A client arrives to the ER with chest pain, tightness and shortness of breath. An EKG is obtained along with a chest x-ray and a set of labs. The client's troponin level comes back elevated. The LPN explains to the family that troponin is:
A marker of cardiac muscle damage
A level of an electrolyte that when abnormal may cause chest pain
A marker of the amount of stretch the ventricle has done
A level of liver enzyme that can be elevated with right sided heart failure
The Correct Answer is A
A. A marker of cardiac muscle damage: Troponin is a protein found specifically in cardiac myocytes that is released into the bloodstream when the heart muscle is injured. Elevated levels are the most specific and sensitive laboratory indicator for diagnosing an acute myocardial infarction. It allows healthcare providers to differentiate between unstable angina and true myocardial necrosis.
B. A level of an electrolyte that when abnormal may cause chest pain: Electrolytes such as potassium or magnesium can cause arrhythmias when abnormal, but they are not troponins. Troponin is a structural protein, not a charged ion involved in cellular electrical potential. Monitoring electrolytes is important in cardiac care, but it is distinct from the necrotic marker testing.
C. A marker of the amount of stretch the ventricle has done: The marker for ventricular stretch and fluid volume overload is Brain Natriuretic Peptide (BNP), not troponin. BNP is used to diagnose and monitor the severity of heart failure. Troponin specifically indicates cell death and injury rather than the degree of volume expansion or pressure within the heart.
D. A level of liver enzyme that can be elevated with right sided heart failure: Liver enzymes like ALT and AST may rise during systemic venous congestion, but they are not cardiac-specific. Troponin has no diagnostic value for liver function or hepatic congestion. It is used exclusively to evaluate the integrity of the myocardial tissue during suspected ischemic events.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Assessing the legs and feet for peripheral edema: While edema is an important indicator of heart failure, it does not provide real-time information about the electrical activity of the heart. Edema is a chronic sign of volume overload rather than an acute indicator of dysrhythmia severity. It is not the most critical assessment prior to antiarrhythmic administration.
B. Checking the results of the most recent ECG: An ECG provides a snapshot of previous electrical activity but may not reflect the patient's current hemodynamic status. The nurse must assess the patient's actual physiological presentation at the moment the medication is being given. Bedside assessment is superior to relying solely on historical diagnostic data.
C. Listening to the apical pulse for a full minute: Antiarrhythmic medications can significantly alter heart rate and rhythm, potentially causing profound bradycardia or new conduction blocks. Assessing the apical pulse for 60 seconds provides the most accurate baseline of the heart's current rate and regularity. This is a mandatory safety step to ensure the patient can tolerate the drug.
D. Taking the blood pressure in both arms: While blood pressure is a vital sign, it is a secondary manifestation of the heart's pumping efficiency rather than a direct measure of the rhythm. A single arm reading is usually sufficient unless a specific vascular discrepancy is suspected. The primary concern with dysrhythmia medications is the heart rate itself.
Correct Answer is ["0.5"]
Explanation
Dose ordered /Dose available ×volume
7.5 /15 ×1=0.5ml
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