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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)?

A.

Depressed ST-segment on ECG and elevated total CPK

B.

Depressed ST-segment on ECG and normal cardiac enzymes

C.

ST-segment elevation on ECG and elevated CK-MB or troponin levels

D.

Q wave on ECG with normal enzymes and troponin levels

Answer and Explanation

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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View Related questions

Correct Answer is B

Explanation

Rationale:

A. Obtaining a stat chest x-ray is important if catheter misplacement is suspected, but in this situation, ensuring the accuracy of the pressure reading through proper leveling and zeroing is the priority.

B. Zero referencing and leveling the catheter at the phlebostatic axis is essential to ensure accurate readings of the pulmonary artery pressure, which is critical for patient assessment and management.

C. Increasing supplemental oxygen is unnecessary given the patient’s stable oxygen saturation and normal respiratory status.

D. While notifying the provider is important, ensuring the accuracy of the pressure reading by leveling and zeroing the catheter should be done first.

Correct Answer is B

Explanation

Rationale:

A. While lowering BP to 120/80 may be an ultimate goal, it is not the initial target in a hypertensive emergency.

B. Rapid reduction in blood pressure can cause hypoperfusion of vital organs such as the brain, heart, and kidneys, leading to ischemic injury. The aim is to reduce the BP gradually to prevent these complications.

C. IV antihypertensive medications generally have a rapid onset, not a slow one.

D. While gradual reduction is important, it is not done to allow rest but to protect organ perfusion.

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