A nurse is reinforcing the education for a patient on the risks of coronary artery disease (CAD) the
LPN knows that the following are modifiable risk factors: (Select all that apply.)
Family History and Genetics
Poorly Controlled Hypertension
Poorly Controlled Diabetes Mellitus
Poorly Controlled Hyperlipidemia
Morbid obesity
Smoking and Use of Tobacco Products
Age
Age
Correct Answer : B,C,D,E,F
A. Family History and Genetics: Genetic predisposition and familial patterns of cardiovascular disease are fixed biological traits. These factors cannot be altered by lifestyle changes or medical interventions. While they inform risk assessment, they are classified as non-modifiable risk factors in clinical practice.
B. Poorly Controlled Hypertension: High blood pressure is a modifiable risk factor that can be managed through diet, exercise, and pharmacological therapy. Reducing systemic vascular resistance decreases the mechanical stress on the coronary arterial walls. Effective control significantly lowers the long-term risk of plaque formation and myocardial infarction.
C. Poorly Controlled Diabetes Mellitus: Chronic hyperglycemia leads to endothelial damage and accelerates the progression of coronary atherosclerosis. Through glycemic control, dietary modifications, and medication adherence, a patient can mitigate the metabolic impact on their vasculature. It is a key target for secondary prevention of coronary artery disease.
D. Poorly Controlled Hyperlipidemia: Elevated levels of low-density lipoproteins contribute directly to the formation of atherosclerotic plaques in the coronary arteries. Lipid levels are modifiable through statin therapy and a low-fat, high-fiber diet. Managing cholesterol is essential for reducing the risk of acute coronary syndromes.
E. Morbid obesity: Excessive adipose tissue is associated with chronic inflammation, insulin resistance, and increased cardiac workload. Weight reduction through caloric restriction and increased physical activity is a direct way to modify this risk factor. It improves the overall metabolic profile and reduces strain on the cardiovascular system.
F. Smoking and Use of Tobacco Products: Tobacco use causes immediate vasoconstriction and long-term damage to the vascular endothelium. Smoking cessation is one of the most impactful modifiable changes a patient can make to prevent coronary artery disease. It results in a rapid decrease in cardiovascular risk after the habit is discontinued.
G. Age: The natural aging process involves the progressive stiffening of arteries and cumulative exposure to various stressors. Age is a non-modifiable risk factor that cannot be influenced by nursing interventions or patient behavior. Risk assessments use age to stratify patients but focus on other variables for active management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Give 2 rescue breaths: In cardiac arrest due to V.Fib, the priority is circulation. High-quality chest compressions are initiated immediately to maintain perfusion until defibrillation can be performed. Rescue breaths are not the first step.
B. Start chest compressions: V.Fib is a lethal rhythm with no effective cardiac output. Immediate chest compressions are essential to circulate oxygenated blood to vital organs while preparing for defibrillation. This is the first action in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS).
C. Assess the client: While assessment is important, in the context of a witnessed rhythm strip showing V.Fib and an alarm, the nurse should assume cardiac arrest and act immediately. Delaying compressions to reassess wastes critical seconds.
D. Call a code blue/call 911: This is necessary, but it comes after starting chest compressions. The priority is to begin CPR without delay, then activate emergency response and prepare for defibrillation.
Correct Answer is B
Explanation
A. Macaroni and cheese: This food is high in carbohydrates and fats but does not contain significant amounts of Vitamin K. While not particularly heart-healthy, it does not directly interfere with the mechanism of warfarin. Patients on anticoagulants do not need to avoid this food specifically for PT/INR stability.
B. Kale chips: Kale is extremely high in Vitamin K, which is the direct physiological antagonist to warfarin. Consuming large or inconsistent amounts of leafy greens can lower the INR, making the blood more prone to clotting and reducing the medication's efficacy. Patients must maintain a consistent intake of Vitamin K to ensure stable anticoagulation levels.
C. Fast food burger and fries: High-fat meals can affect overall cardiovascular health and lipid levels but do not have a direct, acute impact on Vitamin K levels or warfarin metabolism. While the nurse should encourage better nutrition, this meal does not present the same immediate risk to PT/INR monitoring as high-Vitamin K foods.
D. Fruit salad: Most fruits are naturally low in Vitamin K and are safe for patients taking warfarin to consume. Fruit provides essential vitamins and fiber without interfering with the anticoagulant effects of the medication. This is a healthy dietary choice that does not require specific education regarding warfarin interactions.
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