Choice A rationale:

Subendocardial MI typically involves the inner layer of the heart muscle and may not result in marked ST segment elevation. This is not the best choice.

Choice B rationale:

Transmural MI, also known as a full-thickness or ST-elevation myocardial infarction (STEMI), is characterized by marked ST segment elevation on the ECG. This is the correct choice because it accurately describes the scenario in the question.

Choice C rationale:

"Cardial" is not a recognized term in the context of myocardial infarctions. This choice is not appropriate.

Choice D rationale:

"Transient" does not describe the type of MI but rather suggests a temporary or reversible condition. It is not the best choice.

Choice A rationale:

"Permits blood to flow backward" is more characteristic of valvular regurgitation rather than stenosis. This choice is not accurate in the context of valvular stenosis.

Choice B rationale:

"Fails to shut completely" is a description of valvular regurgitation, not stenosis. This is not the correct choice.

Choice C rationale:

Stenosis of a heart valve means that the valve is constricted and narrowed, limiting the flow of blood through it. This choice is accurate and describes valvular stenosis correctly.

Choice D rationale:

"Regurgitates and causes insufficiency" is a description of valvular regurgitation, not stenosis. This choice is not appropriate in this context.

Choice A rationale:

Non-STEMI (Non-ST-Elevation Myocardial Infarction) is a type of heart attack where there is no significant ST segment elevation on the ECG. While it can be serious, it is generally associated with a lower risk of severe complications compared to STEMI.

Choice B rationale:

STEMI (ST-Elevation Myocardial Infarction) is a type of heart attack with significant ST segment elevation on the ECG. It is associated with a higher risk of severe complications and requires more urgent intervention. Patients with STEMI should be monitored most closely for complications.

Choice C rationale:

"QRS type heart attack" is not a recognized medical term. It does not accurately describe a type of heart attack. This choice is not appropriate.

Choice D rationale:

"Non-QRS type heart attack" is not a recognized term in the context of heart attacks. It does not accurately describe a specific type of heart attack. This choice is not suitable.

Choice A rationale:

The client with bipolar disorder speaking loudly may be experiencing a manic episode, but this doesn't represent an immediate physical concern. There's no indication of a medical emergency here.

Choice B rationale:

Olfactory hallucinations in a client with schizophrenia are concerning, but it doesn't necessarily indicate an immediate physical issue that requires urgent attention.

Choice C rationale:

A client taking clozapine and reporting a sore throat is of immediate concern because clozapine is associated with a risk of agranulocytosis, a potentially life-threatening condition that can manifest as a sore throat. Monitoring for this side effect is crucial.

Choice D rationale:

While weight gain in a client taking lithium should be monitored, it's not an acute issue that requires immediate attention.

Choice A rationale:

Lithium is not typically prescribed for attention-deficit hyperactivity disorder (ADHD). It's more commonly used for bipolar disorder.

Choice B rationale:

Valproate is not a first-line treatment for ADHD in school-age children. It is used for mood stabilization in conditions like bipolar disorder.

Choice C rationale:

Risperidone is an atypical antipsychotic and is not a first-line treatment for ADHD. It may be used in some cases where there are comorbid behavioral issues, but it's not the initial choice.

Choice D rationale:

Methylphenidate is a commonly prescribed medication for ADHD in school-age children. It is a central nervous system stimulant that helps improve attention and decrease impulsiveness and hyperactivity in those with ADHD.

Choice A rationale:

Prinzmetal angina is not caused by blood clots in the coronary artery. It is primarily due to vasospasm of the coronary arteries.

Choice B rationale:

Prinzmetal angina is not caused by hypoxemia from respiratory disease. It is a vascular issue, not a respiratory one.

Choice C rationale:

Prinzmetal angina is caused by vasospasm of the coronary arteries. This constriction reduces blood flow to the heart muscle, leading to chest pain.

Choice D rationale:

Prinzmetal angina is not caused by deep vein thrombosis or hypotension. It is primarily related to vasospasm in the coronary arteries.

Choice A rationale:

Sleeping is not a significant factor in orthostatic hypotension. When a patient is sleeping, they are typically lying down, and orthostatic hypotension is related to changes in posture, not during sleep.

Choice B rationale:

Exercising can exacerbate orthostatic hypotension because it increases the demand on the cardiovascular system. When a patient exercises, their heart rate and blood pressure can increase significantly. In the case of orthostatic hypotension, there's a risk of a more pronounced drop in blood pressure when transitioning to an upright position after exercise. Therefore, exercising requires close observation in these patients.

Choice C rationale:

Sitting down is a relatively stable position, and orthostatic hypotension primarily involves changes from a sitting or lying position to a standing position. Sitting down doesn't typically worsen orthostatic hypotension.

Choice D rationale:

Standing up is a crucial moment when dealing with orthostatic hypotension. When a patient with orthostatic hypotension stands up, there is a risk of a significant drop in blood pressure, which can lead to symptoms like dizziness or fainting. This is why standing up requires close observation. Now, let's move on to the next question.

Choice A rationale:

Mitogens like angiotensin II and growth factors stimulate smooth muscle proliferation. Mitogens are substances that promote cell division and growth. Angiotensin II, for example, is known to stimulate smooth muscle cell proliferation, which can lead to conditions like vascular remodeling and hypertension.

Choice B rationale:

Endothelial injury is not directly stimulated by mitogens. Mitogens are more associated with cell growth and proliferation rather than causing injury to endothelial cells.

Choice C rationale:

Mitogens are not typically associated with cardiac muscle toxicity. Cardiac muscle toxicity can result from various factors like certain medications or diseases, but mitogens are not the primary cause of cardiac muscle toxicity.

Choice D rationale:

Mitogens are not directly related to the activation of phagocytes. Phagocytes are white blood cells involved in the immune response, and their activation is more related to infection or inflammation rather than mitogenic stimulation. Moving on to the last question.

Choice A rationale:

Mitral valve prolapse is an autosomal dominant condition. If a patient's history indicates that cardiac valve disease is autosomal dominant, the nurse is likely to find a diagnosis of mitral valve prolapse in the patient's chart. Mitral valve prolapse is a condition where the mitral valve doesn't close properly, allowing blood to flow back into the left atrium.

Choice B rationale:

Pulmonary stenosis is not typically associated with autosomal dominant inheritance. It's more commonly associated with sporadic genetic mutations or other non-genetic factors.

Choice C rationale:

Tricuspid regurgitation is not usually an autosomal dominant condition. Like pulmonary stenosis, it's often caused by other factors rather than being directly related to genetic inheritance.

Choice D rationale:

Aortic stenosis is not typically an autosomal dominant condition. It's more commonly related to age-related degeneration or other non-genetic factors.

Choice A rationale:

The nurse's best response is not choice A because the heart does not store 20 minutes' worth of oxygen supply in myoglobin. Myoglobin is a protein in muscles that stores oxygen, but it is not the primary source of oxygen for the heart.

Choice B rationale:

The nurse's best response is choice B. Collateral blood flow to the myocardium can maintain the myocardium for about 20 minutes during myocardial ischemia. Collateral blood vessels can provide an alternative source of blood supply to the heart muscle, which may temporarily sustain it in the absence of normal blood flow.

Choice C rationale:

Choice C is not the best response because the arrival of neutrophils and macrophages and the activation of inflammation are not the primary reasons for the reversibility of myocardial ischemia within 20 minutes.

Choice D rationale:

Anaerobic metabolism can maintain cellular integrity for a limited time, but it is not the primary reason for the reversibility of myocardial ischemia within 20 minutes. The best response is choice B, which focuses on collateral blood flow as the primary reason.

Choice A rationale:

Troponin T is a cardiac biomarker used to diagnose myocardial infarction, not to determine the severity of heart failure. It is not the most appropriate laboratory result to monitor for heart failure severity.

Choice B rationale:

C-reactive protein is a marker of inflammation and is not typically used to determine the severity of heart failure. While inflammation can be present in heart failure, it is not a specific marker for its severity.

Choice C rationale:

Potassium levels can be important in heart failure management, but they do not directly indicate the severity of heart failure. Abnormal potassium levels can be a consequence of heart failure and its treatment.

Choice D rationale:

Brain natriuretic peptide (BNP) is the most appropriate laboratory result to monitor to determine the severity of heart failure in a patient. Elevated levels of BNP are associated with increased severity of heart failure. BNP is released by the heart in response to increased pressure and volume, which occurs in heart failure.

Choice A rationale:

Pain and edema in the affected limb are typical assessment findings of deep vein thrombosis (DVT) in the lower leg. This is due to the obstruction of blood flow by the thrombus, which leads to swelling and discomfort in the affected limb.

Choice B rationale:

Muscle paralysis and paresthesia are not typical assessment findings of DVT in the lower leg. DVT is more commonly associated with pain and swelling, rather than muscle paralysis or paresthesia.

Choice C rationale:

Reduced pulses in the foot may occur in severe cases of DVT, but it is not one of the primary and typical assessment findings. Pain and edema are more common and reliable indicators of DVT.

Choice D rationale:

Choice A rationale:

Leptin is a hormone produced by adipose tissue, and it plays a key role in regulating appetite and body weight. In obesity, there is an excessive amount of adipose tissue, leading to an increase in leptin levels. However, despite the higher levels of leptin, obese individuals may become resistant to its effects, leading to a decrease in the body's ability to respond to leptin signals. This condition is known as leptin resistance. Therefore, it is important to understand that obesity can cause a decrease in the effectiveness of leptin, which is critical for appetite regulation and body weight control.

Choice B rationale:

Adiponectin is another hormone produced by adipose tissue, but it has the opposite effect of leptin. Adiponectin levels are typically lower in obese individuals. While it is associated with various metabolic benefits, including improved insulin sensitivity, it doesn't directly decrease due to obesity.

Choice C rationale:

Homocysteine is not directly related to obesity. Homocysteine is an amino acid that is involved in various metabolic processes, and elevated levels are more commonly associated with cardiovascular disease and other health conditions, but not obesity.

Choice D rationale:

C-reactive protein (CRP) is a marker of inflammation in the body. While obesity is associated with chronic inflammation, it doesn't directly cause a decrease in CRP levels. In fact, obesity is more likely to lead to increased CRP levels, indicating higher levels of inflammation in the body.

Choice A rationale:

Pressure ulcers are not typically related to blood pooling in superficial veins due to prolonged standing. Pressure ulcers are usually caused by sustained pressure on the skin and underlying tissues, leading to tissue damage.

Choice B rationale:

Varicose veins can develop when blood pools in the superficial veins, often due to prolonged standing or increased pressure on the veins. This can lead to the dilation and twisting of the veins, resulting in varicose veins. Therefore, if a person stands for long periods of time, the nurse should assess for the development of varicose veins.

Choice C rationale:

Emboli and thromboangitis obliterans (Buerger's disease) are not directly related to blood pooling in superficial veins due to prolonged standing. Emboli are blood clots or other materials that travel through the bloodstream and can potentially block vessels in various parts of the body. Thromboangitis obliterans is a rare inflammatory condition that primarily affects the blood vessels of the extremities.

Choice A rationale:

When describing stroke, it is essential to focus on factors related to the cardiovascular system. Pulse rate, hypertension (high blood pressure), and arrhythmia (irregular heart rhythms) are all cardiovascular parameters that can be associated with stroke. An increase in pulse rate, hypertension, and arrhythmia can be signs of a stroke or risk factors for stroke.

Choice B rationale:

Murmurs, hypertrophy, and blood flow are relevant to cardiac conditions and may be associated with stroke if they lead to inadequate blood flow to the brain. However, they are not as directly related to stroke as the factors mentioned in choice A.

Choice C rationale:

Contractility, preload, and afterload are also important cardiac parameters but are more related to the function of the heart itself rather than stroke. While heart function is crucial for maintaining adequate blood flow to the brain, these parameters are not as directly associated with stroke as the factors in choice A.

Choice D rationale:

Myocyte hibernation, stunning, and remodeling are terms often used in the context of cardiac conditions, particularly after myocardial infarction (heart attack). These terms are not typically associated with a general description of stroke. .

Choice A rationale:

Acute pericarditis is a cardiovascular complication that can occur in patients with human immunodeficiency virus (HIV). This condition involves inflammation of the pericardium, the membrane surrounding the heart. In patients with HIV, pericarditis may result from opportunistic infections or HIV-related complications. The inflammation can lead to chest pain, dyspnea, and other cardiac symptoms, making it an important consideration in the assessment of these patients.

Choice B rationale:

Stable angina is not typically a cardiovascular complication of HIV. While HIV can affect the cardiovascular system, stable angina is more commonly associated with coronary artery disease and atherosclerosis.

Choice C rationale:

Buerger's disease is not a cardiovascular complication associated with HIV. Buerger's disease, also known as thromboangiitis obliterans, is a vascular condition primarily linked to tobacco use. It involves inflammation and thrombosis of small and medium-sized arteries, leading to limb ischemia.

Choice D rationale:

Raynaud's phenomenon is not a cardiovascular complication related to HIV. Raynaud's phenomenon is characterized by vasospasm of small arteries and arterioles, typically affecting the fingers and toes. It is not a direct consequence of HIV infection.

Choice A rationale:

Congenital disorders can indeed cause aortic stenosis, but it is not the most common cause in later life. Aortic stenosis primarily results from degeneration and calcification of the valve as individuals age.

Choice B rationale:

Rheumatic heart disease is a significant cause of aortic stenosis in some cases, but it is more common in regions where rheumatic fever is prevalent. Loss of muscle fibers is not the primary cause of aortic stenosis in later life.

Choice C rationale:

This is the correct answer. Aortic stenosis in older adults usually results from degeneration and calcification of the aortic valve. As people age, wear and tear on the valve can lead to the formation of calcium deposits, causing narrowing and obstruction of the valve. This is the most common etiology of aortic stenosis in the elderly.

Choice D rationale:

Marfan syndrome is a genetic connective tissue disorder that can affect the aorta, leading to aortic root dilation or dissection. While it is associated with aortic pathology, it is not the primary cause of aortic stenosis.

Choice A rationale:

Serous fluid is not typically associated with pericardial effusion in acute pericarditis. Pericardial effusion is more likely to contain blood or inflammatory exudate, especially in the context of pericarditis.

Choice B rationale:

Exudate is often found in pericardial effusion associated with acute pericarditis. This inflammatory response can lead to the accumulation of exudative fluid in the pericardial space.

Choice C rationale:

This is the correct answer. Serosanguineous fluid is often associated with pericardial effusion in the context of acute pericarditis. It contains a mixture of serous fluid (clear, yellowish) and blood, reflecting the inflammatory nature of the condition.

Choice D rationale:

Sanguineous fluid, while it may be present in some cases, is not the most typical fluid associated with pericardial effusion in acute pericarditis. Sanguineous fluid is characterized by a higher proportion of blood and is more commonly seen in traumatic or hemorrhagic effusions.

Choice A rationale:

A systolic pressure between 130-139 mmHg and diastolic pressure between 80-89 mmHg is not considered normal. It falls within the range of prehypertension according to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), which classifies normal blood pressure as systolic pressure less than 120 mmHg and diastolic pressure less than 80 mmHg. The rationale for this choice is that the range provided does not align with the current standards for normal blood pressure.

Choice B rationale:

The correct answer is choice B because a systolic pressure greater than or equal to 140 mmHg and a diastolic pressure greater than or equal to 90 mmHg are indicative of hypertension, as per the JNC 7 guidelines. Normal blood pressure is defined as systolic pressure less than 120 mmHg and diastolic pressure less than 80 mmHg. Hypertension is a significant risk factor for cardiovascular diseases and requires medical attention and lifestyle modifications to manage. The rationale for this choice is that it correctly identifies the threshold for hypertension, which is crucial for patient assessment and care.

Choice C rationale:

A systolic pressure less than 120 mmHg and diastolic pressure less than 80 mmHg is indeed considered normal, according to JNC 7 guidelines. However, this choice does not provide an accurate representation of the guidelines as it lacks a systolic pressure range between 120 and 129 mmHg. This gap in the guidelines would lead to confusion when categorizing blood pressure, and the answer is therefore not correct.

Choice D rationale:

A systolic pressure between 120-129 mmHg and diastolic pressure less than 80 mmHg is categorized as elevated blood pressure, not normal. The JNC 7 guidelines clearly specify that normal blood pressure falls below 120 mmHg systolic and below 80 mmHg diastolic. This range is associated with an increased risk of hypertension and should not be considered normal. The rationale for this choice is that it provides an inaccurate representation of normal blood pressure as per the guidelines.

Choice A rationale:

The term the nurse should use to describe the finding of pain on ambulation in a patient with peripheral artery disease is "intermittent claudication.”. Intermittent claudication is a classic symptom of peripheral artery disease and is characterized by muscle pain or cramping in the legs during physical activity, such as walking, which improves with rest. This choice is correct because it accurately describes the symptom associated with the condition and helps in effective communication with both the healthcare team and the patient.

Choice B rationale:

Deep vein thrombosis (DVT) is a different vascular condition that involves the formation of blood clots in deep veins, often in the legs. While DVT can also cause leg pain and swelling, it is not the appropriate term to describe the pain on ambulation in a patient with peripheral artery disease. Using this term would lead to a misunderstanding of the patient's condition, so it is not the correct choice.

Choice C rationale:

Thromboangiitis obliterans, also known as Buerger's disease, is a rare inflammatory condition that primarily affects the blood vessels in the arms and legs. While it can cause pain and other symptoms, it is not the term to describe the pain on ambulation in a patient with peripheral artery disease. Using this term would be misleading and not reflective of the patient's condition.

Choice D rationale:

Venous stasis ulcer is a term used to describe open sores or ulcers that develop on the legs due to chronic venous insufficiency. It is not the appropriate term to describe the pain on ambulation in a patient with peripheral artery disease. Using this term would not accurately convey the patient's symptoms, so it is not the correct choice.

Choice A rationale:

A high-sodium diet is a risk factor for hypertension but is not directly associated with atherosclerosis. Atherosclerosis primarily involves the buildup of plaque within the arteries, which can lead to the narrowing and hardening of these blood vessels. While hypertension is a risk factor for atherosclerosis, the choice does not correctly address the question, as it asks for risk factors associated with atherosclerosis specifically.

Choice B rationale:

Advanced age is indeed a risk factor for atherosclerosis. As individuals age, the risk of atherosclerosis and related cardiovascular diseases increases. Atherosclerosis is a progressive condition that develops over time, and older individuals are more likely to have accumulated risk factors contributing to its development. Therefore, this choice is correct in identifying an associated risk factor for atherosclerosis.

Choice C rationale:

The correct answer is choice C because hyperhomocysteinemia is a known risk factor for atherosclerosis. Elevated levels of homocysteine, an amino acid, have been linked to an increased risk of atherosclerosis and cardiovascular disease. This choice is accurate in identifying a specific risk factor for atherosclerosis and aligns with current medical knowledge.

Choice D rationale:

A low-potassium diet is not a direct risk factor for atherosclerosis. While potassium intake can affect blood pressure regulation, it is not one of the primary risk factors for atherosclerosis. Atherosclerosis is primarily related to factors like high cholesterol levels, hypertension, smoking, and diabetes. Therefore, this choice is not correct in the context of risk factors for atherosclerosis.

Choice A rationale:

Endothelial injury is a component of the Virchow triad. This statement is correct. The Virchow triad consists of three components that contribute to the formation of blood clots: endothelial injury, venous stasis, and a hypercoagulable state. Endothelial injury refers to damage to the inner lining of blood vessels, which can trigger the clotting process.

Choice B rationale:

LDL accumulation is not a component of the Virchow triad. This statement is incorrect. The Virchow triad does not include LDL accumulation as one of its components. LDL (low-density lipoprotein) is related to atherosclerosis and cardiovascular disease but is not a part of the Virchow triad.

Choice C rationale:

Venous stasis is a component of the Virchow triad. This statement is correct. Venous stasis refers to the slowing or stagnation of blood flow in the veins, which can promote the formation of blood clots. It is one of the three components of the Virchow triad.

Choice D rationale:

A hypercoagulable state is a component of the Virchow triad. This statement is correct. A hypercoagulable state refers to a condition where the blood is more prone to clotting. It is one of the three components of the Virchow triad.

Choice A rationale:

Labeling hyperhomocysteinemia as a traditional risk factor is not accurate. This statement is incorrect. Hyperhomocysteinemia is not typically considered a traditional risk factor for coronary artery disease (CAD). Traditional risk factors include factors such as smoking, hypertension, high cholesterol, and diabetes.

Choice B rationale:

Labeling hyperhomocysteinemia as a major risk factor is not common. This statement is incorrect. While elevated homocysteine levels are associated with an increased risk of CAD, it is not typically considered a major risk factor. Major risk factors for CAD usually include factors like smoking, high blood pressure, and high cholesterol.

Choice C rationale:

Labeling hyperhomocysteinemia as a novel risk factor is appropriate. This statement is correct. Hyperhomocysteinemia is considered a novel or emerging risk factor for CAD. Elevated homocysteine levels have been associated with an increased risk of CAD, and it is an area of ongoing research and investigation.

Choice D rationale:

Labeling hyperhomocysteinemia as a conventional risk factor is not accurate. This statement is incorrect. Hyperhomocysteinemia is not considered a conventional risk factor for CAD. Conventional risk factors are well-established and widely recognized risk factors for a particular condition.

Choice A rationale:

Insulin resistance is not a typical complication of sustained hypertension. This statement is incorrect. While hypertension can lead to various complications, insulin resistance is not one of the primary complications associated with high blood pressure.

Choice B rationale:

Left ventricular hypertrophy is a common complication of sustained hypertension. This statement is correct. Prolonged high blood pressure can lead to the thickening and enlargement of the left ventricle of the heart, known as left ventricular hypertrophy. This is a well-recognized and common complication of hypertension.

Choice C rationale:

Excessive excretion of fluid by the kidneys is not a typical complication of sustained hypertension. This statement is incorrect. Hypertension often leads to kidney damage, but it is more likely to result in reduced kidney function and fluid retention rather than excessive fluid excretion.

Choice D rationale:

Hormone dysfunction is not a primary complication of sustained hypertension. This statement is incorrect. While hypertension can affect various physiological processes, it is not a direct cause of hormone dysfunction. Hormone dysfunction may be related to other conditions, but it is not a direct consequence of hypertension. .

Choice A rationale:

Anemia is not directly associated with endothelial injury in atherosclerosis. While anemia can lead to reduced oxygen delivery to tissues, it is not a primary factor in endothelial injury. Atherosclerosis is primarily linked to risk factors like smoking, hypertension, and hyperlipidemia.

Choice B rationale:

Smoking is a significant risk factor for atherosclerosis and can cause endothelial injury. Smoking introduces harmful chemicals into the bloodstream, leading to inflammation and damage to the inner lining of blood vessels (endothelium). This damage can promote the development of atherosclerotic plaques.

Choice C rationale:

Blood pressure of 110/70 is within the normal range, and while hypertension is a risk factor for atherosclerosis, this specific blood pressure measurement does not indicate endothelial injury.

Choice D rationale:

A history of asthma is not a direct risk factor for atherosclerosis or endothelial injury. While chronic inflammatory conditions can contribute to cardiovascular disease, asthma alone is not typically associated with atherosclerosis.