What is the significance of elevated serum levels of troponin?
This intracellular substance can leak into the blood with cardiac cellular injury or death.
Elevated serum levels of troponin occur because of sustained glycogenolysis.
This substance is elevated when a patient has acute tubular necrosis.
Serum elevation of this acute phase reactant occurs because of tissue injury.
The Correct Answer is A
Choice A rationale
Elevated serum levels of troponin indicate cardiac cellular injury or death. Troponin is a protein released into the bloodstream when heart muscle cells are damaged, such as during a myocardial infarction.
Choice B rationale
Sustained glycogenolysis does not cause elevated troponin levels. Glycogenolysis is the breakdown of glycogen to glucose, primarily occurring in the liver and muscles, not related to troponin release.
Choice C rationale
Acute tubular necrosis does not elevate troponin levels. This condition affects the renal tubules and is typically indicated by elevated creatinine and BUN levels.
Choice D rationale
Troponin is not an acute phase reactant. Acute phase reactants are proteins whose levels change in response to inflammation, such as C-reactive protein (CRP), not troponin.
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Correct Answer is A
Explanation
Choice A rationale
Decreasing coronary artery constriction by giving aspirin is a primary objective in managing unstable angina. Aspirin inhibits platelet aggregation, reducing the risk of clot formation and improving blood flow in the coronary arteries. This helps to alleviate chest pain and prevent myocardial infarction.
Choice B rationale
Increasing afterload for the left ventricle to maximize cardiac output is not a desirable objective in managing unstable angina. Increasing afterload would increase the workload on the heart, which is counterproductive in patients with angina. The goal is to reduce the heart’s workload and improve blood flow.
Choice C rationale
Increasing preload to reduce overall cardiac workload is not a primary objective in managing unstable angina. Increasing preload would increase the volume of blood returning to the heart, potentially worsening symptoms. The focus is on reducing myocardial oxygen demand and improving coronary perfusion.
Choice D rationale
Reducing arterial inflammation by administering statins is a long-term strategy for managing cardiovascular disease, but it is not the immediate objective in managing unstable angina. Statins help to lower cholesterol levels and reduce inflammation, but the immediate goal in unstable angina is to relieve chest pain and prevent myocardial infarction.
Correct Answer is C
Explanation
Choice A rationale
Wearing an N95 mask is appropriate for airborne precautions, such as tuberculosis, but not specifically for MRSA, which requires contact precautions.
Choice B rationale
Wearing a facemask is suitable for droplet precautions, such as influenza, but MRSA is primarily spread through direct contact, not droplets.
Choice C rationale
Using a separate disposable blood pressure cuff for patients with draining wounds helps prevent the spread of MRSA. MRSA can be transmitted via contaminated medical equipment.
Choice D rationale
Strict hand washing measures are essential but should be performed more frequently than once every 8-hour shift. Hand hygiene should be practiced before and after patient contact.