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?
Homocysteine.
C-reactive protein.
Myoglobin.
Cardiac-specific troponin.
The Correct Answer is D
Choice A rationale
Homocysteine is an amino acid that your body uses to make protein and to build and maintain tissue. But too much homocysteine in your blood might increase your risk of heart disease.
However, it is not the most specific marker for AMI.
Choice B rationale
C-reactive protein (CRP) is produced by the liver and its level rises when there is inflammation in your body. While its level can increase in those with a heart attack, it is not the most specific marker for AMI6.
Choice C rationale
Myoglobin is a small protein that stores oxygen. It is measured occasionally. Myoglobin is sometimes measured in addition to troponin to help diagnose a heart attack. However, it is not as specific as cardiac-specific troponin.
Choice D rationale
Cardiac-specific troponin is a cardio-specific, highly sensitive marker for myocardial damage. The absolute cardiospecificity of cTnI allows the diagnosis of myocardial infarction distinct from muscle lesions and non-cardiac surgery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D"]
Explanation
Choice A rationale
The need for Metoprolol (Lopresor) STAT does not necessarily indicate progression to septic shock. Metoprolol is a beta-blocker used to treat high blood pressure, heart failure, and angina. While it may be used in the management of sepsis to control heart rate, its use does not specifically indicate progression to septic shock.
Choice B rationale
The need for Norepinephrine to maintain a mean arterial pressure (MAP) greater than 65 mmHg despite fluid replacement is a strong indicator of septic shock. Norepinephrine is a vasopressor, a type of medication used to increase blood pressure. In septic shock, vasopressors are often required to maintain adequate blood pressure and organ perfusion despite aggressive fluid resuscitation.
Choice C rationale
A serum lactate level less than 2 mmol/L is generally not indicative of septic shock. Elevated lactate levels can indicate tissue hypoperfusion, a condition that may occur in septic shock. However, a level less than 2 mmol/L is typically considered within the normal range.
Choice D rationale
A blood pressure of 70/34 after the fluid bolus could indicate progression to septic shock. In septic shock, despite aggressive fluid resuscitation, blood pressure often remains dangerously low, which can lead to inadequate blood flow to the organs.
Correct Answer is B
Explanation
Choice A rationale
Evaluating the need for smoking cessation is a standard part of nursing care, especially for patients with circulatory issues. Smoking can exacerbate circulatory problems and delay wound healing.
Choice B rationale
Applying TED hose to both legs might not be appropriate for this patient. TED hose are compression stockings designed to prevent deep vein thrombosis and promote circulation. However, in a patient with weak pedal pulses and a full-thickness wound on the leg, the compression from the stockings could potentially worsen circulation to the area and impede wound healing.
Choice C rationale
Consulting with physical therapy could be beneficial for this patient. Physical therapists can provide exercises and interventions to improve circulation and mobility, which could help with the patient’s circulatory issues and wound healing.
Choice D rationale
Obtaining an Ankle-Brachial Index (ABI) using a hand-held Doppler could be useful in this situation. The ABI is a simple, non-invasive test that can help diagnose peripheral artery disease (PAD), a condition that could be causing the patient’s weak pedal pulses and wound healing issues.
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