NR507-NP FINAL PAPER 2026 QUESTIONS
WITH ANSWERS GRADED A+
◉ What is Coronary Artery Disease (CAD)? Answer: CAD is
considered the leading cause of death in the United States (U.S.). It is
the result of longstanding atherosclerosis.
Atherosclerosis begins with damage to the endothelium. It is the
endothelium, under normal functioning that maintains balance between
the vasoconstrictive and vasodilation actions, prevents platelets from
aggregating and control of the production of fibrin. When the
endothelium becomes damaged, our familiar inflammatory processes
occur. Macrophages attach to the endothelium, setting up phagocytosis;
plaque formation and vasoconstriction also occurs marking the
beginning of atherosclerosis. The plaque lesions located in the vessels
become enlarged which allows the plaque to progress within the
enlarged vessel lumen. The plaque lesion disrupts normal blood flow
and causes thrombus formation which can be triggered by cardiac risk
factors such as elevated LDL, cholesterol, smoking and diabetes.
So, why is this a problem?
Well, the plaque takes decades to develop in the coronary arteries. With
mild disease, blood flow can get through the arteries and the patient is
asymptomatic. Overtime, this build up can lead to narrowing which
results in decreased oxygen supply. When atherosclerosis reaches a
clinically significant level, the patient will begin to experience angina.
, Further progression of the disease will result in acute coronary syndrome
(ACS), formerly known as myocardial infarction (MI).
◉ The major risk factor for the development of CAD. Answer: The
major risk factor for the development of CAD is family history. There is
a 50% higher risk for individuals to develop heart disease if they have a
first degree relative (especially father) or sibling who has suffered from
ACS or premature cardiac death (< age 55 years). Lifestyle also impacts
risk, especially tobacco use and even secondhand smoke exposure. It is
always important for the NP to stress smoking cessation with all patients
who smoke tobacco, in order to decrease the patient's risk for CAD.
Sedentary lifestyle will also increase one's risk for developing CAD.
Physical inactivity can lead to overweight (BMI 25-29.9) or obesity
(BMI 30 and above). Male gender, hypertension, Elevated total
cholesterol, elevated low-density lipoprotein (LDL), and/or decreased
high-density lipoprotein (HDL) are also risk factors, as well as diabetes
mellitus.
◉ Myocardial ischemia. Answer: Myocardial ischemia is the cause of
his chest pain. Ischemia occurs when the heart's oxygen demand exceeds
supply. For this patient, he experienced his chest pain during exercise.
Ischemia occurred because of the narrowing of at least one coronary
artery by atherosclerotic plaques. The result is the narrowing of the
diameter of the coronary artery. This reduces oxygenated blood flow
through the artery that leads to an insufficient oxygen supply to the
heart. Adenosine is also released that stimulates sympathetic nerve fibers
that causes atrial and ventricular contraction. In addition, sympathetic
stimulation occurs at the upper thoracic dorsal roots of the spinal cord
that leads to the arm pain.
WITH ANSWERS GRADED A+
◉ What is Coronary Artery Disease (CAD)? Answer: CAD is
considered the leading cause of death in the United States (U.S.). It is
the result of longstanding atherosclerosis.
Atherosclerosis begins with damage to the endothelium. It is the
endothelium, under normal functioning that maintains balance between
the vasoconstrictive and vasodilation actions, prevents platelets from
aggregating and control of the production of fibrin. When the
endothelium becomes damaged, our familiar inflammatory processes
occur. Macrophages attach to the endothelium, setting up phagocytosis;
plaque formation and vasoconstriction also occurs marking the
beginning of atherosclerosis. The plaque lesions located in the vessels
become enlarged which allows the plaque to progress within the
enlarged vessel lumen. The plaque lesion disrupts normal blood flow
and causes thrombus formation which can be triggered by cardiac risk
factors such as elevated LDL, cholesterol, smoking and diabetes.
So, why is this a problem?
Well, the plaque takes decades to develop in the coronary arteries. With
mild disease, blood flow can get through the arteries and the patient is
asymptomatic. Overtime, this build up can lead to narrowing which
results in decreased oxygen supply. When atherosclerosis reaches a
clinically significant level, the patient will begin to experience angina.
, Further progression of the disease will result in acute coronary syndrome
(ACS), formerly known as myocardial infarction (MI).
◉ The major risk factor for the development of CAD. Answer: The
major risk factor for the development of CAD is family history. There is
a 50% higher risk for individuals to develop heart disease if they have a
first degree relative (especially father) or sibling who has suffered from
ACS or premature cardiac death (< age 55 years). Lifestyle also impacts
risk, especially tobacco use and even secondhand smoke exposure. It is
always important for the NP to stress smoking cessation with all patients
who smoke tobacco, in order to decrease the patient's risk for CAD.
Sedentary lifestyle will also increase one's risk for developing CAD.
Physical inactivity can lead to overweight (BMI 25-29.9) or obesity
(BMI 30 and above). Male gender, hypertension, Elevated total
cholesterol, elevated low-density lipoprotein (LDL), and/or decreased
high-density lipoprotein (HDL) are also risk factors, as well as diabetes
mellitus.
◉ Myocardial ischemia. Answer: Myocardial ischemia is the cause of
his chest pain. Ischemia occurs when the heart's oxygen demand exceeds
supply. For this patient, he experienced his chest pain during exercise.
Ischemia occurred because of the narrowing of at least one coronary
artery by atherosclerotic plaques. The result is the narrowing of the
diameter of the coronary artery. This reduces oxygenated blood flow
through the artery that leads to an insufficient oxygen supply to the
heart. Adenosine is also released that stimulates sympathetic nerve fibers
that causes atrial and ventricular contraction. In addition, sympathetic
stimulation occurs at the upper thoracic dorsal roots of the spinal cord
that leads to the arm pain.
