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Brunner: Medical-Surgical Nursing, 11 th Edition Test Bank Chapter 28: Management of Patients With Coronary Vascular Disorders Multiple Choice 1. A patient is diagnosed as having elevated cholesterol level. The nurse is aware that plaque on the inner lumen of arteries is composed chiefly of: A) Lipids and fibrous tissue B) WBCs C) Lipoproteins D) High-density cholesterol Ans: A Chapter: 28 Cognitive Level: Comprehension Difficulty: Easy Integrated Process: Nursing Process Objective: 1 Patient Needs: D-4 Feedback: 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. 2. The coronary arteries are susceptible to development of arteriosclerosis because coronary arteries: A) Are smaller in diameter B) Accumulate more low-density cholesterol C) Have numerous twist and turns D) Have a decreased pulse pressure Ans: C Chapter: 28 Cognitive Level: Knowledge Difficulty: Easy Integrated Process: Nursing Process Objective: 1 Patient Needs: D-4 Feedback: Due to the need of the coronary arteries to supply blood to the heart, they have many twists and turns, creating more sites susceptible to developing atheroma. 3. An adult patient who experiences angina pectoris with exertion is informed by the nurse that most often angina is caused by: A) Smoking B) Inadequate cardiac output C) Infarction of the myocardium D) Coronary arteriosclerosis Ans: D Chapter: 28 Cognitive Level: Application Difficulty: Moderate Integrated Process: Teaching/Learning Objective: 2 Patient Needs: D-4 Feedback: In most cases, angina pectoris is due to arteriosclerosis, particularly in older patients. Smoking, hypertension, high cholesterol levels, and diabetes mellitus are all associated with coronary arteriosclerosis. 4. The nurse is teaching a 45-year-old patient about ways to lower elevated cholesterol levels. One method to lower cholesterol levels is to exercise, which: A) Increases HDL and decreases triglycerides B) Increases LDL and decreases triglycerides C) Decreases HDL and increases LDL D) Decreases both HDL and LDL Ans: A Chapter: 28 Cognitive Level: Application Difficulty: Moderate Integrated Process: Teaching/Learning Objective: 1 Patient Needs: B-2 Feedback: Moderate exercise increases HDL levels, which assists in lowering LDL levels. Exercise also decreases triglyceride levels. 5. A patient angina with pectoris secondary to atherosclerotic disease asks why he experiences chest pain with exertion. The nurse informs him that exertion: A) Increases the heart's oxygen demands B) Causes vasoconstriction of the heart C) Increases blood flow to the mesenteric area D) Reduces the effectiveness of medications Ans: A Chapter: 28 Cognitive Level: Application Difficulty: Moderate Integrated Process: Teaching/Learning Objective: 2 Patient Needs: D-4 Feedback: Physical exertion increases the myocardial oxygen demand. If the patient has arteriosclerosis of the coronary arteries, blood supply is diminished to the myocardium.arteriosclerosis of the coronary arteries, blood supply is diminished to the myocardium.... View Full Document

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