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 B
Explanation
A. Primary progressive multiple sclerosis is characterized by a gradual progression of symptoms without relapses, so this does not match the client's pattern.
B. Relapsing-remitting multiple sclerosis is defined by episodes of exacerbation (active symptoms) followed by periods of remission (no symptoms), which aligns with the client's description.
C. Secondary progressive multiple sclerosis follows an initial relapsing-remitting course but leads to a more continuous decline in function, so it does not match the pattern described.
D. Clinically isolating syndrome refers to a single episode of neurological symptoms but does not indicate the pattern of relapses and remissions typical of relapsing-remitting multiple sclerosis.
Correct Answer is C
Explanation
A. Decreasing activity is not advisable; clients with peripheral venous disease should engage in regular, moderate exercise to improve venous circulation.
B. Massaging the legs is not recommended as it can exacerbate venous insufficiency and potentially lead to complications such as thrombosis.
C. Inspecting the legs daily for changes in color, size, and temperature is crucial for early detection of complications and indicates an understanding of self-monitoring.
D. Keeping the legs in a dependent position can worsen venous pooling; the client should elevate their legs when resting to promote venous return.