydration, are dry mucous membranes and sunken eyeballs. Weak, thready pulseA weak, thready pulse is an indication of fluid volume deficit. Other indications of fluid volume deficit, or dehydration, include an increased hematocrit and urine specific gravity. Slow capillary refillA decrease in capillary refill time is an indication of fluid volume deficit. Other indications of fluid volume deficit, or dehydration, include output of less than 30 mL/hr and dark yellow urine. Distended neck veinsMY ANSWERIndications of fluid volume excess include distended neck veins, edema, tachycardia, crackles in the lungs, dyspnea, a bounding pulse, and an increase in blood pressure. A nurse is planning care for a client who has vision loss. Which of the following interventions should the nurse include in the plan of care to assist the client with feedings? A) assign a staff member to feed the client B) Provide small-handle utensils for the client. C) Thicken liquids on the client's tray. D) arrange food in a consistent pattern on the clients plate - CORRECT ANSWERS arrange food in a consistent pattern on the client's plate RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. Consistency in preparing the client's plate helps to facilitate self-feeding for clients who have vision loss. Staff can describe the location of the food on the plate by using a clock pattern, allowing the client to have greater independence during meals. A nurse is caring for a client who has limited mobility in his lower extremities. Which of the following actions should the nurse take to prevent skin breakdown? A) Place the client in high-Fowler's position. B) Increase the client's intake of carbohydrates. C) Massage reddened areas with unscented lotion. D) Have the client use a trapeze bar when changing position. - CORRECT ANSWERS have the client use a trapeze bar when changing positions High-Fowler's position places additional pressure on the sacrum and the heels, increasing the risk for skin breakdown. By using a trapeze bar to assist with repositioning and transferring, the client avoids the friction and shearing that result from sliding up and down in bed. Shearing is a risk factor for pressure-injury development. a client who is non ambulatory notifies the nurse that his trash can is on fire. after the nurse confirms the presence of the fire, which of the following actions should the nurse take next? a. activate the emergency fire alarm b. extinguish the fire c. evacuate the client d. confine the fire - CORRECT ANSWERS evacuate the client Rescue alarm confine RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. extinguish a nurse is admitting a client who has been having frequent tonic-clonic seizures. which of the following actions should the nurse add to the clients plan of care? a. wrap blankets around all four sides of the bed b. apply restraints during seizure activity c. place the client in a supine position during seizure activity d. have a tongue depressor at the clients bedside - CORRECT ANSWERS wrap blankets around all four sides of the bed Wrap blankets around all four sides of the bed.MY ANSWERThe nurse should affix linens or blankets around the head, foot, and side rails of the bed to pad them and prevent injury for a client who has been having frequent tonic-clonic seizures. Apply restraints during seizure activity.Restraining a client who is having a seizure increases her risk for injury. Place the client in a supine position during seizure activity.The nurse should turn the client to the side so that the tongue does not occlude the airway and so that secretions can flow out of the side of the client's mouth. Have a tongue depressor at the client's bedside.Inserting any object into the mouth of a client who is having a seizure increases the risk for injury to the mucous membranes in the mouth and damage to the teeth. a nurse has accepted a verbal prescription "for three tenths of a milligram of levothyroxine IV stat" for a client who has myxedema coma. how should the nurse transcribe the dosage of this medication in the clients medical record? a. .3 mg b. 0.3 mg c. 0.30 mg d. 3/10 mg - CORRECT ANSWERS 0.3 mg RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. c. The newly licensed nurse holds the bottle of sterile saline outside the edge of the field when pouring. d. The sterile field is positioned at the level of the newly licensed nurse's waist. - CORRECT ANSWERS The newly licensed nurse places the cap of a bottle of sterile saline solution on the sterile field. The newly licensed nurse should place the cap with the sterile side up on a clean surface because the outer edges are unsterile and will contaminate the sterile field. a nurse is caring for a client who requires an informed consent for a surgical procedure. which of the following actions is the nurses responsibility? a. describe the procedure to the client b. witness the clients signature on the consent form c. inform the client of alternatives to the procedure d. tell the client which team members will assist with the procedure - CORRECT ANSWERS witness the clients signature on the consent form The nurse is responsible for witnessing the client sign the consent form. The nurse should confirm that the client appears competent to give consent and that the client understands the procedure. restgivenbyprovider a nurse is planning an educational program for a group of older adults at a senior living center. which of the following recommendations should the nurse include? a. "You should have an eye examination every 2 years." b. "You should receive a tetanus booster every 5 years." c. "You should receive a shingles vaccine when you are 70 years old." d. "You should receive a pneumococcal vaccine when you are 65 years old." - CORRECT ANSWERS "You should receive a pneumococcal vaccine when you are 65 years old." RN FUNDAMENTALS ONLINE PRACTICE 2019 TEST B QUESTIONS AND ANSWERS LATEST UPDATE 2023/2024 BEST EXAM SOLUTION GRADED A+ FOR SUCCESS. a.1 b.10 c.The nurse should instruct older adult clients to receive a shingles vaccine when they are 60 years old. d.The nurse should instruct older adult clients to receive one of the two pneumococcal vaccines when they are 65 years old. The vaccines can be given to clients who are 19 years of age and older and have certain conditions, such as chronic heart, lung, or liver disease, diabetes mellitus, and alcohol disease, or to those who smoke cigarettes.