Management of Patients with Coronary Vascular Disorders

Question 1

1. The nurse is caring for a client who has been diagnosed with an elevated cholesterol level. The nurse is aware that plaque on the inner lumen of arteries is composed chiefly of what?
   A. Lipids and fibrous tissue
   B. White blood cells
   C. Lipoproteins
   D. High-density cholesterol

Answer 1

ANS: A
Rationale: As T-lymphocytes and monocytes infiltrate to ingest lipids on the arterial wall and then die, a fibrous tissue develops. This causes plaques to form on the inner lumen of arterial walls. These plaques do not consist of white cells, lipoproteins, or high-density cholesterol.

Question 2

2. A client presents to the clinic reporting intermittent chest pain on exertion, which is eventually attributed to angina. The nurse should inform the client that angina is most often attributable to what cause?
   A. Decreased cardiac output
   B. Decreased cardiac contractility
   C. Infarction of the myocardium
   D. Coronary arteriosclerosis

Answer 2

ANS: D

Rationale: In most cases, angina pectoris is due to arteriosclerosis. The disease is not a result of impaired cardiac output or contractility. Infarction may result from untreated angina, but it is not a cause of the disease.

Question 3

3. The nurse is caring for an adult client who had symptoms of unstable angina upon admission to the hospital. What nursing diagnosis underlies the discomfort associated with angina?
   A. Ineffective breathing pattern related to decreased cardiac output
   B. Anxiety related to fear of death
   C. Ineffective cardiopulmonary tissue perfusion related to coronary artery disease (CAD)
   D. Impaired skin integrity related to CAD

Answer 3

ANS: C
Rationale: Ineffective cardiopulmonary tissue perfusion directly results in the symptoms of discomfort associated with angina. Anxiety and ineffective breathing may result from angina chest pain, but they are not the causes. Skin integrity is not impaired by the effects of angina.