The patient is admitted with a suspected acute myocardial infarction (AMI). In assessing the 12-lead electrocardiogram (ECG) changes, which findings would indicate to the nurse that the patient is in the process of a myocardial infarction (MI)?
Depressed ST-segment on ECG and elevated total CPK
Depressed ST-segment on ECG and normal cardiac enzymes
ST-segment elevation on ECG and elevated CK-MB or troponin levels
Q wave on ECG with normal enzymes and troponin levels
The Correct Answer is C
Rationale:
A. A depressed ST-segment is often associated with ischemia or non-ST elevation myocardial infarction (NSTEMI), not an ongoing MI.
B. A depressed ST-segment with normal cardiac enzymes suggests ischemia rather than an active MI.
C. ST-segment elevation on ECG combined with elevated cardiac biomarkers such as CK-MB or troponin levels is a hallmark of an acute ST-segment elevation myocardial infarction (STEMI), indicating an ongoing MI.
D. A Q wave on ECG indicates an old infarction and is not associated with an acute MI if enzymes and troponin levels are normal.
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Correct Answer is D
Explanation
Rationale:
A. Documentation of waveform values is important but does not directly enhance patient safety during monitoring.
B. Limiting the pressure tubing length can help maintain accuracy, but it is not the primary safety measure.
C. Zero referencing is crucial for accurate readings, but it must be done in conjunction with ensuring alarms are active.
D. Ensuring that alarm limits are turned on and appropriately set is the best safety measure to immediately alert the nurse to any critical changes in the patient's status.
Correct Answer is B
Explanation
Rationale:
A. Spironolactone is a potassium-sparing diuretic, so it would not cause hypokalemia.
B. Furosemide is a loop diuretic that causes the kidneys to excrete potassium, leading to hypokalemia.
C. Metoprolol is a beta-blocker and does not directly affect potassium levels.
D. Nitroglycerin is a vasodilator and does not affect potassium levels.