Which change occurs first, making patients susceptible to coronary artery disease?
Formation of thrombus in the coronary artery.
Formation of fibrous plaque in the endothelium.
Reduction of blood flow through the coronary arteries.
Development of fatty streaks in the smooth muscles of the endothelium.
The Correct Answer is D
Choice A rationale:
Thrombus formation is a later stage event in coronary artery disease (CAD) and occurs after the development of fatty streaks. Thrombus formation usually happens due to the rupture of atherosclerotic plaques, leading to platelet aggregation and clot formation.
Choice B rationale:
Formation of fibrous plaque in the endothelium is a progression that occurs after the initial development of fatty streaks. Fibrous plaques are formed as a response to the inflammation caused by fatty deposits. They are more stable than fatty streaks but can still lead to narrowing of the arteries.
Choice C rationale:
Reduction of blood flow through the coronary arteries is a consequence of atherosclerosis, which occurs after the initial development of fatty streaks. As the fatty deposits accumulate, they narrow the arteries, leading to reduced blood flow. However, this is not the initial change that makes patients susceptible to CAD.
Choice D rationale:
Development of fatty streaks in the smooth muscles of the endothelium is the initial change that occurs in the development of atherosclerosis, making patients susceptible to coronary artery disease. Fatty streaks are composed of lipid-laden macrophages and smooth muscle cells. Over time, these fatty streaks can progress into fibrous plaques and eventually lead to complications such as thrombus formation and reduced blood flow.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Chronic stable angina typically occurs with both activity and rest due to the increased oxygen demand of the heart during exertion. It is relieved with rest or nitroglycerin, which helps to decrease the heart's workload. This choice accurately represents the characteristic of chronic stable angina.
Choice B rationale:
Chronic stable angina usually lasts for a short duration, usually around 5 minutes, and is relieved with rest or nitroglycerin. Prolonged pain lasting 10-15 minutes or more could indicate an unstable angina or myocardial infarction. This choice is incorrect for chronic stable angina.
Choice C rationale:
Pain due to chronic stable angina subsides when the precipitating factor, such as physical exertion, is resolved or with medication like nitroglycerin. Therefore, this statement is incorrect for chronic stable angina.
Choice D rationale:
Chronic stable angina follows a predictable pattern, occurring intermittently over a period of time, and is usually triggered by physical exertion or emotional stress. This option does not accurately represent the typical pattern of chronic stable angina.
Correct Answer is D
Explanation
Choice A rationale:
Stenosis of the heart valves typically leads to murmurs and changes in heart sounds but does not directly impact blood pressure regulation.
Choice B rationale:
Decreased adrenergic sensitivity might lead to lower heart rate and blood pressure, not an increase in systolic blood pressure as seen in this case.
Choice C rationale:
Increased parasympathetic activity would lead to decreased heart rate, not an increase in systolic blood pressure as observed in the patient.
Choice D rationale:
Loss of elasticity in arterial vessels is the correct answer. With aging, arterial walls become less flexible and more rigid due to the accumulation of calcium and collagen. This loss of elasticity results in increased systolic blood pressure, which is the top number in a blood pressure reading. The diastolic pressure, represented by the bottom number, does not usually increase significantly with age. This change is a result of arteriosclerosis, which commonly occurs in elderly individuals.
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