The patient is admitted with a suspected acute myocardial infarction (AMI). In assessing the 12-lead electrocardiogram (ECG) changes, which findings would indicate to the nurse that the patient is in the process of a myocardial infarction (MI)?

Depressed ST-segment on ECG and elevated total CPK

Depressed ST-segment on ECG and normal cardiac enzymes

ST-segment elevation on ECG and elevated CK-MB or troponin levels

Q wave on ECG with normal enzymes and troponin levels

Answer and Explanation

The Correct Answer is C

A. A depressed ST-segment is often associated with ischemia or non-ST elevation myocardial infarction (NSTEMI), not an ongoing MI.

B. A depressed ST-segment with normal cardiac enzymes suggests ischemia rather than an active MI.

C. ST-segment elevation on ECG combined with elevated cardiac biomarkers such as CK-MB or troponin levels is a hallmark of an acute ST-segment elevation myocardial infarction (STEMI), indicating an ongoing MI.

D. A Q wave on ECG indicates an old infarction and is not associated with an acute MI if enzymes and troponin levels are normal.

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Correct Answer is A

Explanation

A. Thrombolytic therapy is the priority in managing an ST-elevated myocardial infarction (STEMI) when percutaneous coronary intervention (PCI) is not available. It helps dissolve the blood clot causing the blockage in the coronary artery.

B. Maintaining oxygen saturation is important, but the priority is to restore coronary blood flow.

C. The focus should be on stabilizing the heart rhythm, not specifically maintaining a high heart rate.

D. Diuretics are important in managing heart failure but are not the priority in acute STEMI management.

A. Obtain a stat chest x-ray to verify proper catheter placement. B. Zero reference and level the catheter at the phlebostatic-axis. C. Increase supplemental oxygen and notify respiratory therapy. D. Notify the provider immediately of the assessment findings.

Correct Answer is B

Explanation

A. Obtaining a stat chest x-ray is important if catheter misplacement is suspected, but in this situation, ensuring the accuracy of the pressure reading through proper leveling and zeroing is the priority.
B. Zero referencing and leveling the catheter at the phlebostatic axis is essential to ensure accurate readings of the pulmonary artery pressure, which is critical for patient assessment and management.
C. Increasing supplemental oxygen is unnecessary given the patient’s stable oxygen saturation and normal respiratory status.
D. While notifying the provider is important, ensuring the accuracy of the pressure reading by leveling and zeroing the catheter should be done first.

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The patient is admitted with a suspected acute myocardial infarction (AMI). In assessing the 12-lead electrocardiogram (ECG) changes, which findings would indicate to the nurse that the patient is in the process of a myocardial infarction (MI)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

Correct Answer is B

Explanation

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