For each risk factor, specify whether the risk factor is a modifiable or non-modifiable risk factor for coronary artery disease.
Stress.
High cholesterol and diet.
Menopause and aging.
Genetics
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"}}
Choice A rationale
Stress is considered a modifiable risk factor because individuals can implement lifestyle changes or therapies to manage it. Chronic stress triggers the sympathetic nervous system, increasing heart rate and blood pressure, which damages arterial walls over time. By using relaxation techniques, exercise, or counseling, a person can reduce these physiological stressors. Modifying the psychological and environmental sources of stress directly impacts the cardiovascular system's workload and reduces the long-term risk of developing coronary artery disease.
Choice B rationale
High cholesterol and diet are classic modifiable risk factors. A diet high in saturated fats and trans fats increases low-density lipoprotein levels, contributing to plaque formation. By transitioning to a diet rich in fiber, fruits, and vegetables, and potentially using statin medications, a person can significantly lower their cholesterol levels. Normal total cholesterol is generally less than 200 mg/dL. These changes directly alter the biochemical environment of the arteries, slowing or preventing the progression of atherosclerosis.
Choice C rationale
Menopause and aging are non-modifiable risk factors because they are natural physiological processes that cannot be stopped or reversed. As individuals age, the arteries naturally lose elasticity and are more prone to injury. For women, the loss of estrogen during menopause removes a protective factor for the endothelium, leading to an increased risk of heart disease. Since these are chronological and biological milestones, the patient has no control over their occurrence, making them non-modifiable variables.
Choice D rationale
Genetics is a non-modifiable risk factor because an individual cannot change their inherited DNA. Family history often plays a significant role in the early onset of coronary artery disease, reflecting genetic predispositions to high blood pressure, diabetes, or hyperlipidemia. If parents or siblings had heart disease at a young age, the individual’s baseline risk is elevated regardless of lifestyle. While one can manage other factors, the underlying genetic blueprint remains a permanent influence on their cardiovascular health.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Decreased blood pressure is usually a sign of autonomic neuropathy rather than simple peripheral neuropathy. While peripheral neuropathy affects the distal nerves of the limbs, autonomic dysfunction affects the nerves controlling involuntary functions like vascular tone. A drop in blood pressure, specifically orthostatic hypotension, is a related but distinct neurological complication. Therefore, decreased blood pressure is not the primary expected complication when discussing sensory or motor deficits in the extremities of the patient.
Choice B rationale
Increased blood sugar is a common cause of peripheral neuropathy, particularly in diabetes mellitus, rather than a complication of the neuropathy itself. Chronic hyperglycemia leads to the glycation of proteins and oxidative stress that damages the myelin sheath and axons. High glucose levels remain an ongoing metabolic issue that the patient must manage to prevent further nerve damage. It is the metabolic driver of the condition, not a secondary physiological outcome resulting from nerve death.
Choice C rationale
Decreased urine output is generally associated with renal dysfunction or dehydration rather than peripheral neuropathy. While neurogenic bladder can occur if the autonomic nerves serving the urinary system are damaged, peripheral neuropathy typically focuses on the long nerves of the hands and feet. Urinary retention or decreased output would point toward kidney failure or a lower urinary tract obstruction. It is not a standard complication of the sensory and motor losses found in the limbs.
Choice D rationale
Increased falls are a major complication of peripheral neuropathy due to the loss of proprioception and sensory feedback from the feet. When a person cannot feel the ground or determine the position of their joints, their balance is severely compromised. Additionally, motor nerve damage can lead to muscle weakness and foot drop, further increasing the risk of tripping. This lack of sensory input makes navigating uneven surfaces difficult, leading to a high incidence of injury.
Correct Answer is C
Explanation
Choice A rationale
Stroke volume is the volume of blood pumped from the left ventricle per beat. It is calculated as the difference between end-diastolic volume and end-systolic volume. While it is a critical measure of cardiac function, it represents the output of the heart rather than the resistance the heart must work against. Stroke volume is influenced by contractility, preload, and afterload, but it is not the term for the resistance itself encountered during the ejection phase of the cardiac cycle.
Choice B rationale
Cardiac reserve refers to the difference between the rate at which the heart pumps blood at any given time and its maximum capacity for pumping blood. it is a measure of the heart's ability to increase its output during physical exertion or stress. It indicates the health and functional flexibility of the cardiovascular system. It does not describe the specific physical resistance or pressure that the ventricles must overcome to move blood into the aorta or pulmonary artery.
Choice C rationale
Afterload is the technical term for the resistance or pressure that the ventricles must pump against to eject blood during systole. It is primarily determined by systemic vascular resistance and the pressure within the large arteries. Scientifically, if the afterload increases, such as in hypertension or aortic stenosis, the heart must work harder to open the semilunar valves and push blood out, which can eventually lead to ventricular hypertrophy and heart failure due to the chronic workload.
Choice D rationale
Preload is the initial stretching of the cardiac myocytes prior to contraction. It is related to ventricular filling and is determined by the end-diastolic volume. According to the Frank-Starling law, an increase in preload leads to a stronger contraction, up to a certain point. Preload represents the volume of blood entering the heart and the resulting "stretch" on the muscle fibers, whereas afterload represents the "squeeze" or force needed to push that blood out.
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