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 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.

A. express no complaints of chest discomfort or shortness of breath. B. discuss which lifestyle modifications will be necessary to maintain health. C. have clear breath sounds bilaterally upon auscultation. D. have a urinary output of greater than 30 ml per hour for 24 hours.

Correct Answer is A

Explanation

A) Express no complaints of chest discomfort or shortness of breath: This outcome directly relates to the goal of improving tissue perfusion. Chest discomfort and shortness of breath can indicate inadequate perfusion, particularly in a client with coronary artery disease. By achieving this outcome, the nurse can assess that tissue perfusion is sufficient and the client is stable.

B) Discuss which lifestyle modifications will be necessary to maintain health: While this is an important aspect of ongoing care and management for coronary artery disease, it does not directly address the immediate concern of impaired tissue perfusion. The priority is to ensure the client is currently experiencing effective perfusion rather than just planning for future health modifications.

C) Have clear breath sounds bilaterally upon auscultation: Clear breath sounds are a positive indicator of pulmonary function but do not directly measure tissue perfusion related to coronary artery disease. While this is important for overall health, it does not specifically target the issue of impaired perfusion in cardiac tissue.

D) Have a urinary output of greater than 30 ml per hour for 24 hours: While adequate urinary output can be a sign of good kidney perfusion and overall fluid balance, it is not a direct indicator of cardiac tissue perfusion. The priority in this scenario is more closely tied to the client’s cardiac status and symptoms related to coronary artery disease.

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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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