Answer to Question 1
ANS: D
Cigarette smoking leads to vasoconstriction and should be the first behavior the patient changes. Eating meat alone would not lead to the development of coronary artery disease. The living ar-rangement of the patient's home would not lead to the development of coronary artery disease. Drinking tomato juice would not lead to the development of coronary artery disease.
Answer to Question 2
ANS: B
Angina is chest pain caused by myocardial ischemia, which develops if the flow or oxygen con-tent of coronary blood is insufficient to meet the metabolic demands of myocardial cells. A de-crease in cardiac output would lead to general systemic symptoms, not just chest pain, which is due to a decrease in myocardial oxygenation. Myocardial stretch does not affect angina symp-toms. When the vagus nerve is stimulated, a change in rate occurs; it does not precipitate chest pain.
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Example of a patient’s ledger in practice management software.
Patient health history form Cont.