A 59-Year-Old Man Comes to the Office for Follow-Up

question 14

Multiple Choice

A 59-year-old man comes to the office for follow-up.  The patient had an acute myocardial infarction 1 month ago, and a drug-eluting stent was placed successfully.  He has no cardiovascular symptoms, but he does have hypertension and hyperlipidemia and a 40-pack-year smoking history.  Blood pressure is 132/86 mm Hg and pulse is 68/min.  BMI is 30.8 kg/m².  Physical examination is unremarkable.  The patient says, "I can't wait to get back to work, but at the same time, I'm concerned about having another heart attack.  I have a high-pressure job, but I need to find time to exercise.  Plus, I know I should stop smoking and lose at least 20 pounds."  Which of the following is the most appropriate response by the physician at this time?

• A)"Having a heart attack was frightening.  It's great that you've decided to stop smoking, lose weight, and start exercising."
• B)"I suggest we prioritize quitting smoking first.  That will decrease your risk significantly and make it easier to exercise."
• C)"Those are excellent goals.  Let's make a comprehensive list of all the health changes you want to make."
• D)"You've been through a tough time.  Would you consider working fewer hours for the time being so you can focus on your health?"
• E)"You've brought up important issues.  What are one or two small changes you feel most ready to tackle now?"

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Definitions:

Pair of Equations

A pair of equations that are simultaneously solved to identify a shared solution for their variables.

Three Figure Accuracy

The precision of a numerical value rounded to the nearest hundredth, typically used in scientific or technical contexts.

Pair of Equations

Two equations related in such a way that they share at least one common variable, often solved together.

Graphically

Using diagrams, charts, or visuals to represent data, trends, or relationships between variables.