Author Question: The nurse is teaching a client about reducing the risk for coronary artery disease. An elevation in ... (Read 81 times)

nummyann · **on:** Jul 23, 2018

The nurse is teaching a client about reducing the risk for coronary artery disease. An elevation in which laboratory value is most directly associated with atherosclerosis, leading to coronary artery disease?

1. Total cholesterol
2. Very low-density lipoprotein (VLDL)
3. Low-density lipoprotein (LDL)
4. High-density lipoprotein (HDL)

Question 2

The nurse is caring for a client diagnosed with coronary artery disease. When examining the results of laboratory tests, the nurse notes that which findings are consistent with this diagnosis?

1. Decreased total serum cholesterol and LDL, and elevated HDL
2. Elevated total serum cholesterol, LDL, and HDL
3. Elevated total serum cholesterol and LDL, and decreased HDL
4. Decreased total serum cholesterol, LDL, and HDL

ky860224 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 3
Rationale 1: Total cholesterol represents the sum of all types of cholesterol. An elevation in total cholesterol is not the most direct predictor of atherosclerosis risk.
Rationale 2: Very low-density lipoprotein (VLDL) is a precursor of LDL and thus does not have the most direct relationship with initiation of atherosclerosis.
Rationale 3: The strength of the association between LDL cholesterol and atherosclerosis is demonstrated by the direct relationship between reduction in LDL cholesterol and acute coronary syndrome risk. LDL cholesterol contains lipoprotein (a), which is highly associated with atherosclerotic plaque.
Rationale 4: High-density lipoprotein (HDL) carries cholesterol from the peripheral tissues to the liver for metabolism and excretion, so an elevation rather than a decrease in HDL is associated with lowered atherosclerosis risk.
Global Rationale: The strength of the association between LDL cholesterol and atherosclerosis is demonstrated by the direct relationship between reduction in LDL cholesterol and acute coronary syndrome risk. LDL cholesterol contains lipoprotein (a), which is highly associated with atherosclerotic plaque. Total cholesterol represents the sum of all types of cholesterol. An elevation in total cholesterol is not the most direct predictor of atherosclerosis risk. Very low-density lipoprotein (VLDL) is a precursor of LDL and thus does not have the most direct relationship with initiation of atherosclerosis. High-density lipoprotein (HDL) carries cholesterol from the peripheral tissues to the liver for metabolism and excretion, so an elevation rather than a decrease in HDL is associated with lowered atherosclerosis risk.

Answer to Question 2

Correct Answer: 3
Rationale 1: Decreased total serum cholesterol and LDL are inconsistent with coronary artery disease because LDL reflects the amount of cholesterol that is being transported from the liver to peripheral tissue. An elevation in HDL is inconsistent with coronary artery disease because this value reflects how much cholesterol is being carried from the peripheral tissue to the liver for metabolism and excretion.
Rationale 2: Elevated total serum cholesterol and LDL are consistent with coronary artery disease because LDL reflects the amount of cholesterol that is being transported from the liver to peripheral tissue. An elevation in HDL is inconsistent with coronary artery disease because this value reflects how much cholesterol is being carried from the peripheral tissue to the liver for metabolism and excretion.
Rationale 3: Elevated total serum cholesterol is consistent with coronary artery disease. Increased LDL is consistent with coronary artery disease because LDL reflects the amount of cholesterol that is being transported from the liver to peripheral tissue. A decrease in HDL is inconsistent with coronary artery disease because this value reflects how much cholesterol is being carried from the peripheral tissue to the liver for metabolism and excretion.
Rationale 4: Decreased total serum cholesterol is inconsistent with coronary artery disease, and decreased LDL is inconsistent with coronary artery disease because low-density lipoprotein level reflects the amount of cholesterol that is being transported from the liver to peripheral tissue. A decrease in high-density lipoprotein is consistent with coronary artery disease because this value reflects how much cholesterol is being carried from the peripheral tissue to the liver for metabolism and excretion.
Global Rationale: Elevated total serum cholesterol is consistent with coronary artery disease. Increased LDL is consistent with coronary artery disease because LDL reflects the amount of cholesterol that is being transported from the liver to peripheral tissue. A decrease in HDL is inconsistent with coronary artery disease because this value reflects how much cholesterol is being carried from the peripheral tissue to the liver for metabolism and excretion.