The nurse is caring for a client who is newly admitted with severe chest pain and suspected myocardial infarction. Which diagnostic blood test would be considered the most reliable and critical indicator of myocardial injury?

Troponin

Alkaline phosphatase

Creatine kinase

Myoglobin

Answer and Explanation

The Correct Answer is A

A. Troponin: Troponin is the most specific and reliable biomarker for myocardial injury. Levels rise within 3-6 hours and remain elevated for days, providing diagnostic and prognostic information.

B. Alkaline phosphatase: This is related to liver and bone disorders, not cardiac events.

C. Creatine kinase (CK): While CK-MB is specific to cardiac tissue, it is less specific and remains elevated for a shorter period compared to troponin.

D. Myoglobin: Myoglobin is an early but nonspecific marker of muscle damage and is not as reliable for diagnosing myocardial injury.

Nursing Test Bank

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Correct Answer is C

Explanation

A. The new graduate nurse elevates the client's head of the bed to 30 degrees. Elevating the head of the bed to 30 degrees helps reduce ICP by promoting venous drainage from the brain.

B. The new graduate nurse administers an analgesic before turning the client. Analgesics are often necessary before turning a client with a head injury to minimize discomfort and prevent additional stress.

C. The new graduate nurse is frequently suctioning the client without breaks: Frequent suctioning without breaks can increase intracranial pressure (ICP) and compromise the patient's condition. Suctioning should be done with caution and only as needed, allowing for breaks in between to prevent ICP elevation.

D. The new graduate nurse assesses the client's neurologic status every hour. Regular neuro assessments are necessary for patients with head injuries to monitor changes in condition.

A. Elevated serum calcium levels B. Elongated trunk C. Warm, swollen areas over femur D. Mosaic pattern of bone

Correct Answer is D

Explanation

A. Elevated serum calcium levels: This is not typical for Paget's disease. While hypercalcemia can occur in advanced stages, the primary issue in Paget's disease is abnormal bone remodeling.

B. Elongated trunk: This is not characteristic of Paget's disease. Paget's disease affects bone remodeling and can lead to deformities such as bowing of the legs or enlarged bones, but not an elongated trunk.

C. Warm, swollen areas over femur: This can occur in Paget's disease due to increased blood flow to the affected bones, but it is not the most distinctive feature.

D. Mosaic pattern of bone: This pattern, which appears on X-ray, is a hallmark of Paget’s disease, indicating disorganized bone remodeling and a disruption of normal bone architecture.

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The nurse is caring for a client who is newly admitted with severe chest pain and suspected myocardial infarction. Which diagnostic blood test would be considered the most reliable and critical indicator of myocardial injury?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The charge nurse observes a new graduate nurse who is caring for a client who has a severe head injury. Which action by the new graduate nurse requires the charge nurse to intervene?

Correct Answer is C

Explanation

The nurse is assessing a client with Paget's disease. Which finding would the nurse identify as being characteristic of this disease?

Correct Answer is D

Explanation

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