The nurse is caring for a client admitted with unstable angina. The laboratory result for the initial troponin I is elevated in this client. The nurse should recognize what implication of this assessment finding?

This result indicates muscle injury but does not specify the source.

Because the client has a history of unstable angina, this is a poor indicator of myocardial injury.

This is only an accurate indicator of myocardial damage when it reaches its peak in 24 hours.

This is an accurate indicator of myocardial injury.

Answer and Explanation

The Correct Answer is D

A. This result indicates muscle injury but does not specify the source.

This statement is partly correct. An elevated troponin I level does indicate muscle injury, specifically damage to the heart muscle. However, troponin I is highly specific to cardiac muscle, so an elevated level would indeed specify the source as cardiac or myocardial injury.

B. Because the client has a history of unstable angina, this is a poor indicator of myocardial injury.

This statement is incorrect. A history of unstable angina does not diminish the significance of an elevated troponin I level. In fact, unstable angina is itself a serious condition that can lead to myocardial injury or heart attack, and an elevated troponin I level in this context indicates ongoing or recent myocardial damage.

C. This is only an accurate indicator of myocardial damage when it reaches its peak in 24 hours.

This statement is not entirely accurate. While it is true that troponin I levels may continue to rise and peak within 12-24 hours after the onset of myocardial injury, an elevated troponin I level at any point is still a significant indicator of myocardial damage. It's essential to recognize elevated troponin I levels promptly to initiate appropriate interventions and monitor the client's cardiac status closely.

D. This is an accurate indicator of myocardial injury.

This statement is correct. An elevated troponin I level is a highly sensitive and specific marker of myocardial injury. It indicates damage to the heart muscle, which can occur due to conditions like unstable angina, heart attack (myocardial infarction), myocarditis, or other cardiac issues. Therefore, recognizing an elevated troponin I level in a client with unstable angina is crucial for proper management and further evaluation.

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Correct Answer is B

Explanation

A. "I will wear layered clothing when walking outside in winter": This statement shows an understanding of the need to dress appropriately for weather conditions, which is important in managing symptoms during physical activity.

B. "I will walk early in the morning when it is hot outside": This statement indicates a lack of understanding regarding the ideal timing for outdoor activities, especially in hot weather. Exercising during the cooler parts of the day (such as early morning or late evening) is recommended to avoid heat-related stress and potential exacerbation of cardiovascular symptoms.

C. "If I get shortness of breath, I should slow down a bit": This statement demonstrates an understanding of monitoring symptoms during exercise and adjusting activity levels accordingly, which is an important aspect of managing coronary artery disease.

D. "My exercise intensity should not exceed my ability to talk": This statement reflects an understanding of the recommended exercise intensity level based on the ability to talk comfortably during physical activity, known as the "talk test."

A. "Dehydration Is the primary reason for the pain that is experienced during a sickle cell crisis; try to increase your son's fluid intake." B. "We really don't know what causes the pain that is experienced during a sickle cell crisis." C. "Sickled cells get clogged in the blood vessels, preventing blood from getting to the tissues, which causes the severe pain of a crisis." D. "You will need to discuss this with your doctor. I cannot explain why this pain occurs to your son."

Correct Answer is C

Explanation

A. "Dehydration Is the primary reason for the pain that is experienced during a sickle cell crisis; try to increase your son's fluid intake."

This response is not the best choice because while dehydration can indeed exacerbate sickle cell crises and lead to complications, it is not the primary reason for the pain experienced during a sickle cell crisis. The severe pain during a crisis is primarily due to vaso-occlusion, where sickled red blood cells block blood flow in the small blood vessels, leading to tissue ischemia and pain. While adequate hydration is important in managing sickle cell disease, it alone does not address the underlying cause of the pain during a crisis.

B. "We really don't know what causes the pain that is experienced during a sickle cell crisis."

This response is not accurate and not the best choice because the medical community does understand the underlying cause of pain during a sickle cell crisis. It is primarily due to vaso-occlusion, as mentioned earlier, where sickled red blood cells block blood flow in the blood vessels.

C. "Sickled cells get clogged in the blood vessels, preventing blood from getting to the tissues, which causes the severe pain of a crisis."

This response is the best choice because it provides an accurate and clear explanation of why individuals with sickle cell anemia experience severe pain during a sickle cell crisis. It addresses the underlying mechanism of vaso-occlusion, where sickled red blood cells block blood flow in the small blood vessels, leading to tissue ischemia and severe pain.

D. "You will need to discuss this with your doctor. I cannot explain why this pain occurs to your

son."

This response is not the best choice because the nurse should be able to provide basic information about the disease and its symptoms to the mother. It's important for healthcare professionals to educate patients and their families about their condition to improve understanding and facilitate better management and coping strategies.

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The nurse is caring for a client admitted with unstable angina. The laboratory result for the initial troponin I is elevated in this client. The nurse should recognize what implication of this assessment finding?

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Naxlex Comprehensive Predictor Exams

The nurse is educating a client newly diagnosed with coronary artery disease. What statement by the client would lead the nurse to understand more teaching is needed?

Correct Answer is B

Explanation

The mother of a teenage boy with sickle cell anemia asks the nurse why her son has such horrible pain during a sickle cell crisis. Which of the following is the best response by the nurse?

Correct Answer is C

Explanation

The nurse is caring for a client admitted with unstable angina. The laboratory result for the initial troponin I is elevated in this client. The nurse should recognize what implication of this assessment finding?

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