A 75-year-old male has severe chest pain and dials 911. Lab tests at the hospital reveal elevated levels of cardiac troponin. Based upon the lab findings, the nurse suspects which of the following has occurred:
Left ventricular heart failure
Unstable angina
Myocardial infarction (MI)
Prinzmetal angina
The Correct Answer is C
Choice A reason:
Left ventricular heart failure can cause severe chest pain and elevated cardiac enzymes but is not as directly associated with elevated cardiac troponin levels as a myocardial infarction. The presence of elevated troponin levels specifically indicates myocardial cell injury, which is most consistent with an MI.
Choice B reason:
Unstable angina involves chest pain that is not relieved by rest and may indicate a higher risk for an MI. However, it typically does not result in elevated cardiac troponin levels unless there is actual myocardial damage. Elevated troponin is a marker for myocardial infarction rather than just unstable angina.
Choice C reason:
Myocardial infarction (MI) is the correct answer. Elevated levels of cardiac troponin are a key indicator of myocardial infarction as they reflect heart muscle damage. The patient's severe chest pain and elevated troponin levels strongly suggest that an MI has occurred.
Choice D reason:
Prinzmetal angina, or variant angina, is characterized by chest pain caused by coronary artery spasms. While it can cause significant pain, it does not typically lead to elevated cardiac troponin levels unless it results in myocardial damage, which is less common than in an MI.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Holding the heparin and notifying the provider is the appropriate action. The significant drop in platelet count suggests the possibility of heparin-induced thrombocytopenia (HIT), a serious complication of heparin therapy. Immediate discontinuation of heparin and further evaluation are necessary to manage this condition.
Choice B reason:
Requesting an order for vitamin K (phytonadione) is not appropriate in this scenario. Vitamin K is used to reverse the effects of warfarin, not heparin. The issue here is the potential for HIT, not an over-anticoagulation that requires vitamin K.
Choice C reason:
While requesting a PTT test is part of managing anticoagulation therapy, it is not the immediate priority in this case. The significant drop in platelet count is more concerning for HIT, which requires stopping heparin and notifying the provider for further evaluation.
Choice D reason:
Administering oxygen and notifying the provider is not specific to managing the issue of a significantly low platelet count in a patient on heparin. The primary concern here is the potential for HIT, which necessitates stopping the heparin.
Correct Answer is D
Explanation
Choice A reason:
Nonadherence to the antiviral regimen could result in suboptimal control of the HIV infection, but it is not typically associated with symptoms of increased hunger, thirst, and frequent urination. Therefore, this choice does not explain the patient's symptoms.
Choice B reason:
An allergic reaction might cause a variety of symptoms, such as rash, itching, or swelling, but it would not typically cause increased hunger, thirst, and frequent urination. This choice is incorrect as it does not align with the presented symptoms.
Choice C reason:
Pancreatic infiltration by HIV is a rare and serious condition that can lead to various metabolic complications, but it is not a common cause of the specific symptoms described (increased hunger, thirst, and frequent urination). This choice is not consistent with the patient's symptoms.
Choice D reason:
Hyperglycemia, or high blood sugar, can cause symptoms like increased hunger, thirst, and frequent urination. These symptoms are indicative of diabetes, which can be a side effect of some antiviral medications, particularly protease inhibitors used in HIV treatment. Therefore, this choice accurately reflects the patient's symptoms and is the correct answer.
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