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NCLEX · General

A patient is being discharged after a myocardial infarction (MI). Which lifestyle modification is the highest priority?

Correct answer

Cessation of smoking — if the patient smokes, this is the single most impactful lifestyle modification for preventing a second MI; smoking is an independent, modifiable risk factor for coronary artery disease

  1. A Start a high-protein diet
  2. B Cessation of smoking — if the patient smokes, this is the single most impactful lifestyle modification for preventing a second MI; smoking is an independent, modifiable risk factor for coronary artery disease
  3. C Eliminate all physical activity
  4. D Stop all saturated fat immediately

Why this is the answer

CARDIAC RISK REDUCTION AFTER MI — PRIORITY ORDER: SMOKING CESSATION: Smoking is one of the strongest modifiable risk factors for CAD — doubles the risk; cessation reduces recurrent MI risk by up to 50% within 1 year. This is the highest priority single lifestyle intervention. MEDICATION ADHERENCE: Aspirin, beta-blocker, statin, and ACE inhibitor/ARB are standard post-MI therapy — adherence is critical. DIET: Heart-healthy diet (Mediterranean or DASH); reduce saturated and trans fats, sodium, added sugars; increase fruits, vegetables, whole grains, fish. PHYSICAL ACTIVITY: Cardiac rehabilitation programme; gradual return to activity; exercise reduces recurrence risk. STRESS MANAGEMENT: Chronic stress is an independent risk factor. TEACHING PRIORITY: Smoking cessation is the answer to 'highest priority modification' — the others are also important but the magnitude of benefit from cessation is greatest.
Source: NCLEX-PN, Post-MI Lifestyle Teaching Priority

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