A 75-year-old male experiences severe chest pain and calls 911.

Given that lab findings indicate elevated levels of cardiac troponins I and T, what condition does the nurse suspect?

Orthostatic hypotension.

Raynaud disease.

Angina.

Myocardial infarction (MI).

Answer and Explanation

The Correct Answer is D

Choice A rationale
Orthostatic hypotension, a form of low blood pressure that happens when you stand up from sitting or lying down, would not typically cause severe chest pain or result in elevated levels of cardiac troponins I and T6.
Choice B rationale
Raynaud’s disease, a condition that causes some areas of your body — such as your fingers and toes — to feel numb and cold in response to cold temperatures or stress, would not typically cause severe chest pain or result in elevated levels of cardiac troponins I and T6.
Choice C rationale
Angina, a type of chest pain caused by reduced blood flow to the heart, could cause severe chest pain, but it would not typically result in elevated levels of cardiac troponins I and T6. Elevated troponin levels are more indicative of damage to the heart muscle, which is not characteristic of angina.
Choice D rationale
A myocardial infarction (MI), also known as a heart attack, could cause severe chest pain and would typically result in elevated levels of cardiac troponins I and T7. Troponins are proteins found in the heart muscle, and levels can rise in the blood when there is damage to the heart, such as during an MI.

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Correct Answer is D

Explanation

Choice A rationale
Redness on both sides of the sternal incision could indicate a normal inflammatory response post-surgery or could be a sign of infection. However, it is not the most crucial observation to report in the context of a patient who has undergone coronary artery bypass grafting using a right radial artery graft.
Choice B rationale
Fine crackles heard at both lung bases could indicate fluid accumulation in the lungs, possibly due to heart failure or pneumonia. While this is a significant finding that requires further investigation, it is not the most crucial observation in this specific context.
Choice C rationale
Complaints of incisional chest pain are common after coronary artery bypass grafting. Pain management is an important part of post-operative care, but this symptom is not the most crucial to report in this context.
Choice D rationale
Pallor and weakness of the right hand could indicate compromised blood flow to the hand, which is a serious complication considering the right radial artery was used for the graft. This could lead to ischemia and tissue damage in the hand, thus it is the most crucial observation to report to the healthcare provider.

A. Reduce anxiety and relieve pain. B. Improve myocardial oxygenation and reduce cardiac workload. C. Eliminate family stressors and provide a calm environment. D. Start the client on a low-sodium diet and decrease fluid intake.

Correct Answer is B

Explanation

Choice A rationale
While reducing anxiety and relieving pain are important aspects of care, they are not the primary goal for a client with an elevated ST segment on the ECG and an elevated cardiac troponin level. These findings indicate myocardial injury, which requires interventions to improve myocardial oxygenation and reduce cardiac workload.
Choice B rationale
The primary goal for a client with an elevated ST segment on the ECG and an elevated cardiac troponin level is to improve myocardial oxygenation and reduce cardiac workload. This can be achieved through medications, oxygen therapy, and bed rest.
Choice C rationale
Eliminating family stressors and providing a calm environment can contribute to reducing anxiety and promoting relaxation, but it is not the primary goal in this situation.
Choice D rationale
Starting the client on a low-sodium diet and decreasing fluid intake are interventions for managing heart failure, not for an acute myocardial injury.

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A 75-year-old male experiences severe chest pain and calls 911. Given that lab findings indicate elevated levels of cardiac troponins I and T, what condition does the nurse suspect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In the context of a patient who has undergone coronary artery bypass grafting using a right radial artery graft, which observation is most crucial for the nurse to report to the healthcare provider?

Correct Answer is D

Explanation

A client is admitted to the telemetry unit with an episode of substernal chest pain. His diagnostic studies reveal an elevated ST segment on the electrocardiogram (ECG) and an elevated cardiac troponin level. What would be an appropriate initial nursing goal?

Correct Answer is B

Explanation

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A 75-year-old male experiences severe chest pain and calls 911.

Given that lab findings indicate elevated levels of cardiac troponins I and T, what condition does the nurse suspect?