A nurse is providing care for a client who experienced a myocardial infarction prior to a cardiac arrest. Which of the following laboratory tests will identify early injury to the cardiac muscle?

Creatine kinase (CK) test

Creatine kinase-myocardial band (CK-MB) test

Brain natriuretic peptide (BNP) test

Troponin T test

Answer and Explanation

The Correct Answer is D

A. Creatine kinase (CK) test: While creatine kinase isoenzymes, including CK-MB, can be elevated following myocardial infarction (MI), they are not specific to cardiac muscle injury. CK is found in various tissues throughout the body, so elevated levels can also indicate damage to skeletal muscle or brain tissue, among other sources.

B. Creatine kinase-myocardial band (CK-MB) test: CK-MB is a cardiac-specific isoform of creatine kinase, and elevated levels can indicate myocardial injury, particularly in the context of an acute MI. However, troponin T is a more sensitive and specific marker for myocardial injury.

C. Brain natriuretic peptide (BNP) test: Brain natriuretic peptide is primarily used in the diagnosis and management of heart failure. While elevated BNP levels can indicate heart muscle strain or stress, they are not specific markers for acute myocardial infarction or early injury to the cardiac muscle.

D. Troponin T test: This is the correct answer. Troponin T is a highly specific marker for cardiac muscle injury. Elevated troponin levels can be detected within hours of myocardial infarction and persist for several days, making it an essential tool in the diagnosis of acute coronary syndromes, including myocardial infarction. Troponin T is considered one of the gold standard biomarkers for detecting early injury to the cardiac muscle.

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Correct Answer is A

Explanation

A. Loss of sensation and cognition difficulties: Secondary conditions commonly associated with traumatic brain injury (TBI) include sensory impairments such as loss of sensation, as well as cognitive difficulties such as memory loss, attention deficits, and impaired executive functioning. These issues arise due to the damage to brain tissue caused by the initial injury and can have significant impacts on the client's overall function and quality of life.

B. Development of emotional disorders and acute pain : While emotional disorders such as depression, anxiety, and post-traumatic stress disorder (PTSD) are common following TBI, acute pain is not typically considered a primary secondary condition associated with TBI. Chronic pain may develop as a secondary condition, but acute pain is more often associated with the immediate aftermath of the injury.

C. Body dysmorphia and neurofibrillary tangles : Body dysmorphia, a condition characterized by obsessive preoccupation with perceived flaws in physical appearance, and neurofibrillary tangles, abnormal protein aggregates found in the brains of individuals with neurodegenerative disorders such as Alzheimer's disease, are not typically associated with TBI.

D. Decreased appetite and a lack of sleep : While changes in appetite and sleep disturbances may occur as secondary symptoms of TBI, they are not as commonly anticipated as loss of sensation and cognition difficulties. These issues may arise due to disruptions in brain function or changes in lifestyle following the injury.

A. Lower extremities edematous with decreased pulses and cool to the touch B. Pain, pallor, and paresthesia in the foot C. Murmur auscultated at the left 5th midclavicular line, slight dyspnea, and lower extremity edema D. Presence of an open wound near the ankle with serous drainage and pruritus

Correct Answer is B

Explanation

A. Lower extremities edematous with decreased pulses and cool to the touch While this finding suggests impaired circulation associated with peripheral artery disease, it does not indicate an immediate need for intervention. However, it requires timely assessment and intervention to prevent further complications.

B. Pain, pallor, and paresthesia in the foot This finding indicates critical limb ischemia, which is a severe complication of peripheral artery disease requiring immediate intervention. Pain, pallor (pale color), and paresthesia (abnormal sensations like tingling or numbness) suggest inadequate blood flow to the affected limb, putting the client at risk for tissue damage and limb loss if not promptly addressed.

C. Murmur auscultated at the left 5th midclavicular line, slight dyspnea, and lower extremity edema These findings are suggestive of cardiac issues such as heart failure rather than immediate complications of peripheral artery disease. While they require attention, they do not signify an urgent need for intervention specific to peripheral artery disease.

D. Presence of an open wound near the ankle with serous drainage and pruritus While an open wound warrants assessment and appropriate wound care, it does not indicate an immediate need for intervention unless there are signs of infection or severe tissue damage. In this scenario, the presentation of pain, pallor, and paresthesia indicates a more urgent need for intervention to prevent tissue necrosis and limb loss.

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A nurse is providing care for a client who experienced a myocardial infarction prior to a cardiac arrest. Which of the following laboratory tests will identify early injury to the cardiac muscle?

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