Answer to Question 1
ANS: B
Murmurs are caused by turbulent blood flow, such as occurs when blood flows through a dam-aged valve. Relevant information includes the position in which the murmur is heard best (e.g., sitting and leaning forward), the timing of the murmur in relation to the cardiac cycle (e.g., sys-tole, diastole), and where on the thorax the murmur is heard best. The other information is also important in the cardiac assessment but will not provide information that is relevant to the mur-mur.
Answer to Question 2
ANS: C
Cardiac troponins start to elevate 4 to 6 hours after myocardial injury and are highly specific to myocardium. They are the preferred diagnostic marker for myocardial infarction. Myoglobin rises in response to myocardial injury within 30 to 60 minutes. It is rapidly cleared from the body, thus limiting its use in the diagnosis of myocardial infarction. LDL cholesterol is useful in assessing cardiovascular risk but is not helpful in determining whether a patient is having an acute myocar-dial infarction. Creatine kinase (CK-MB) is specific to myocardial injury and infarction and in-creases 4 to 6 hours after the infarction occurs. It is often trended with troponin levels.
The nurse is using Standard Precautions to draw blood.
Patient Teaching
This engraving by William Russell Birch shows Congress Hall (left), which was occupied by Congress f
Position of cupula with head in still position (left) and when head rotates (right)
Darwin’s Notes on Transmutation of Species