Nur 323 Exam 2 Practice Questions and
Correct Answers
What is the most preventable type of heart disease? ✅coronary artery disease
- cad occurs when the coronary arteries become narrowed and hardened
What is the most common cause for coronary artery disease? ✅atherosclerosis
Atherosclerosis ✅is the abnormal accumulation of lipid and fatty substances and
fibrous tissue in the lining of arterial blood vessels. It is the result of inflammatory
processes responding to endothelial wall injury which prevents the normal secretion of
antithrombotics and vasodilating agents
Non-modifiable risk factors for cad ✅genetic (family history)
Increasing age (> 45 men >55 women)
Gender
Race
Modifiable risk factors for cad ✅hyperlipidemia
Smoking, tobacco use
Hypertension
Diabetes
Metabolic syndrome
Obesity
Physical inactivity
Prevention strategies for those at risk for cad ✅control cholesterol abnormalities
Promote smoking cessation
Manage hypertension
Control diabetes
Controlling cholesterol ✅total cholesterol should be less than 200
Ldl should be less than 100
Hdl should be more than 40 for men and 50 for women
Triglycerides should be less than 150
Control lipids through diet, exercise and medications
Manage hypertension ✅htn is 140/up mmhg
- the physiologic effects of htn
Stiffens vessel walls leads to vessel wall injury
Vessels thicken, become hyperresponsive
Heart works harder, overcome hypertrophies, thickens, weakens
,Early detection of htn with adherence to treatment regimen prevents serious
consequences - may reduce risk for stroke, mi and other cardiovascular events
Control diabetes ✅diabetes is an accelerant in the development of cad
Dyslipidemia
Increased platelet aggregation
Altered rbc function (leads to thrombus)
Metabolic alterations impair vessel endothelium (ability to vasodilate and smooth
muscle function)
Adherence to treatments reducing blood glucose levels improves endothelial function as
well as patient health outcomes
Peripheral arterial disease (pad) ✅most common cause is athersclerosis
Also inadequate blood flow = vessel narrowing and loss of elasticity
Obstructive lesions confined to segments of arterial system
Inflow = distal aorta to iliac arteries
Outflow = femoral, popliteal, and tibial arteries
Distal occlusive involves smaller arteries of feet
Tissue damage occurs below arterial obstruction
Risk factors of pad ✅htn,
Hyperlipidemia,
Cigarette smoking,
Obesity,
sedentary lifestyle,
Diabetes mellitus,
Familial predisposition,
Female sex,
Age older than 65,
Elevated c-reactive protein,
Hyperhomocysteinemia
Differentiate subjective and objective assessment findings. ✅subjective - symptoms
Objective - signs (assesment)
, Symptoms of pad ✅burning, cramping, and pain in the legs during exercise
"intermittent claudication" hallmark symptom
Numbness or burning pain primarily in the feet when in bed
Pain that is relieved by placing legs at rest in a dependent position
Signs of pad ✅bruit over femoral and aortic arteries
Decreased capillary refill of toes (greater than 3 seconds)
Decreased (faint +1) or nonpalpable pulses
Unequal pulses (key sign of pad)
Loss of hair on lower calf, ankle, and foot
Dry, scaly, molted skin
Cold and cyanotic extremity
Pallor of extremity with elevation
Dependent rubor (redness) of the extremity
Muscle atrophy
Ulcers and possible gangrene of toes
Diagnostics for pad ✅ateriography and ankle brachial index ration
Ateriography ✅invasive, contrast medium injection, visualize areas with decreased
arterial blood flow (used only to identify isolated areas of occlusion for treatment during
procedure)
Post procedure nursing care include monitoring for bleeding or hemorrhage, palpate
pedal pulses to identify possible occlusions
Ankle brachial index ratio (abi) ✅the compression of ankle blood pressure to brachial
artery blood pressure
Ankle systolic blood pressure divided by brachial systolic blood pressure
Expected finding 0.9-1.3
Pad finding is abi ratio of less than 0.9 in either leg
A decrease in ratio indicates increase arterial narrowing and less blood flow
Correct Answers
What is the most preventable type of heart disease? ✅coronary artery disease
- cad occurs when the coronary arteries become narrowed and hardened
What is the most common cause for coronary artery disease? ✅atherosclerosis
Atherosclerosis ✅is the abnormal accumulation of lipid and fatty substances and
fibrous tissue in the lining of arterial blood vessels. It is the result of inflammatory
processes responding to endothelial wall injury which prevents the normal secretion of
antithrombotics and vasodilating agents
Non-modifiable risk factors for cad ✅genetic (family history)
Increasing age (> 45 men >55 women)
Gender
Race
Modifiable risk factors for cad ✅hyperlipidemia
Smoking, tobacco use
Hypertension
Diabetes
Metabolic syndrome
Obesity
Physical inactivity
Prevention strategies for those at risk for cad ✅control cholesterol abnormalities
Promote smoking cessation
Manage hypertension
Control diabetes
Controlling cholesterol ✅total cholesterol should be less than 200
Ldl should be less than 100
Hdl should be more than 40 for men and 50 for women
Triglycerides should be less than 150
Control lipids through diet, exercise and medications
Manage hypertension ✅htn is 140/up mmhg
- the physiologic effects of htn
Stiffens vessel walls leads to vessel wall injury
Vessels thicken, become hyperresponsive
Heart works harder, overcome hypertrophies, thickens, weakens
,Early detection of htn with adherence to treatment regimen prevents serious
consequences - may reduce risk for stroke, mi and other cardiovascular events
Control diabetes ✅diabetes is an accelerant in the development of cad
Dyslipidemia
Increased platelet aggregation
Altered rbc function (leads to thrombus)
Metabolic alterations impair vessel endothelium (ability to vasodilate and smooth
muscle function)
Adherence to treatments reducing blood glucose levels improves endothelial function as
well as patient health outcomes
Peripheral arterial disease (pad) ✅most common cause is athersclerosis
Also inadequate blood flow = vessel narrowing and loss of elasticity
Obstructive lesions confined to segments of arterial system
Inflow = distal aorta to iliac arteries
Outflow = femoral, popliteal, and tibial arteries
Distal occlusive involves smaller arteries of feet
Tissue damage occurs below arterial obstruction
Risk factors of pad ✅htn,
Hyperlipidemia,
Cigarette smoking,
Obesity,
sedentary lifestyle,
Diabetes mellitus,
Familial predisposition,
Female sex,
Age older than 65,
Elevated c-reactive protein,
Hyperhomocysteinemia
Differentiate subjective and objective assessment findings. ✅subjective - symptoms
Objective - signs (assesment)
, Symptoms of pad ✅burning, cramping, and pain in the legs during exercise
"intermittent claudication" hallmark symptom
Numbness or burning pain primarily in the feet when in bed
Pain that is relieved by placing legs at rest in a dependent position
Signs of pad ✅bruit over femoral and aortic arteries
Decreased capillary refill of toes (greater than 3 seconds)
Decreased (faint +1) or nonpalpable pulses
Unequal pulses (key sign of pad)
Loss of hair on lower calf, ankle, and foot
Dry, scaly, molted skin
Cold and cyanotic extremity
Pallor of extremity with elevation
Dependent rubor (redness) of the extremity
Muscle atrophy
Ulcers and possible gangrene of toes
Diagnostics for pad ✅ateriography and ankle brachial index ration
Ateriography ✅invasive, contrast medium injection, visualize areas with decreased
arterial blood flow (used only to identify isolated areas of occlusion for treatment during
procedure)
Post procedure nursing care include monitoring for bleeding or hemorrhage, palpate
pedal pulses to identify possible occlusions
Ankle brachial index ratio (abi) ✅the compression of ankle blood pressure to brachial
artery blood pressure
Ankle systolic blood pressure divided by brachial systolic blood pressure
Expected finding 0.9-1.3
Pad finding is abi ratio of less than 0.9 in either leg
A decrease in ratio indicates increase arterial narrowing and less blood flow
