Pretend you are a teacher preparing a quiz for the text I will provide. 
            Each quiz question should follow the format below. 
            Ensure that you carefully recheck the questions and answers for accuracy. 
            The output should be a ready-to-use list of dictionaries for the Python eval function:

            [

                    "question": "WRITE THE QUESTION HERE",
                    "options": ["A) OPTION_1", "B) OPTION_2", "C) OPTION_3", "D) OPTION_4"],
                    "answer": INDEX_OF_CORRECT_ANSWER_IN_OPTIONS_LIST,
                    "explanation": "EXPLAIN WHY THE ANSWER IS CORRECT"

            ]

            Text:
            
IV. Cardiovascular System: 
 
Figure (4). Available at www.saingstudentsmony.orgw 
1. Changes in the heart: 
 A slight increase in the size of the heart, especially the left ventricle, is 
common. The heart wall thickens, so the amount of blood that the 
chamber can hold may actually decrease . 
 The heart may fill more slowly.   
 The valves of the heart thicken and become stiffer 
 ↓
Muscle strength, efficiency 
 The heart, like other muscles, weakens and loses pumping capacity.  
 Decreased amount of blood that is pumped throughout the circulatory 
system lead to decrease heart rate. 
 Arteries or veins may become rigid or blocked, which restricts blood flow 
and circulation. 
2. Blood vessels:   
 Thickening & stiffening in the large arteries   
 Smaller arteries may thicken/stiffen minimally; their ability to dilate & 
constrict diminishes significantly  
 The aorta becomes thicker, stiffer, and less flexible.  This makes the blood 
pressure higher resulting in LV hypertrophy. 
Nursing Interventions: 
 Inform patient that exercise can reduce the strain on the heart, lower blood 
pressure and lower cholesterol levels. 
 Monitor older adults’ cholesterol levels with lowering agents to prevent 
 
Content 
 
~ 16 ~ 
atherosclerosis and arteriosclerosis. 
 Take healthy diet as increase fruits and vegetables decrease fats …etc. 
 Discuss the right medication, exercise program, and diet for the patient as a 
means to slow the progression of cardiac changes. 
V. Respiratory System: 
 The number of cilia & their level of activity are reduced. 
 The cough reflex is blunted thus decreasing the effectiveness of cough.  
 Decreased levels of secretory IgA in nose & lungs that lead to decreased 
ability to neutralize viruses. 
 The number of alveoli does not change significantly.   
 The number of functional alveoli decreases as the alveolar walls become 
thin, the alveoli enlarge, are less elastic.  
 Decreased elasticity of the lungs may be due to collagen cross-linking. 
 The respiratory muscles lose strength. 
 There is increased stiffness of chest wall.  
 Pulmonary vasculature becomes less elastic and pulmonary artery thickens 
lead to increased resistance to blood flow in lungs result in increased 
pulmonary artery pressure. 
 ↑ Risk of infection.  
 
Figure (5). Available at www.ccok.adam.com 
Nursing Interventions: 
 Inform that pollution and smoking worsens the cilia (try to help stop 
smoking by recommending behavioral management classes, support 
groups/nicotine replacement therapies, antidepressant medications). 
 Tell patients that they are at risk for choking. 
 
 
Content 
 
~ 17 ~ 
 Make sure patient’s respiratory function is frequently assessed. 
 Encourage regular exercise. 
 Teach breathing exercise as deep breathing and coughing exercise. 
 Give extra fluids to ensure hydrated & loosen secretions) to increase ability 
to cough up secretions. 
 Get influenza vaccine. 
VI. Immune System: 
 The efficiency

            Quiz: