Correct Answer: A

Rationale: Troponin is the most specific cardiac biomarker for myocardial injury. Troponin I and Troponin T are proteins released into the bloodstream when there is damage to the heart muscle, making them highly indicative of myocardial infarction. Troponin levels rise within a few hours of cardiac injury, peak within 24-48 hours, and can remain elevated for up to 2 weeks. Troponin is considered the gold standard biomarker for the diagnosis of acute myocardial infarction due to its high specificity and sensitivity for cardiac injury. In contrast, Creatine kinase-MB (CK-MB) and myoglobin are also used in diagnosing myocardial infarction but are less specific than troponin. Brain natriuretic peptide (BNP) is primarily used in heart failure diagnosis and management, and its levels are not specific to myocardial injury.

Correct Answer: D

Rationale: An elevation of blood pressure would warrant stoppage of pills. High blood pressure, or hypertension, in a 4-year-old child is abnormal and needs prompt medical attention. Giving pills without monitoring or stopping them if blood pressure is elevated can lead to serious health complications. It is important to address the underlying cause of high blood pressure in a child, which may require further evaluation and management by a healthcare provider.

Correct Answer: D

Rationale: The Philippine Regulatory Commission - Board of Nursing (PRC-BON) has the power to regulate nursing practice in the Philippines.

Correct Answer: B

Rationale: The most effective treatment for addressing the underlying pathophysiology of cystic fibrosis (CF) and preventing disease progression is the use of mucolytic agents, such as dornase alfa. CF is a genetic disorder that leads to the production of thick, sticky mucus in the respiratory tract. This mucus buildup can obstruct airways, lead to recurrent infections, and contribute to pulmonary exacerbations. Mucolytic agents work by reducing the viscosity of the mucus, making it easier to clear from the airways. This helps to improve lung function, reduce the frequency of exacerbations, and slow down disease progression in CF patients. Inhaled corticosteroids may be used for managing airway inflammation, but they do not target the underlying mucus production in CF. Antibiotic therapy is important for treating respiratory infections in CF patients, but it does not address the primary

Correct Answer: B

Rationale: Acute otitis media is the most likely condition responsible for this presentation. The sudden onset of severe, unilateral ear pain, diminished hearing, and purulent otorrhea are classic symptoms of acute otitis media. Otoscopic examination revealing a bulging, erythematous tympanic membrane with obscured landmarks further supports the diagnosis. The bulging of the tympanic membrane is due to the accumulation of fluid and pus behind it, causing the characteristic appearance. Treatment typically involves antibiotics to help clear the infection and relieve symptoms. If left untreated, acute otitis media can lead to complications such as perforation of the eardrum or mastoiditis.