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. Notify the blood bank of the discrepancy:

This choice suggests that there is a discrepancy between the blood type of the unit on hand (type B) and the client's blood type (type AB). However, in reality, there is no discrepancy in this case because individuals with type AB blood are universal recipients and can receive blood from donors of any blood type, including type B. Therefore, there is no need to notify the blood bank of any discrepancy.

B. Administer the blood as ordered:

This choice is the correct action. Type AB individuals are known as universal recipients because they can safely receive blood from donors of any blood type (A, B, AB, or O) without causing a major transfusion reaction. Since the client has type AB blood and the unit of blood on hand is type B, the nurse can administer the blood as ordered without concerns about blood type compatibility.

C. Complete an incident report:

Completing an incident report is typically done when an unexpected event or error occurs during patient care. In this scenario, there is no error or unexpected event related to blood type compatibility, so there is no need to complete an incident report.

D. Contact the provider for further orders:

Contacting the provider for further orders would be necessary if there were a specific reason or concern related to the blood transfusion that requires clarification or additional instructions. However, in this case, there are no issues with blood type compatibility, so contacting the provider is not necessary.

A. History of smoking B. Body mass index (BMI) of 20 C. History of diabetes D. Family history of coronary heart disease E. Female gender F. Age greater than 45 years for men

Correct Answer is ["A","C","D","F"]

Explanation

A. History of smoking:

Smoking is a well-established risk factor for coronary artery disease (CAD). Cigarette smoke contains harmful chemicals that damage blood vessels, promote the formation of atherosclerotic plaques, and increase the risk of blood clots, all of which can lead to CAD, heart attacks, and strokes.

B. Body mass index (BMI) of 20:

While obesity and elevated BMI are risk factors for CAD, a BMI of 20 falls within the healthy weight range for most adults. However, it's important to note that BMI alone may not fully capture an individual's overall cardiovascular risk, as factors like body composition, waist circumference, diet, and physical activity level also contribute to heart health.

C. History of diabetes:

Diabetes, especially type 2 diabetes, is a significant risk factor for CAD. Elevated blood sugar levels over time can damage blood vessels (atherosclerosis), increase inflammation, and contribute to other metabolic abnormalities that raise the risk of heart disease, including heart attacks and peripheral vascular disease.

D. Family history of coronary heart disease:

Having a family history of coronary heart disease (CHD) or premature heart attacks (before age 55 in men or before age 65 in women) increases the risk of developing CAD. Genetic factors play a role in the development of heart disease, and individuals with close relatives affected by CHD have a higher likelihood of developing similar conditions.

E. Female gender:

While gender can influence cardiovascular risk factors and presentation, being female alone is not considered a specific risk factor for CAD. However, women may have different risk profiles or risk factors compared to men, such as hormonal influences (e.g., menopause) and unique symptom presentation for heart disease.

F. Age greater than 45 years for men:

Advancing age is a significant risk factor for CAD, especially for men. Men aged 45 years and older are at increased risk compared to younger age groups due to factors such as the cumulative effects of risk factors over time, hormonal changes, and age-related changes in blood vessels and heart function.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer blood to a client. The unit of blood on hand is type B, and the client has type AB blood. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

A nurse is teaching about risk factors that increase the probability of coronary artery disease to a community group. Which risk factors will the nurse Include in the discussion? (Select All that Apply.)

Correct Answer is ["A","C","D","F"]

Explanation

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