A nurse is reinforcing teaching to a client who has coronary artery disease. Which of the following statements should the nurse include in the teaching to explain the correlation between changes in the coronary arteries and manifestations that occur?
"Coronary arteries become more elastic causing the arteries to stretch as individuals age causing the heart not to receive enough oxygen."
"The heart and the coronary arteries weaken, leading to poor perfusion and resulting in angina."
"Manifestations occur due to dilation of coronary arteries with increased blood flow causing increased pressure."
"Coronary arteries decrease in diameter leading to insufficient blood, oxygen, and nutrients reaching the heart muscle."
The Correct Answer is D
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.
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Correct Answer is C
Explanation
A. A nonskid mat might be helpful for plate stability, but it does not address the visual deficit related to homonymous hemianopsia.
B. Wide grip utensils are useful for motor difficulties, but the primary issue here is a visual field deficit, not motor impairment.
C. Homonymous hemianopsia results in loss of vision in the same half of the visual field in both eyes. Encouraging the client to turn her head or look for food on the affected side (left side of the tray) can help compensate for the visual loss.
D. While using the right hand may be important after a right-sided stroke, the more pressing issue here is addressing the visual field deficit, not hand preference.
Correct Answer is B
Explanation
A. Shopping for shoes in the morning is not recommended, as feet tend to swell later in the day, and shoe fitting should account for potential swelling.
B. Incorporating walking into the daily routine helps improve circulation and can aid in managing peripheral vascular disease by promoting blood flow in the legs.
C. Elevating the legs might decrease circulation and is not advised for clients with peripheral vascular disease, as it can reduce blood flow to the extremities.
D. Knee-length stockings can restrict circulation, especially if they are too tight, and should be avoided to promote proper blood flow in clients with this condition.