The nurse is reviewing the chart of a client with a diagnosis of unstable angina. Which laboratory test(s) result(s) should the nurse recognize as an Indication of heart damage? (SELECT ALL THAT APPLY)

Increased platelet count

Elevated troponins

Decreased homocysteine levels

Elevated CK-MB

Decreased alkaline phosphatase (ALT)

Answer and Explanation

The Correct Answer is B

A. Increased platelet count: While platelet activation can occur in unstable angina, an increased platelet count alone does not indicate heart damage. It is more relevant to thrombotic events than direct myocardial injury.

B. Elevated troponins: Troponin is a protein released when the heart muscle is damaged. Elevated levels are a key indicator of myocardial injury, making this a significant finding in the context of unstable angina.

C. Decreased homocysteine levels: Homocysteine levels are related to cardiovascular risk but are not directly indicative of heart damage. Elevated levels may suggest risk but do not confirm damage.

D. Elevated CK-MB: Creatine kinase-MB is an enzyme found in heart muscle. Elevated levels are indicative of myocardial injury, making this a relevant laboratory test for assessing heart damage in unstable angina.

E. Decreased alkaline phosphatase (ALT): Alkaline phosphatase is primarily related to liver and bone health and does not indicate heart damage. Decreased levels of ALT (alanine aminotransferase) are not relevant to myocardial injury.

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Correct Answer is C

Explanation

A. 2 inches 21 gauge: This option is too long and too large in gauge for subcutaneous administration. Typically, a longer needle is not necessary for subcutaneous injections, especially for standard adult adipose tissue.

B. 1 1/2 inch 27 gauge: While this gauge is acceptable, the length is still longer than typically required for subcutaneous injections. A 1 1/2 inch needle is more suited for intramuscular injections.

C. 5/8 inch 25 gauge: This is the most appropriate choice for a subcutaneous injection. A 5/8 inch needle is typically adequate for subcutaneous tissue in adults, and a 25 gauge needle provides a suitable size for comfort while allowing the medication to be administered effectively.

D. 1/4 inch 19 gauge: This option is not suitable for subcutaneous injections. A 1/4 inch length is too short for effective penetration into subcutaneous tissue, and a 19 gauge needle is larger than necessary, which could increase discomfort.

A. "You can take 81 mg of enteric coated aspirin with orange juice at lunch time B. "Take the aspirin with a glass of milk or food in the morning" C. "Take a baby aspirin with a full glass of cold water at bedtime." D. "It's ok to take the aspirin with some ginseng tea in the evening."

Correct Answer is B

Explanation

A) "You can take 81 mg of enteric coated aspirin with orange juice at lunch time": While enteric-coated aspirin can help reduce gastrointestinal irritation, taking it with orange juice is not advisable. Citrus can increase gastric acidity, which might irritate the GI tract further, especially in a patient with a history of GI bleeding.

B) "Take the aspirin with a glass of milk or food in the morning": This instruction is appropriate as taking aspirin with food or milk can help minimize gastrointestinal irritation and promote safer use, especially in a client with iron deficiency anemia from a GI bleed. It also helps with absorption and can reduce the risk of an upset stomach.

C) "Take a baby aspirin with a full glass of cold water at bedtime": Taking aspirin with only water, particularly at bedtime, may increase the risk of gastric irritation and does not provide the protective effect that food or milk would. This is not the best practice for someone with a history of GI issues.

D) "It's ok to take the aspirin with some ginseng tea in the evening": Ginseng can interact with blood-thinning medications and may increase bleeding risk. Advising the client to combine aspirin with ginseng tea could be harmful, especially given their history of GI bleeding. This is not a safe or appropriate recommendation.

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The nurse is reviewing the chart of a client with a diagnosis of unstable angina. Which laboratory test(s) result(s) should the nurse recognize as an Indication of heart damage? (SELECT ALL THAT APPLY)

Nursing Test Bank

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Correct Answer is C

Explanation

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Correct Answer is B

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