A nurse is providing teaching to a client who has coronary artery disease. Which of the following statements should the nurse include in the teaching to explain the correlation between changes in the coronary arteries and manifestations that occur?
"The heart and the coronary arteries weaken, leading to poor perfusion and resulting in angina."
"Coronary arteries become more elastic causing the arteries to stretch as individuals age causing the heart not to receive enough oxygen."
"Coronary arteries decrease in diameter leading to insufficient blood, oxygen, and nutrients reaching the heart muscle." "Manifestations occur due to dilation of coronary arteries with increased blood flow causing increased pressure."
"Coronary arteries decrease in diameter leading to insufficient blood, oxygen, and nutrients reaching the heart muscle."
The Correct Answer is D
A. "The heart and the coronary arteries weaken, leading to poor perfusion and resulting in angina": This statement is inaccurate. While angina can result from poor perfusion to the heart muscle, it is not typically due to weakening of the heart and coronary arteries. Angina often occurs due to coronary artery narrowing or blockage, leading to reduced blood flow and oxygen delivery to the myocardium.
B. "Coronary arteries become more elastic causing the arteries to stretch as individuals age causing the heart not to receive enough oxygen": This statement is incorrect. Coronary arteries do not become more elastic with age; in fact, they tend to become less elastic due to the development of atherosclerosis, which leads to arterial stiffening and decreased compliance. Atherosclerosis can cause narrowing or occlusion of the coronary arteries, resulting in reduced oxygen delivery to the heart muscle.
C. "Coronary arteries decrease in diameter leading to insufficient blood, oxygen, and nutrients reaching the heart muscle. Manifestations occur due to dilation of coronary arteries with increased blood flow causing increased pressure": This statement is partially incorrect. While it accurately describes the consequences of coronary artery narrowing (decrease in diameter) leading to insufficient blood, oxygen, and nutrient delivery to the heart muscle, the second part of the statement regarding dilation of coronary arteries with increased blood flow causing increased pressure is inaccurate. Coronary artery dilation is a compensatory response to increased demand for oxygen, aiming to improve blood flow to the myocardium. However, dilation alone does not increase pressure in the coronary arteries.
D. "Coronary arteries decrease in diameter leading to insufficient blood, oxygen, and nutrients reaching the heart muscle": This statement is accurate. Coronary artery disease (CAD) involves the progressive narrowing of the coronary arteries due to atherosclerosis, which reduces blood flow to the myocardium. As the arteries narrow, there is insufficient blood, oxygen, and nutrients reaching the heart muscle, leading to manifestations such as angina, myocardial ischemia, and potentially myocardial infarction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Answer: C. "I am not worried. This sort of thing happens all the time to us 'old people.'"
A. "I brought an updated list of all the medications he takes at home to help you and the doctors determine what the cause of this could be."
This response indicates understanding and proactive involvement in the client’s care. An updated medication list is crucial in evaluating potential causes of delirium, as certain medications or interactions can contribute to changes in mental status.
B. "I notified our family members that they should not come visit for a while, until they are better."
This statement reflects an understanding of the need for a calm environment for the client experiencing delirium. Reducing stimuli and visitors can help the client focus on recovery. It indicates the spouse is aware of the potential impact of social interactions on the client’s condition.
C. "I am not worried. This sort of thing happens all the time to us 'old people.'"
This response indicates a need for further teaching. It reflects a possible misunderstanding of delirium as a normal part of aging, which can be dismissive of the seriousness of the condition. Delirium is often a sign of underlying medical issues and should be treated with concern and urgency. Clients and their families need to understand that delirium is not a typical or benign occurrence and requires appropriate evaluation and intervention.
D. "I am trying to stay positive. I know that most people return to normal, but it is hard to see them like this."
This statement indicates a hopeful attitude while acknowledging the difficulty of the situation. It shows understanding that recovery is possible and reflects the spouse's emotional processing of the situation. Maintaining a positive outlook can be beneficial for both the client and the family during recovery.
Correct Answer is D
Explanation
A. "Vision changes occur when blood vessels leak fluid or blood under a portion of the retina": This statement describes a symptom of diabetic retinopathy, not open-angle glaucoma. In open-angle glaucoma, vision changes primarily result from increased intraocular pressure (IOP) due to impaired drainage of aqueous humor, not leakage of fluid or blood under the retina.
B. "Vision changes occur when the cloudy lens alters the passage of light through the eye": This statement describes a symptom of cataracts, not open-angle glaucoma. Cataracts involve clouding of the lens inside the eye, which affects the passage of light and leads to visual disturbances. Open-angle glaucoma, however, primarily affects the optic nerve and visual field due to increased intraocular pressure.
C. "Vision changes occur when retinal tissue pulls away from the blood vessels in the eye": This statement describes a symptom of retinal detachment, not open-angle glaucoma. Retinal detachment occurs when the retina detaches from the underlying layers of the eye, leading to vision changes and potentially vision loss. Open-angle glaucoma, on the other hand, primarily involves increased intraocular pressure and optic nerve damage.
D. "Vision changes occur when pressure in the eye is increased due to a decrease of aqueous humor": This statement is accurate. In open-angle glaucoma, vision changes occur due to increased intraocular pressure resulting from inadequate drainage of aqueous humor from the eye. This increased pressure can lead to damage of the optic nerve, resulting in peripheral vision loss and potentially blindness if left untreated.
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