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:
            amber 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 
 
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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. 
 
 
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 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 of the immune system declines with age, but this is variable 
among persons. 
 The ability of the body to make antibodies diminishes. 
 Autoimmune disorders are increased in older adults. Not everyone believes 
that the increased incidence of autoimmune di

            Quiz: