The nurse is reviewing the chart of a client with an indication of myocardial infarction or unstable angina. Which laboratory test result(s) should the nurse recognize as an indication of myocardial injury? (Select all that apply)

Elevated troponins

Decreased homocysteine levels

Elevated CK-MB

Decreased alkaline phosphatase (ALP)

Increased platelet count

Answer and Explanation

Correct Answer : A,C

Choice A: Elevated troponins. This is a correct answer. Troponins are proteins that regulate the myocardial contractile process². They are released into the bloodstream when the myocardial cells are damaged by ischemia or infarction². Troponins are highly specific and sensitive indicators of myocardial injury². The normal range for troponin I is less than 0.03 ng/mL and for troponin T is less than 0.01 ng/mL².

Choice B: Decreased homocysteine levels. This is not a correct answer. Homocysteine is an amino acid that is involved in the metabolism of methionine². Elevated homocysteine levels are associated with an increased risk of cardiovascular disease, but they are not a direct marker of myocardial injury². The normal range for homocysteine is 5 to 15 micromol/L².

Choice C: Elevated CK-MB. This is a correct answer. CK-MB is one of the isoenzymes of creatine kinase, an enzyme that catalyzes the conversion of creatine to phosphocreatine, which is used for energy storage in the muscles². CK-MB is found mainly in the myocardium and is released into the blood when the myocardial cells are injured². CK-MB is a specific and sensitive marker of myocardial injury, but it is less specific than troponins². The normal range for CK-MB is 0 to 3 ng/mL².

Choice D: Decreased alkaline phosphatase (ALP).This is not a correct answer. ALP is an enzyme that is found in various tissues, such as the liver, bone, intestine, and placenta². ALP is not a marker of myocardial injury, and its levels are not affected by ischemia or infarction². The normal range for ALP is 30 to 120 U/L².

Choice E: Increased platelet count.This is not a correct answer. Platelets are blood cells that are involved in hemostasis and clot formation². Increased platelet count, or thrombocytosis, can be a sign of inflammation, infection, malignancy, or other conditions². Platelet count is not a marker of myocardial injury, and it does not reflect the extent of ischemia or infarction². The normal range for platelet count is 150,000 to 450,000 per microliter of blood².

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A reason: Preparing for endotracheal intubation and ventilatory support is not the action that the nurse should take for a client with thyroid storm. This intervention is indicated for clients with respiratory failure or impending airway obstruction, which are not the case for this client.

Choice B reason: Providing continuous sedation for pain relief is not the action that the nurse should take for a client with thyroid storm. This intervention may worsen the client's condition by suppressing the respiratory drive and lowering the blood pressure. The nurse should administer antithyroid medications, beta blockers, and corticosteroids as prescribed to reduce the thyroid hormone levels and the associated symptoms.

Choice C reason: Initiating cardiac monitoring and assessing for reflex bradycardia is not the action that the nurse should take for a client with thyroid storm. This intervention is indicated for clients with hyperkalemia or digoxin toxicity, which are not the case for this client. The nurse should monitor the client's heart rate and rhythm, but not expect a reflex bradycardia, which is a paradoxical slowing of the heart rate in response to a rapid rise in blood pressure.

Choice D reason: Maintaining IV fluid infusion and assessing adequacy of hydration is the action that the nurse should take for a client with thyroid storm. This intervention is indicated for clients with thyroid storm, as they are at risk of dehydration and electrolyte imbalance due to increased metabolic rate, fever, sweating, vomiting, and diarrhea. The nurse should administer isotonic fluids, such as normal saline, and monitor the client's fluid intake and output, urine specific gravity, and serum electrolytes.

A. An early morning headache. B. Occasional nausea. C. A chronic cough. D. A dry mouth after eating.

Correct Answer is C

Explanation

Choice A reason: An early morning headache is not the most common side effect of lisinopril. Lisinopril is a drug that lowers blood pressure and prevents the complications of heart failure. ¹ It belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors, which work by relaxing the blood vessels and reducing the workload of the heart. ¹ Headache is a possible side effect of lisinopril, but it is not very frequent or specific to this drug. ²

Choice B reason: Occasional nausea is not the most common side effect of lisinopril. Lisinopril is a drug that lowers the blood pressure and prevents the complications of heart failure. ¹ It belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors, which work by relaxing the blood vessels and reducing the workload of the heart. ¹ Nausea is a possible side effect of lisinopril, but it is not very frequent or specific to this drug. ²

Choice C reason: A chronic cough is the most common side effect of lisinopril. Lisinopril is a drug that lowers the blood pressure and prevents the complications of heart failure. ¹ It belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors, which work by relaxing the blood vessels and reducing the workload of the heart. ¹ However, ACE inhibitors can also cause a dry, persistent cough that does not go away with time or treatment. ² This cough is due to the accumulation of a substance called bradykinin in the lungs, which irritates the airways and triggers the cough reflex. ³ The cough can be annoying and interfere with the quality of life of the client, but it is not harmful or dangerous. ²

Choice D reason: A dry mouth after eating is not the most common side effect of lisinopril. Lisinopril is a drug that lowers the blood pressure and prevents the complications of heart failure. ¹ It belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors, which work by relaxing the blood vessels and reducing the workload of the heart. ¹ Dry mouth is a possible side effect of lisinopril, but it is not very frequent or specific to this drug. ² Dry mouth can be caused by many factors, such as dehydration, medication, or disease. It can be relieved by drinking water, chewing gum, or using saliva substitutes.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse is reviewing the chart of a client with an indication of myocardial infarction or unstable angina. Which laboratory test result(s) should the nurse recognize as an indication of myocardial injury? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is experiencing a thyroid storm precipitated by a right lower lobe pneumonia. The vital signs are: HR-140/min; RR-28, B/P-196/54; T-101.4°F, Pulse Oximetry-96%. What action should the nurse take?

Correct Answer is D

Explanation

The nurse is providing medication teaching to a client prescribed lisinopril 10 mg PO daily. Which side effect of the medication will the nurse explain to the client is most common?

Correct Answer is C

Explanation

The nurse is reviewing the chart of a client with an indication of myocardial infarction or unstable angina. Which laboratory test result(s) should the nurse recognize as an indication of myocardial injury? (Select all that apply)

During an admission assessment of a client, the nurse palpates enlarged axillary lymph nodes. Which question should the nurse ask the client related to this finding?

The nurse is reviewing the laboratory test results of a client with long-standing hypertension. Which result would be of most concern to the nurse?

When developing a plan of care for the client diagnosed with iron-deficiency anemia, the nurse would encourage intake of which foods?

A client with coronary artery disease complains of chest pain while brushing their teeth in the bathroom. Which action should the nurse implement first?

The nurse is providing care for a client diagnosed with cardiovascular disease and hypertension who is complaining of chest pain. Which medication should the nurse administer?

A client with alcoholism is admitted to a medical-surgical unit with a serum magnesium level of 0.9 mEq/L. Which clinical manifestations would the nurse expect to find in this client?

A client is experiencing a thyroid storm precipitated by a right lower lobe pneumonia. The vital signs are: HR-140/min; RR-28, B/P-196/54; T-101.4°F, Pulse Oximetry-96%. What action should the nurse take?