A patient who has been experiencing chest pain for several hours is admitted with a diagnosis of rule out acute myocardial infarction (AMI). Which laboratory test is most specific for the nurse to monitor in determining whether the patient has had an AMI?

Choice A rationale
Cramping of the toes is not typically associated with a positive Homans sign. Homans sign is a test used to check for deep vein thrombosis (DVT), a blood clot in a deep vein of the leg. While cramping can occur with DVT, it is not specific to this condition and can occur with many other conditions.
Choice B rationale
Blanching of the sole is not associated with a positive Homans sign. Blanching, or whitening of the skin, can occur with various conditions, but it is not a typical sign of DVT45.
Choice C rationale
Resisting dorsiflexion is not a typical response indicating a positive Homans sign. While pain or resistance during dorsiflexion of the foot can occur with various conditions, it is not a specific sign of DVT45.
Choice D rationale
Pain in the calf area during dorsiflexion of the foot (Homans sign) can indicate a positive sign for DVT. However, it’s important to note that Homans sign is not a reliable or definitive test for DVT. Other diagnostic tests, such as ultrasound, are needed to confirm the diagnosis.

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.