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Practice Question

A nurse in an emergency department is caring for a client who reports substernal chest pain and dyspnea. The client is vomiting and is diaphoretic. Which of the following laboratory tests are used to diagnose a myocardial infarction? (Multiple Response- Select all that apply.) 

Answer Choices:

Correct Answer:

Myoglobin.

Rationale:

Myoglobin

🔹 Myoglobin is an early marker released into the bloodstream when muscle injury occurs, including cardiac muscle.

🔹 It appears within 2 hours of myocardial injury and peaks around 3–15 hours.

🔹 While not specific to cardiac tissue, it is useful for early detection of myocardial infarction (MI).

🔹 It helps in ruling out MI if levels remain normal after chest pain onset.

🔹 It is often used in combination with more specific markers like troponins for accurate diagnosis.

Troponin T

🔹 Troponin T is a cardiac-specific protein, highly sensitive and specific for myocardial cell damage.

🔹 It begins to rise within 3–6 hours after injury and can remain elevated for 10–14 days, aiding in late diagnosis.

🔹 Elevated levels confirm myocardial infarction, even in the absence of ECG changes.

🔹 It is one of the gold-standard markers for MI diagnosis in emergency settings.

🔹 Troponin testing is central in evaluating chest pain and suspected cardiac events.

CK-MB (Creatine Kinase-MB)

🔹 CK-MB is an enzyme found primarily in cardiac muscle, making it a moderately specific marker for MI.

🔹 Levels begin to rise 4–6 hours after myocardial injury, peaking around 24 hours, and return to baseline in 2–3 days.

🔹 It is useful for detecting reinfarction due to its short half-life compared to troponins.

🔹 Elevated CK-MB levels support a diagnosis of acute MI, especially when used with troponin.

🔹 Serial measurements can help determine evolving infarction patterns.

Troponin I

🔹 Troponin I, like Troponin T, is highly specific to myocardial tissue and sensitive to damage.

🔹 It elevates 3–6 hours after MI, peaks at 12–24 hours, and stays elevated up to 7 days.

🔹 It is used to differentiate cardiac from non-cardiac chest pain.

🔹 Persistent elevation is useful in detecting myocardial injury, especially in unstable angina.

🔹 Troponin I is preferred in clinical practice due to its specificity and diagnostic reliability.

Want to practice more questions like this?

This question is from Custom: NUR 211 Midpoint Assessment- Summer 2 2025 which contains 29 questions.

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Answer Choices:

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From Exam
Custom: NUR 211 Midpoint Assessment- Summer 2 2025

29 Questions

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Question Details
  • Category: RN Nursing Exam(s)
  • Subcategory: ATI Exam(s)
  • Domain: RN Custom Exam(s)
  • Answer Choices: 5
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