The nurse is reviewing the chart of a client with a diagnosis of unstable angina. Which laboratory test(s) result(s) should the nurse recognize as an Indication of heart damage? (SELECT ALL THAT APPLY)

Increased platelet count

Elevated troponins

Decreased homocysteine levels

Elevated CK-MB

Decreased alkaline phosphatase (ALT)

Answer and Explanation

The Correct Answer is B

A. Increased platelet count: While platelet activation can occur in unstable angina, an increased platelet count alone does not indicate heart damage. It is more relevant to thrombotic events than direct myocardial injury.

B. Elevated troponins: Troponin is a protein released when the heart muscle is damaged. Elevated levels are a key indicator of myocardial injury, making this a significant finding in the context of unstable angina.

C. Decreased homocysteine levels: Homocysteine levels are related to cardiovascular risk but are not directly indicative of heart damage. Elevated levels may suggest risk but do not confirm damage.

D. Elevated CK-MB: Creatine kinase-MB is an enzyme found in heart muscle. Elevated levels are indicative of myocardial injury, making this a relevant laboratory test for assessing heart damage in unstable angina.

E. Decreased alkaline phosphatase (ALT): Alkaline phosphatase is primarily related to liver and bone health and does not indicate heart damage. Decreased levels of ALT (alanine aminotransferase) are not relevant to myocardial injury.

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Correct Answer is A

Explanation

A. Crackles heard at the lung bases: An S4 heart sound often indicates left ventricular hypertrophy or decreased compliance of the left ventricle, commonly seen in conditions like heart failure. Crackles in the lungs can suggest pulmonary congestion related to heart failure, making this the most relevant correlation.

B. Dorsalis pedis pulses +1: A weak pulse may indicate peripheral vascular issues, but it doesn't directly correlate with an S4 heart sound.

C. A pericardial friction rub: This is associated with pericarditis and not directly related to the S4 heart sound.

D. Heart rate 50 beats per minute: While bradycardia may be present in various cardiac conditions, it does not specifically correlate with the S4 sound, which is more about ventricular filling pressures.

A. increased fluid in the pericardial sac. B. dysfunction of one or more heart valves. C. an aneurysm of the descending aorta. D. an occlusion of the right coronary artery.

Correct Answer is B

Explanation

A. increased fluid in the pericardial sac: While fluid accumulation can affect heart sounds, it typically leads to muffled heart sounds rather than a loud murmur. Increased fluid in the pericardial sac (pericardial effusion) usually does not produce a classic heart murmur.

B. dysfunction of one or more heart valves: This statement is correct. Heart murmurs are often caused by turbulence in blood flow due to the dysfunction of heart valves, such as stenosis (narrowing) or regurgitation (leaking). A loud murmur suggests significant turbulence, which is often indicative of valvular heart disease.

C. an aneurysm of the descending aorta: While an aortic aneurysm can cause other types of heart sounds or signs of cardiovascular compromise, it is not primarily associated with heart murmurs.

D. an occlusion of the right coronary artery: An occlusion may lead to ischemia or myocardial infarction, which can cause changes in heart sounds, but it does not directly cause a heart murmur. Murmurs are more specifically related to blood flow dynamics, particularly involving valves.

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The nurse is reviewing the chart of a client with a diagnosis of unstable angina. Which laboratory test(s) result(s) should the nurse recognize as an Indication of heart damage? (SELECT ALL THAT APPLY)

Nursing Test Bank

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Correct Answer is B

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