Following cardiopulmonary resuscitation (CPR) and multiple defibrillations, the client's blood is drawn for STAT analysis. The client's heart rate is 130 beats/minute with ST elevation. Which of the client's serum laboratory values is most important for the nurse to monitor?

Creatine phosphokinase MB (CK-MB).

Troponin.

Lactate dehydrogenase (LDH or LD).

Alanine aminotransferase (ALT or SGPT).

Answer and Explanation

The Correct Answer is B

A. Creatine phosphokinase MB (CK-MB): CK-MB is a cardiac marker that rises after myocardial injury, but it is less specific and peaks later than troponin. While it can support diagnosis, it is not the most critical marker to monitor immediately following resuscitation and ST elevation.

B. Troponin: Troponin is the most sensitive and specific marker of MI. It rises within 3–6 hours of cardiac muscle damage. In a post-CPR client with ST elevation, monitoring troponin is crucial for assessing the extent of cardiac injury and guiding further treatment.

C. Lactate dehydrogenase (LDH or LD): LDH is a nonspecific enzyme elevated in many conditions involving tissue breakdown. It lacks the specificity and rapid diagnostic utility needed for acute coronary syndrome assessment post-resuscitation.

D. Alanine aminotransferase (ALT or SGPT): ALT is a liver enzyme and is not relevant to immediate cardiac status or post-resuscitation myocardial injury. Monitoring it does not provide useful information for evaluating acute ST elevation or cardiac ischemia.

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Correct Answer is B

Explanation

A. Instruct the client to monitor daily caloric intake: Nutritional monitoring does not directly address the client’s current signs of early fluid overload. Caloric intake is not the immediate concern given the recent weight gain and decreased ejection fraction.

B. Assess compliance with routine prescriptions: With a postoperative ejection fraction of 30%, the client likely has heart failure with reduced ejection fraction (HFrEF). A weight gain of 5 pounds and pedal edema suggest fluid retention, which may indicate suboptimal adherence to prescribed medications such as diuretics.

C. Arrange transport for admission to the hospital: Although the client shows signs of mild fluid retention, lung sounds are clear and only +1 edema is noted. Hospital admission is not yet indicated unless symptoms worsen or do not respond to outpatient interventions.

D. Insert saline lock for IV diuretic therapy: IV diuretics are used in acute decompensated heart failure, especially when there is pulmonary congestion or volume overload. Since the client has mild edema and clear lungs, oral medication review is the appropriate initial step.

A. First degree AV heart block. B. Junctional escape rhythm. C. Sinus bradycardia. D. Normal sinus rhythm.

Correct Answer is A

Explanation

A. First degree AV heart block: The rhythm is regular, P waves are present and consistent, and each P wave is followed by a QRS. The defining feature is the consistently prolonged PR interval (greater than 0.20 seconds), which indicates a delay in conduction through the AV node.

B. Junctional escape rhythm: A junctional escape rhythm originates in the AV node, typically has a slower rate (40-60 bpm), and P waves are either absent, inverted, or occur after the QRS complex. This strip has P waves preceding each QRS and a normal rate.

C. Sinus bradycardia: Sinus bradycardia has a heart rate less than 60 bpm. This strip shows a rate of approximately 75 bpm.

D. Normal sinus rhythm: While many parameters (rate, regularity, P wave presence, QRS width) might suggest a sinus rhythm, a normal sinus rhythm requires a PR interval within the normal range (0.12-0.20 seconds). This strip has a prolonged PR interval.

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Following cardiopulmonary resuscitation (CPR) and multiple defibrillations, the client's blood is drawn for STAT analysis. The client's heart rate is 130 beats/minute with ST elevation. Which of the client's serum laboratory values is most important for the nurse to monitor?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

Based on this strip, which is the interpretation of this rhythm?

Correct Answer is A

Explanation

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