A 52-year-old patient presents to the emergency department with reports of substernal chest pain
A history is taken; serum creatine kinase (CK) and lactate dehydrogenase (LDH) isoenzymes and serum lipid studies are ordered, as is a 12-lead ECG. Which of the following results is most significant in diagnosing an MI during the first 12 hours of chest pain?
a. ECG-inverted T waves
b. Serum enzymes-elevated LDH4
c. Serum enzymes-elevated CK-MB
d. Patient history-substernal chest pain
C
The creatine kinase (CK) muscle/brain (MB) biomarker (CK-MB) is released as a result of myocardial damage, and serum levels rise 4 to 8 hours after myocardial infarction (MI), peak at 15 to 24 hours, and remain elevated for 2 to 3 days. Serial samples are drawn routinely at 6- or 8-hour intervals, and three samples are usually sufficient to support or rule out the diagnosis of MI.
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The charge nurse on a medical unit is preparing to admit several "clients" who have possible pandemic flu during a preparedness drill. What action by the nurse is best?
a. Admit the "clients" on Contact Precautions. b. Cohort the "clients" in the same area of the unit. c. Do not allow pregnant caregivers to care for these "clients." d. Place the "clients" on enhanced Droplet Precautions.
A delusional client walks up to the nurse and says, "I am the appointed overseer. Who are you and why are you here?" The most therapeutic response is which of the following?
1. "I am your nurse and I will be here to help you until suppertime." 2. "You don't know who I am?" 3. "You know who I am." 4. "You are not the overseer; you are a client in the hospital."
A pretest is not usually used for which of the following purposes?
A) To identify the parts of the data collection package that might be difficult or objectionable B) To prioritize data collection needs C) To obtain information on the proper sequencing of instruments within the data collection package D) To examine whether pretest responses are sufficiently variable
A client newly admitted to the behavioral medicine unit with a diagnosis of borderline personality disorder wants to continue watching TV in the community room when clients are supposed to be asleep in their rooms
The client says to the nurse, "This is my first night here. Can't you bend the rules just this one time?" The MOST therapeutic response by the nurse would be to say: a. "No, rules are rules." b. "Let us spend a few minutes going over the rules of the unit." c. "Yes, this one time only because this is your first night here." d. "If it were up to me, it would be all right. I also like watching late-night TV."