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 C
Explanation
Choice A rationale:
Purpura refers to purple or red discolorations on the skin caused by bleeding underneath the skin. It is larger than petechiae and ecchymosis and could be a sign of a more serious underlying condition. Petechiae are small, red or purple dots that appear on the skin due to minor bleeding from broken capillaries. In the context of leukemia and thrombocytopenia (low platelet count), petechiae are common due to impaired clotting mechanisms.
Choice B rationale:
Bruising occurs due to damage to blood vessels underneath the skin, resulting in the leakage of blood into the surrounding tissues. Bruises are typically larger than petechiae and can occur with various conditions, including trauma. In this case, the small 1-mm red macules are more indicative of petechiae.
Choice D rationale:
Ecchymosis refers to a larger area of subcutaneous bleeding or bruising. It is larger than both petechiae and purpura and often results from more significant trauma or bleeding disorders. The description of multiple 1-mm red macules is characteristic of petechiae rather than ecchymosis.
Correct Answer is C
Explanation
Choice A rationale:
Silent ischemia refers to a lack of oxygen to the heart that doesn't cause symptoms like chest pain. It is often diagnosed during an electrocardiogram (ECG) done for other reasons. The patient in this scenario is experiencing chest pain, so silent ischemia is not the correct choice.
Choice B rationale:
Angina decubitus refers to chest pain that occurs while lying down and is relieved by standing or sitting. The patient in this scenario is experiencing chest pain at rest, which is not characteristic of angina decubitus.
Choice D rationale:
Chronic stable angina is chest pain or discomfort that typically occurs with activity or stress and is relieved by rest or nitroglycerin. The patient in this scenario is experiencing chest pain at rest, which is not characteristic of chronic stable angina.
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