Nokea
A patient admitted to the emergency room with a possible myocardial infarction (MI) has reports back from the laboratory. Which laboratory report is specific for myocardial damage?
- A. CK-MB
- B. Elevated white count
- C. Elevated sedimentation rate
- D. Low level of sodium
Correct Answer: A
Rationale: The CK-MB is elevated when there is infarcted myocardial muscle. The elevated white count, low sodium, and ESR are nonspecific.
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The cardiac marker rises 3 hours after a myocardial infarct and measures myocardial contractile protein.
Correct Answer: troponin I
Rationale: Troponin I is a serum cardiac marker that rises 3 hours after an MI and can measure myocardial contractile tissue. Troponin I is not affected by skeletal muscle injury as is troponin T.
The life support system that uses special techniques, ventilation equipment, and therapies for emergency situations is
Correct Answer: advanced cardiac life support (ACLS)
Rationale: ACLS is a life support system that uses special techniques, ventilation equipment, and therapies for emergency situations.
The nurse assessing a cardiac monitor notes that the cardiac complexes each have a P wave followed by a QRS and a T. The rate is 120. The nurse recognizes this as which arrhythmia?
- A. sinus bradycardia.
- B. atrial fibrillation.
- C. sinus tachycardia.
- D. ventricular tachycardia.
Correct Answer: C
Rationale: Sinus tachycardia has a P wave followed by the QRS and the T. All the components of the complex are present and in the correct order, but the rate is over 100 beats/min.
The patient has a total cholesterol of 190 with a high-density lipid (HDL) of 110 and a low-density lipid (LDL) of 80. The nurse reinforces which instruction?
- A. Good job! Continue with your low fat diet.
- B. These levels are borderline: you still aren't eating properly.
- C. The dietician will need to talk to you about lowering your cholesterol a lot more.
- D. Your cholesterol level needs to be lowered a great deal to improve your survival chances.
Correct Answer: A
Rationale: Total cholesterol of less than 200 is desirable. The higher the number of HDLs the better. A high number of LDLs puts the patient at risk for heart disease.
During a health interview by the home health nurse, which patient report suggests left-sided heart failure?
- A. I have to sleep in my recliner and I have this hacking cough.'
- B. I have no appetite and I have lost $3 \mathrm{lb}$ in the last week.'
- C. I have to urinate every 2 hours, even during the night.'
- D. I go barefoot most of the time because my feet are so hot.'
Correct Answer: A
Rationale: Left ventricular failure is often among the first of signs and symptoms of decreased cardiac output. The second is pulmonary congestion. Signs and symptoms of this condition include dyspnea, orthopnea, pulmonary crackles, hemoptysis, and cough.