Weekly 5 Questions and Answers

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Hello Everyone! I’m creating a Weekly 5 Questions and Answers. All medical subjects included. As for now, my favourite topic: Cardiology

1.       A 22-year-old adult has a cholesterol blood test done at a screening clinic sponsored by a local health club. The nurse volunteering at the screening teaches the client that diet and exercise should be used as measures to keep the cholesterol level below:

a.       80 mg/dl

b.      200 mg/dl

c.       250 mg/dl

d.      300 mg/dl

AR:   B   The nurse should counsel  the client to keep the total cholesterol level under 200 mg/dL. This will aid in the prevention of atherosclerosis, which can lead to a number of cardiovascular disorders later in life. Recalling that the normal cholesterol level ranges from 140 to 199 mg/dL.

2.       A client arrives in the emergency room complaining of chest pain that began 4 hours ago. A troponin T blood specimen is obtained, and the results indicate a level of 0.6 ng/mL. The nurse interprets that this result indicates a:

a.       Normal level

b.      Low value that indicates possible gastritis

c.       Level that indicates a myocardial infarction

d.      Level that indicates  the presence of possible angina

AR:   C   Troponin is a regulatory protein found in striated muscle. The troponins function together in the contractile apparatus for striated muscle in skeletal muscle and in the myocardium. Increased amounts of troponins are released into the bloodstream when an infarction causes damage to the myocardium. A troponin T value that is higher than 0.1 to 0.2 ng/mL is consistent with a myocardial infarction. A normal troponin I level is lower than 0.6 ng/mL.

3.       A client is suspected of having a myocardial infarction. The nurse assesses the elevations in which of the following isoenzyme values reported with the creatine kinase level?

a.       MM

b.      MB

c.       BB

d.      MK

AR:   B   Creatine Kinase (CK) is a cellular enzyme that can be fractionated into three isoenzymes. The MB band reflects CK from cardiac muscle. This is the level that elevates with myocardial infarction. The MM band reflects CK from skeletal muscle. The BB band reflects CK from the brain. There is no MK band.  

4.       A client with atrial fibrillation who is receiving maintenance therapy of warfarin sodium (Coumadin) has a prothrombin time of 35 seconds. Based on the prothrombin time, the nurse anticipates which of the following orders?

a.       Adding a dose of heparin solution

b.      Increasing the next dose of warfarin

c.       Administering the next dose of warfarin

d.      Holding the next dose of warfarin

The normal prothrombin time (PT) is 9.6 to 11.8 seconds (male adult) or 9.5 to 11.3 seconds (female adult). A therapeutic PT level is 1.5 to 2.0 times higher than the normal level. Because the value of 35 seconds is high (and perhaps near the critical range), the nurse should anticipate that the client would not receive further doses at this time.
  

5.       The nurse checks the laboratory result for a serum digoxin level that was determined for a client earlier in the day and notes that the result is 2.4 ng/mL. Which of the following is the most important action on the part of the nurse?

a.       Notify the physician

b.      Check the client’s last pulse rate

c.       Record the normal value on the client’s flow sheet

d.      Administer the next dose of the medication as scheduled

AR:   A   The normal therapeutic range for digoxin is 0.5 to 2.0 ng/mL. A level of 2.4 ng/mL exceeds the therapeutic range and indicates toxicity. The most important action is to notify the physician, who may give further order about holding further doses of digoxin.  

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