Coronary Artery Disease: Pathophysiology, Diagnosis, and Management

Question 1

Identify the modifiable risk factor for coronary artery disease:

Accepted Answer

Smoking

Answer

Age

Answer

Family history

Answer

Gender

Question 2

Which of the following is the most common symptom of stable angina?

Accepted Answer

Chest pain relieved by rest or nitroglycerin

Answer

Sharp, stabbing chest pain

Answer

Chest pain radiating to the back or arms

Question 3

Aspirin is widely used to prevent coronary artery disease (CAD). Describe its mechanism of action and clinical applications.

Accepted Answer

Aspirin irreversibly inhibits cyclooxygenase-1 (COX-1), reducing thromboxane A2 production and inhibiting platelet aggregation.

Answer

Aspirin dilates blood vessels, increasing blood flow to the heart and reducing clot risk.

Answer

Aspirin prevents atherosclerotic plaque formation in coronary arteries.

Question 4

Which of the following is the most significant risk factor for developing coronary artery disease (CAD)?

Accepted Answer

Tobacco use

Answer

Increasing age

Answer

Female gender

Answer

Elevated cholesterol levels

Question 5

Which diagnostic test is considered the gold standard for assessing coronary artery anatomy?

Accepted Answer

Coronary angiography

Answer

Electrocardiogram (ECG)

Answer

Echocardiography

Answer

Stress testing

Question 6

Which nursing intervention is inappropriate for a patient experiencing an acute myocardial infarction (AMI)?

Accepted Answer

Promoting early ambulation

Answer

Administering supplemental oxygen

Answer

Monitoring cardiac rhythm

Answer

Providing emotional support

Question 7

In the INTERHEART study, which modifiable risk factor was identified as the strongest contributor to CAD?

Accepted Answer

Tobacco smoking

Answer

Hypertension

Answer

Physical inactivity

Answer

Obesity

Question 8

Which diagnostic criterion specifically differentiates unstable angina from stable angina?

Accepted Answer

New or worsening chest pain at rest or with minimal exertion

Answer

Chest pain lasting more than 30 minutes

Answer

Resting ECG showing ischemia

Answer

Elevated serum cardiac troponin levels

Question 9

Which of the following is the leading risk factor for coronary artery disease (CAD)?

Accepted Answer

Tobacco use

Answer

Hypertension

Answer

Dyslipidemia

Answer

Diabetes

Question 10

The primary pathophysiological process underlying CAD is:

Accepted Answer

Atherosclerosis

Answer

Thrombosis

Answer

Vasospasm

Answer

Inflammation

Question 11

Which symptom is NOT typically associated with CAD?

Accepted Answer

Nausea and vomiting

Answer

Chest discomfort (angina)

Answer

Shortness of breath

Answer

Leg pain during exertion

Question 12

The gold standard diagnostic test for identifying CAD is:

Accepted Answer

Cardiac catheterization

Answer

Electrocardiogram (ECG)

Answer

Echocardiogram

Answer

Magnetic resonance imaging (MRI)

Question 13

Which medication class is primarily used to lower blood pressure in patients with CAD?

Accepted Answer

ACE inhibitors

Answer

Antianginals

Answer

Antiplatelets

Answer

Statins

Question 14

The primary objective of antiplatelet therapy in patients with CAD is to:

Accepted Answer

Prevent blood clot formation

Answer

Reduce inflammation

Answer

Improve blood flow to the heart

Answer

Lower blood pressure

Question 15

Which sequence accurately describes the development of an atherosclerotic plaque?

Accepted Answer

Endothelial dysfunction, inflammation, lipid deposition, plaque formation, lumen narrowing

Answer

Plaque rupture, collagen exposure, platelet aggregation, thrombosis

Answer

Vasospasm, endothelial damage, atherogenesis

Answer

Elevated LDL cholesterol, arterial wall deposition, plaque formation

Question 16

Which of the following is the most characteristic clinical manifestation of unstable angina?

Accepted Answer

Chest pain that occurs at rest or with minimal exertion

Answer

Chest pain that is relieved by rest

Answer

Chest pain that radiates only to the left arm

Question 17

Which of the following is a known and well-established risk factor for the development of coronary artery disease?

Accepted Answer

Smoking

Answer

Regular physical activity

Answer

Moderate alcohol consumption

Answer

Adherence to a balanced diet

Question 18

The most common clinical presentation of coronary artery disease is:

Accepted Answer

Chest pain (angina)

Answer

Leg pain

Answer

Shortness of breath

Answer

Fatigue

Question 19

Which diagnostic test is considered the gold standard for evaluating the presence and extent of coronary artery disease?

Accepted Answer

Coronary angiography

Answer

Electrocardiogram (ECG)

Answer

Stress test

Answer

Chest X-ray

Question 20

The primary objective of pharmacological management in coronary artery disease is to:

Accepted Answer

Reduce myocardial oxygen demand and improve blood flow

Answer

Prevent heart attacks

Answer

Cure coronary artery disease

Question 21

Which of the following medications is contraindicated for use in patients with coronary artery disease who are also taking sildenafil (Viagra)?

Accepted Answer

Nitrates

Answer

Aspirin

Answer

Beta-blockers

Answer

Statins

Question 22

The most prevalent complication of coronary artery disease is:

Accepted Answer

Myocardial infarction (heart attack)

Answer

Stroke

Answer

Arrhythmias

Answer

Heart failure

Question 23

Which of the following lifestyle modifications is recommended for individuals with coronary artery disease?

Accepted Answer

Regular exercise, healthy diet, and smoking cessation

Answer

Complete avoidance of all physical activity

Answer

Strict bed rest

Question 24

During a stress test, the presence of which of the following indicates a positive test result?

Accepted Answer

Angina or ST-segment depression

Answer

Fatigue

Answer

Leg pain

Answer

Shortness of breath

Question 25

Which type of coronary artery bypass graft surgery involves using a vein harvested from the leg?

Accepted Answer

Saphenous vein graft

Answer

Internal mammary artery graft

Answer

Radial artery graft

Answer

Arterial graft

Question 26

Which nursing intervention is crucial in the care of a patient with coronary artery disease?

Accepted Answer

Providing education about lifestyle modifications and medications

Answer

Administering oxygen as needed

Answer

Inserting an intra-aortic balloon pump

Question 27

Which of the following is a typical characteristic of stable angina?

Accepted Answer

Pain relieved by rest or nitroglycerin

Answer

Sudden onset of pain lasting over 20 minutes

Answer

Pain radiating to the back, neck, or jaw

Answer

Severe and crushing pain

Question 28

Which factor significantly increases the risk of developing coronary artery disease (CAD)?

Accepted Answer

Persistent high blood pressure (hypertension)

Answer

Regular physical activity

Answer

Limited intake of fruits and vegetables

Question 29

Describe the fundamental pathophysiological process of atherosclerosis.

Accepted Answer

Chronic inflammation and lipid deposition in the arterial wall

Answer

Progressive narrowing of coronary arteries caused by plaque accumulation

Answer

Complete blockage of coronary arteries by blood clots

Answer

Replacement of healthy arterial tissue with fibrous tissue

Question 30

Identify a well-established risk factor for developing coronary artery disease (CAD):

Accepted Answer

Hypertension

Answer

Asthma

Answer

Scoliosis

Answer

Osteoporosis

Question 31

Which of the following is considered the primary underlying pathological process in CAD?

Accepted Answer

Atherosclerosis

Answer

Vasospasm

Answer

Inflammation

Answer

Thrombosis

Question 32

Which symptom is most commonly experienced in patients with stable angina?

Accepted Answer

Chest pain or discomfort

Answer

Dyspnea

Answer

Syncope

Answer

Claudication

Question 33

In the pharmacological management of stable angina, which drug class is typically recommended as the initial treatment option?

Accepted Answer

Nitrates

Answer

Statins

Answer

Beta-blockers

Answer

Antiplatelets

Question 34

Which diagnostic test is widely recognized as the gold standard for definitively diagnosing CAD?

Accepted Answer

Coronary angiography

Answer

Echocardiogram

Answer

Stress test

Answer

Electrocardiogram (ECG)

Question 35

In managing CAD, what is the primary objective of implementing lifestyle modifications?

Accepted Answer

Reducing modifiable cardiovascular risk factors

Answer

Preventing complications

Answer

Improving cardiac function

Answer

Reversing atherosclerosis

Question 36

Which medication class should be avoided in patients with CAD who also have heart failure?

Accepted Answer

Calcium channel blockers

Answer

Statins

Answer

Beta-blockers

Answer

Nitrates

Question 37

For a patient experiencing unstable angina, which nursing intervention is considered appropriate?

Accepted Answer

Administer oxygen therapy

Answer

Provide reassurance

Answer

Ambulate the patient

Answer

Enforce bed rest

Question 38

When educating patients about CAD prevention, which aspect should be emphasized as the most important?

Accepted Answer

Lifestyle modifications and risk factor management

Answer

Regular follow-up appointments

Answer

Emergency preparedness

Answer

Medication adherence

Question 39

Which of the following is considered the most significant modifiable risk factor for coronary artery disease (CAD)?

Accepted Answer

Hypercholesterolemia

Answer

Family history of CAD

Answer

Age

Answer

Obesity

Question 40

What is the characteristic chest pain associated with stable angina pectoris?

Accepted Answer

Substernal chest pain that is typically brought on with exertion and relieved with rest

Answer

Chest pain that worsens with lying down

Answer

Chest pain that is accompanied by shortness of breath

Answer

Sharp, stabbing chest pain that is unrelated to activity

Question 41

Which diagnostic modality is considered the gold standard for evaluating the severity of coronary artery narrowing?

Accepted Answer

Coronary angiography

Answer

Stress testing

Answer

Echocardiography

Answer

Electrocardiogram

Question 42

What is the principal aim of medical therapy for unstable angina?

Accepted Answer

To prevent the occurrence of myocardial infarction

Answer

To prevent recurrent episodes of unstable angina

Answer

To relieve symptoms of chest pain

Answer

To improve cardiac function

Question 43

Which antiplatelet agent is commonly used for long-term prevention of atherothrombotic events in patients with CAD?

Accepted Answer

Aspirin

Answer

Ticagrelor

Answer

Warfarin

Answer

Clopidogrel

Question 44

What is the underlying process that leads to the development of atherosclerotic plaques in CAD?

Accepted Answer

Progressive accumulation of lipids and inflammatory cells within the arterial wall

Answer

Rupture of the fibrous cap of a plaque

Answer

Spasm of coronary arteries

Question 45

Which type of acute coronary syndrome is characterized by sustained elevation of the ST-segment on an electrocardiogram?

Accepted Answer

ST-elevation myocardial infarction (STEMI)

Answer

Non-ST-elevation myocardial infarction (NSTEMI)

Answer

Unstable angina

Answer

Prinzmetal's angina

Question 46

What is the overarching goal of nursing care for individuals with CAD?

Accepted Answer

To optimize cardiac health, promote well-being, and prevent complications

Answer

To provide emotional support and counseling

Answer

To administer medications as prescribed