A nurse working in an emergency department is assessing a client who is experiencing chest pain that began 6 hr ago. Which of the following findings indicates that the client is having a myocardial Infarction?

Decreased creatine kinase-MB

Decrease in respiratory rate

ST segment depression

Increased troponin I

Answer and Explanation

The Correct Answer is D

Rationale:

A. Decreased creatine kinase-MB: CK-MB is a cardiac enzyme that rises within 4–6 hours of myocardial infarction and peaks around 24 hours. A decrease in CK-MB would not indicate acute myocardial injury and is not a diagnostic marker in this case.

B. Decrease in respiratory rate: A lower respiratory rate is not a typical or reliable indicator of myocardial infarction. Clients experiencing an MI are more likely to show signs of dyspnea, anxiety, or increased respiratory effort due to pain or decreased oxygenation.

C. ST segment depression: ST segment depression may indicate myocardial ischemia or a non-ST elevation myocardial infarction (NSTEMI), but it is less specific than biomarkers like troponin. It may also appear in other conditions such as angina or electrolyte imbalances.

D. Increased troponin I: Troponin I is a highly specific and sensitive cardiac biomarker that rises within 3–6 hours of myocardial injury. An elevated troponin I level 6 hours after the onset of chest pain strongly supports the diagnosis of myocardial infarction.

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Correct Answer is C

Explanation

Rationale:

A. Penicillin: Saw palmetto does not interfere with antibiotic action or metabolism. No significant pharmacodynamic or pharmacokinetic interaction exists between penicillin and saw palmetto.

B. Zolpidem: While both may cause some central nervous system effects, there is no established adverse interaction between zolpidem and saw palmetto. Co-administration is generally not contraindicated.

C. Clopidogrel: Saw palmetto has antiplatelet properties and can potentiate the effects of clopidogrel, increasing the risk of bleeding. Clients taking both may face elevated risk of gastrointestinal or intracranial hemorrhage.

D. Ipratropium: Ipratropium is an anticholinergic agent used primarily for respiratory conditions. It does not have a known interaction with saw palmetto, and their pharmacologic mechanisms do not overlap.

A. "I should avoid over-the-counter medications that contain alcohol." B. "I will need to get a monthly injection of this medication." C. "My provider wants me to take this medication for 2 weeks before I try to quit drinking." D. "I will plan to continue taking this medication for at least 5 years."

Correct Answer is A

Explanation

Rationale:

A. "I should avoid over-the-counter medications that contain alcohol.": Disulfiram causes an unpleasant reaction when alcohol is consumed, even in small amounts. Clients must avoid alcohol-containing products such as certain cough syrups, mouthwashes, and topical solutions to prevent serious adverse effects like flushing, nausea, and hypotension.

B. "I will need to get a monthly injection of this medication.": Disulfiram is an oral medication taken daily, not administered via monthly injection. The injectable form is associated with other medications used in substance use disorder treatment, such as naltrexone.

C. "My provider wants me to take this medication for 2 weeks before I try to quit drinking.": Disulfiram is intended for clients who have already stopped drinking. It is not used to initiate abstinence but to maintain it by discouraging alcohol use through aversive effects.

D. "I will plan to continue taking this medication for at least 5 years.": The duration of disulfiram therapy varies based on the client’s progress and treatment plan. Long-term use beyond 1–2 years is uncommon and typically guided by continued risk of relapse and provider judgment.

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A nurse working in an emergency department is assessing a client who is experiencing chest pain that began 6 hr ago. Which of the following findings indicates that the client is having a myocardial Infarction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Explanation

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