NRS 400 Exam 4 questions with
Complete Solutions
Which patient is most likely to be in the fibrous stage of development of coronary artery
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n disease (CAD)? n n
a. Age 40 years, thrombus adhered to the coronary artery wall
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b. Age 50 years, rapid onset of disease with hypercholesterolemia
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c. Age 32 years, thickened coronary arterial walls with narrowed vessel lumen
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d. Age 19 years, high low-density lipoprotein (LDL) cholesterol, lipid-filled smooth muscle
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n cells - ANS-C
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What accurately describes the pathophysiology of CAD?
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a. Partial or total occlusion of the coronary artery occurs during the stage of raised fibrous
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n plaque. n
b. Endothelial changes may be caused by chemical irritants, such as hyperlipidemia or by
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n tobacco use. n n
c. Collateral circulation in the coronary circulation is more likely to be present in the
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n young patient with CAD.
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d. The leading theory of atherogenesis proposes that infection and fatty dietary intake are
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n the basic underlying causes of atherosclerosis. - ANS-B
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,After obtaining patient histories, which patient does the nurse identify as having the
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n highest risk for CAD? n n n n
a. A white man, age 54 years, who is a smoker and has a stressful lifestyle
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b. A white woman, age 75 years, with a BP of 172/100 mm Hg and who is physically
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n inactive n
c. An Asian woman, age 45 years, with a cholesterol level of 240 mg/dL and a BP of
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n 130/74 mm Hg n n n
d. An obese Hispanic man, age 65 years, with a cholesterol level of 195 mg/dL and a BP of
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n 128/76 mm Hg - ANS-b. A white woman, age 75 years, with a BP of 172/100 mm Hg and
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n who is physically inactive
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Priority Decision: What should the nurse emphasize when teaching women about the
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n risks and incidence of CAD?
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a. Smoking is not as significant a risk factor for CAD in women as it is in men.
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b. Women seek treatment sooner than do men when they have symptoms of CAD.
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c. Estrogen replacement therapy in postmenopausal women decreases the risk for CAD.
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d. CAD is the leading cause of death in women, with a higher mortality rate after
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n myocardial infarction (MI) than in men. - ANS-D n n n n n n n
Which characteristics are associated with LDLs (select all that apply)?
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a. Increases with exercise
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b. Contains the most cholesterol
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,c. Has an affinity for arterial walls
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d. Carries lipids away from arteries to liver
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e. High levels correlate most closely with CAD
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f. The higher the level, the lower the risk for CAD - ANS-b, c, e.
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LDLs contain more cholesterol than the other lipoproteins, have an attraction for arterial
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n walls, and correlate most closely with increased incidence of atherosclerosis and CAD.
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n HDLs increase with exercise and carry lipids away from arteries to the liver for
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n metabolism. A high HDL level is associated with a lower risk of CAD.
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Which serum lipid elevation, along with high LDL, is strongly associated with CAD?
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a. Apolipoproteins
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b. Fasting triglycerides
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c. Total serum cholesterol
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d. High-density lipoprotein (HDL) - ANS-b. Fasting triglycerides
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The laboratory tests for 4 patients show the following results. Which patient should the
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n nurse teach first about preventing CAD because the patient is at the greatest risk for CAD
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n even without other risk factors?
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a. Total cholesterol: 152 mg/dL, triglycerides: 148 mg/dL, LDL: 148 mg/dL, HDL: 52
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n mg/dL n
b. Total cholesterol: 160 mg/dL, triglycerides: 102 mg/dL, LDL: 138 mg/dL, HDL: 56
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n mg/dL n
, c. Total cholesterol: 200 mg/dL, triglycerides: 150 mg/dL, LDL: 160 mg/dL, HDL: 48
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n mg/dL n
d. Total cholesterol: 250 mg/dL, triglycerides: 164 mg/dL, LDL: 172 mg/dL, HDL: 32
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n mg/dL - ANS-D n n
The nurse is encouraging a sedentary patient with major risks for CAD to perform
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n physical exercise on a regular basis. In addition to decreasing the risk factor of physical
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n inactivity, the nurse tells the patient that exercise will directly contribute to reducing
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n which risk factors?
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a. Diabetes and hypertension
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b. Hyperlipidemia and obesity
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c. Increased serum lipids and stressful lifestyle
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d. Hypertension and increased serum homocysteine - ANS-b. Hyperlipidemia and obesity
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During a routine health examination, a 48-year-old patient is found to have a total
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n cholesterol level of 224 mg/dL (5.8 mmol/L) and an LDL level of 140 mg/dL (3.6
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n mmol/L). What does the nurse teach the patient based on the Therapeutic Lifestyle
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n Changes diet (select all that apply)?
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a. Use fat-free milk.
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b. Abstain from alcohol use.
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c. Reduce red meat in the diet.
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d. Eliminate intake of simple sugars.
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e. Avoid foods prepared with egg yolks. - ANS-A, C, E
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