A patient is admitted to the emergency department with clinical indications of an ST elevated myocardial infarction. The facility does not have the capability for percutaneous coronary intervention. Given this scenario, what is the priority intervention in the treatment and nursing management of this patient?

Administer thrombolytic therapy unless contraindicated

Keep oxygen saturation levels to at least 88%

Maintain heart rate above 100 beats/min

Administer diuretics aggressively and monitor daily weight

Answer and Explanation

The Correct Answer is A

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.

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Correct Answer is D

Explanation

A. CK-MB is a cardiac enzyme that rises in response to myocardial injury, but it is less specific and takes longer to rise than troponin.
B. BNP is associated with heart failure, not myocardial infarction.
C. Myoglobin is an early marker but is non-specific, as it rises with any muscle damage.
D. Troponin is the most specific and sensitive biomarker for myocardial infarction. It rises within 3-4 hours after myocardial injury and remains elevated for days, making it the most useful test for confirming an MI.

A. Epinephrine administration B. Defibrillation C. Airway management D. Amiodarone administration

Correct Answer is B

Explanation

A. Epinephrine is an important drug in resuscitation but is administered after defibrillation in the algorithm.

B. Defibrillation is the priority intervention for ventricular fibrillation, as it is the only treatment that can convert the heart rhythm back to a viable one.

C. Airway management is crucial, but in the context of ventricular fibrillation, defibrillation takes precedence to restore a life-sustaining rhythm.

D. Amiodarone is used in the treatment of refractory ventricular fibrillation, but it is not the immediate priority over defibrillation.

View Question and Answer

A nurse is caring for a client who has heart failure.

<div id="exhibits">Exhibits</div>

For each potential provider's prescription, click to specify if the prescription is essential (high priority) non-essential (low priority) or contraindicated(unrelated) for the client.

View Question and Answer

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse has received the laboratory results for a patient who developed chest pain 4 hours ago and may be having a myocardial infarction. Which laboratory test result should be most helpful in indicating myocardial infarction?

Correct Answer is D

Explanation

A nurse is caring for a client who develops a ventricular fibrillation rhythm. The client is unresponsive, pulseless, and apneic. Which of the following actions is the nurse's priority?

Correct Answer is B

Explanation

While close family members are visiting, a patient has a respiratory arrest, and resuscitation is started. Which action by the nurse is best?

A nurse is caring for a client who has heart failure. <div id="exhibits">Exhibits</div> For each potential provider's prescription, click to specify if the prescription is essential (high priority) non-essential (low priority) or contraindicated(unrelated) for the client.

The patient presents to the ED with severe chest discomfort. A cardiac catheterization and angiography shows an 90% occlusion of the left main coronary artery. Which procedure will be most likely performed on this patient?

The nurse is caring for a patient who has an intraaortic balloon pump in place. Which action should be included in the plan of care?

Which of the following describes a situation in which the blood pressure is severely elevated and there is evidence of actual target organ damage?

When treating hypertensive emergencies, the nurse identifies the most appropriate route of administration for antihypertensive agents as being which of the following?