A patient who has had chest pain for several hours is admitted with a diagnosis of rule out acute myocardial infarction (AMI). Which laboratory test is most specific for the nurse to monitor in determining whether the patient has had an AMI?

Correct Answer: D

Rationale: The correct answer is D: Cardiac-specific troponin. Troponin is a highly specific marker for myocardial injury, especially in diagnosing acute myocardial infarction (AMI). It is released into the bloodstream when there is damage to the heart muscle. Monitoring troponin levels helps in confirming the diagnosis of AMI. A: Myoglobin is less specific and can also be elevated in skeletal muscle injury. B: Homocysteine is a marker for cardiovascular risk but not specific to AMI. C: C-reactive protein is a marker for inflammation and not specific to AMI. In summary, monitoring cardiac-specific troponin levels is crucial in diagnosing AMI due to its high specificity for myocardial injury compared to the other options.

Correct Answer: B

Rationale: The correct answer is B: Place warm compresses on the site. Warm compresses help to increase blood flow, promote healing, and reduce pain and swelling in the affected area. By applying warm compresses to the site, the nurse can help to alleviate the client's pain and discomfort. Rationale for other choices: A: Administer topical lidocaine to the site - Topical lidocaine may help with numbing the area but may not address the underlying issue of pain, redness, and swelling. C: Administer prescribed oral pain medication - Oral pain medication may take time to take effect and may not provide immediate relief for the client's symptoms. D: Massage the site with scented oils - Massaging the site with scented oils can potentially irritate the skin further and does not address the client's symptoms effectively.

Correct Answer: A

Rationale: The correct answer is A: Hypokalemia. Thiazide diuretics can lead to potassium loss, causing hypokalemia. Anorexia and fatigue are common symptoms of hypokalemia due to potassium's role in muscle and nerve function. Hyperkalemia (choice B) is unlikely with thiazide diuretics. Hyponatremia (choice C) and hypernatremia (choice D) are related to sodium levels, not potassium imbalance as seen with thiazide diuretics.

Correct Answer: B

Rationale: The correct answer is B. Ensuring that an x-ray is completed to confirm placement is crucial after the insertion of a central venous access line to verify proper positioning within the vein and rule out potential complications such as pneumothorax. This step is essential for patient safety before any infusion is initiated. Checking medication calculations with a second RN (Choice C) is important for medication safety but not the immediate next step. Beginning the prescribed infusion (Choice A) without confirming placement can lead to serious complications. Ensuring the solution is appropriate for a central line (Choice D) is important but not the immediate priority.

Correct Answer: A

Rationale: The correct answer is A because the American Nurses Association (ANA) believes that it is the nursing profession itself that should have the authority to determine the scope of nursing practice. This principle emphasizes the importance of nursing professionals being actively involved in defining and regulating their own practice. Choice B is incorrect because while RNs may have a role in supervising unlicensed assistive personnel, it is not solely the responsibility of the RN to define and supervise the education and training of NAPs. Choice C is incorrect because ultimate responsibility and accountability for nursing practice lies with the licensed nurse, not the unlicensed NAP. Choice D is incorrect because the purpose of the RN is not just to work in a supportive role to assistive personnel; rather, it is to provide comprehensive nursing care and lead the nursing team.