Which change occurs first, making patients susceptible to coronary artery disease?
Formation of thrombus in the coronary artery.
Formation of fibrous plaque in the endothelium.
Reduction of blood flow through the coronary arteries.
Development of fatty streaks in the smooth muscles of the endothelium.
The Correct Answer is D
Choice A rationale:
Thrombus formation is a later stage event in coronary artery disease (CAD) and occurs after the development of fatty streaks. Thrombus formation usually happens due to the rupture of atherosclerotic plaques, leading to platelet aggregation and clot formation.
Choice B rationale:
Formation of fibrous plaque in the endothelium is a progression that occurs after the initial development of fatty streaks. Fibrous plaques are formed as a response to the inflammation caused by fatty deposits. They are more stable than fatty streaks but can still lead to narrowing of the arteries.
Choice C rationale:
Reduction of blood flow through the coronary arteries is a consequence of atherosclerosis, which occurs after the initial development of fatty streaks. As the fatty deposits accumulate, they narrow the arteries, leading to reduced blood flow. However, this is not the initial change that makes patients susceptible to CAD.
Choice D rationale:
Development of fatty streaks in the smooth muscles of the endothelium is the initial change that occurs in the development of atherosclerosis, making patients susceptible to coronary artery disease. Fatty streaks are composed of lipid-laden macrophages and smooth muscle cells. Over time, these fatty streaks can progress into fibrous plaques and eventually lead to complications such as thrombus formation and reduced blood flow.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Adequate platelet production does not explain the prolonged bleeding times in von Willebrand disease. These patients often have normal platelet counts, but their platelets do not function properly due to the absence or dysfunction of von Willebrand factor.
Choice B rationale:
Deficiency in intrinsic clotting system factor is not the primary cause of prolonged bleeding times in von Willebrand disease. The deficiency or dysfunction of von Willebrand factor, a protein that helps platelets adhere to the blood vessel walls and clot properly, is the key issue in this disorder.
Choice C rationale:
Impairment of the thrombin fibrinogen reaction does not directly relate to von Willebrand disease. This disorder primarily involves platelet dysfunction and variable factor VIII deficiencies, leading to prolonged bleeding times.
Choice D rationale:
Variable factor VIII deficiencies and platelet dysfunction are characteristic of von Willebrand disease. Factor VIII helps with blood clotting, and its deficiency, along with impaired platelet function, contributes to the prolonged bleeding times in patients with von Willebrand disease.
Correct Answer is C
Explanation
Choice A rationale:
Metabolic acidosis is characterized by low blood pH and low bicarbonate ion levels. The patient's bicarbonate ion level (24 mEq/L) is within the normal range, and the low pH (7.32) and elevated PaCO2 (56 mm Hg) indicate respiratory acidosis, not metabolic acidosis.
Choice B rationale:
Metabolic alkalosis is characterized by high blood pH and high bicarbonate ion levels. The patient's pH is low (7.32), and the bicarbonate ion level (24 mEq/L) is within the normal range, indicating respiratory acidosis rather than metabolic alkalosis.
Choice C rationale:
Respiratory acidosis is characterized by low blood pH and high PaCO2 levels. In this case, the patient has a low pH (7.32) and elevated PaCO2 (56 mm Hg), indicating respiratory acidosis. The bicarbonate ion level (24 mEq/L) is a compensatory response. Respiratory alkalosis would present with high pH and low PaCO2 levels.
Choice D rationale:
Respiratory alkalosis is characterized by high blood pH and low PaCO2 levels. The patient's PaCO2 level is elevated (56 mm Hg), indicating respiratory acidosis, not alkalosis. The low pH (7.32) further supports the diagnosis of respiratory acidosis.
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