A primary prevention for reducing a female patient's risk of developing coronary heart disease is to:

Correct Answer: C

Rationale: The correct answer is C: take aspirin 81 mg/d. Aspirin is recommended for primary prevention of coronary heart disease in high-risk individuals, including females. It helps reduce the risk of blood clot formation by inhibiting platelet aggregation. This action can prevent blockages in the arteries that supply the heart. Avoiding weight gain during pregnancy (A) is important for overall health but not a primary prevention specifically for coronary heart disease. Enrolling in a cardiac rehabilitation program (B) is more suitable for individuals who already have cardiovascular disease. Taking nitroglycerin (D) is used for acute relief of chest pain but is not a primary prevention strategy.

Correct Answer: B

Rationale: Step 1: Prazosin is an alpha-adrenergic blocker that can cause orthostatic hypotension. Step 2: Adding prazosin to the regimen can further lower the patient's blood pressure. Step 3: Changing position slowly and avoiding prolonged standing helps prevent dizziness and falls. Step 4: Teaching the patient to change positions slowly is crucial to prevent orthostatic hypotension. Step 5: This education is essential for the patient's safety and well-being.

Correct Answer: C

Rationale: The correct answer is C: Lactic acid accumulation during anaerobic metabolism. During myocardial ischemia, there is a decrease in blood flow leading to insufficient oxygen supply to the heart muscle. This results in anaerobic metabolism, causing lactic acid accumulation. Lactic acid buildup leads to tissue acidosis, which is sensed as pain by nerve endings in the heart. Incorrect choices: A: Death of myocardial tissue - This is the result of prolonged ischemia leading to irreversible damage, not the direct cause of pain. B: Dysrhythmias caused by cellular irritability - Dysrhythmias can occur with ischemia, but they are not the primary cause of pain. D: Elevated pressure in the ventricles and pulmonary vessels - While elevated pressure can be a consequence of ischemia, it is not the direct cause of pain.

Correct Answer: C

Rationale: The correct answer is C: Percutaneous coronary intervention (PCI). PCI is the preferred treatment to open a blocked artery in a patient with a confirmed MI within 90 minutes as it is a minimally invasive procedure that can quickly restore blood flow. Stent placement (A) is part of PCI and can be performed during the procedure. Coronary artery bypass graft (CABG) (B) is a more invasive surgery usually done in stable patients, not in emergency situations like an acute MI. Transmyocardial laser revascularization (TMR) (D) is not a first-line treatment for acute MI and is typically used in specific cases where other treatments have failed.

Correct Answer: C

Rationale: The correct answer is C: Imaging studies. Assessing a patient with an aortic aneurysm requires imaging studies such as ultrasound, CT scan, or MRI to visualize the size, location, and severity of the aneurysm. This helps in determining the appropriate management plan. Pulse check (A) and blood pressure monitoring (B) are important but do not directly provide information about the aneurysm itself. Electrocardiogram (D) is used to assess heart function and rhythm, which may be affected by an aneurysm but does not provide direct visualization of the aneurysm.