A family of a client who has a medical history of stroke, hyperlipidemia, and peptic ulcer disease arrives at the memory care clinic with concerns about their loved one. The family states that the client has experienced worsening memory loss and forgetfulness over the last 6 months. The nurse is concerned the client is experiencing vascular dementia, due to which of the following factors?
The client's history of hyperlipidemia, because hyperlipidemia can lead to dementia due to blocked neuron communication throughout the body.
The client's history of peptic ulcer disease, because peptic ulcer disease can lead to dementia due to the loss of nerve cells in the stomach.
The client's history of peptic ulcer disease, because peptic ulcer disease can lead to dementia by destroying neuron communication in the stomach.
The client's history of stroke, because stroke can lead to dementia due to changes in the blood vessels of the brain.
The Correct Answer is D
A. While hyperlipidemia can contribute to vascular damage, it primarily increases the risk of cardiovascular disease and stroke, rather than directly blocking neuron communication to cause dementia.
B. Peptic ulcer disease is not associated with dementia, and the loss of nerve cells in the stomach does not lead to cognitive decline.
C. Peptic ulcer disease does not cause dementia by impacting neuron communication in the stomach.
D. Vascular dementia is often caused by stroke due to reduced blood flow or damage to the blood vessels in the brain, leading to cognitive decline and memory loss.
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Correct Answer is A
Explanation
A. Computerized tomography angiography (CTA) is commonly used to visualize blood vessels and identify any blockages or abnormalities in blood flow that may have contributed to a TIA.
B. While a complete blood count (CBC) may be ordered as part of the general assessment, it is not specific for diagnosing TIA and does not provide information on cerebrovascular issues.
C. A transesophageal echocardiogram (TEE) is used to assess cardiac function and may be indicated in some stroke cases, but it is not the primary diagnostic test for TIA.
D. Prothrombin time (PT) assesses clotting function but is not specific for diagnosing TIA; it may be ordered for other reasons but is not a primary diagnostic tool in this context.
Correct Answer is D
Explanation
A. While coronary arteries may change with age, the increased elasticity does not lead to insufficient oxygen; rather, it can affect their ability to respond to increased demand.
B. Weakening of the heart can contribute to heart failure but is not a direct explanation for how coronary artery disease causes angina.
C. Dilation of coronary arteries typically does not cause manifestations in coronary artery disease; instead, it is the narrowing (stenosis) that leads to issues.
D. Decreased diameter of the coronary arteries due to atherosclerosis is the primary issue in coronary artery disease, which leads to inadequate blood supply, oxygen, and nutrients to the heart muscle, causing symptoms like angina.