The nurse has finished reviewing the shift report on a cardiac unit. The nurse should plan to see which of the following assigned clients first?

Correct Answer: C

Rationale: The correct answer is C because a client receiving antibiotics for bacterial endocarditis who is reporting anxiety and chest pain is showing signs of a potential cardiac emergency that requires immediate attention to prevent further complications. Chest pain and anxiety are red flags for cardiac issues such as myocardial infarction that could lead to life-threatening situations. Therefore, the nurse should prioritize this client to assess and intervene promptly. Choice A is incorrect because dyspnea in a client with hypertrophic cardiomyopathy, while concerning, does not indicate an acute cardiac emergency that requires immediate attention. Choice B is incorrect because a client who had a cardiac catheterization and will be ambulating for the first time does not exhibit urgent signs that necessitate immediate intervention compared to a client with chest pain and anxiety. Choice D is incorrect because a temperature of 101 F in a client recovering from CABG surgery is not as concerning as chest pain and anxiety, which could indicate a cardiac complication.

Correct Answer: D

Rationale: The correct answer is D: Troponin. Troponin is a cardiac-specific protein released into the bloodstream following myocardial injury, making it the most sensitive and specific marker for detecting acute myocardial infarction. It rapidly rises within 3-6 hours of injury, peaks at 12-48 hours, and remains elevated for up to 14 days. LDH (choice A) and SGOT (choice C) are less specific for cardiac injury, while CK-MM (choice B) is a skeletal muscle enzyme, not specific to the heart. Troponin's kinetics, cardiac specificity, and prolonged elevation make it the best choice for quickly identifying recent myocardial infarction.

Correct Answer: B

Rationale: The correct answer is B: A junctional rhythm. In a junctional rhythm, the atrioventricular (AV) node takes over as the pacemaker, resulting in the absence of P waves. The other components (QRS complex and T waves) are normal, indicating a regular ventricular depolarization and repolarization. A normal sinus rhythm (choice A) would have visible P waves preceding each QRS complex. Atrial fibrillation (choice C) would show irregularly irregular rhythm with no discernible P waves. A ventricular rhythm (choice D) would display wide QRS complexes and lack preceding P waves.

Correct Answer: B

Rationale: The correct sign for cardiac tamponade is Beck's triad, which consists of hypotension, distant heart sounds, and elevated jugular venous pressure. This is due to the compression of the heart by fluid in the pericardial sac. Shortness of breath (A) can be a symptom of many heart conditions, but is not specific to cardiac tamponade. Holosystolic murmur (C) is more indicative of mitral regurgitation. Bounding peripheral pulse (D) is seen in conditions like aortic regurgitation, not cardiac tamponade.

Correct Answer: B

Rationale: The correct answer is B: Give Digibind as an antidote. Digibind is the specific antidote for digoxin toxicity as it binds to digoxin and removes it from the body. This action helps to rapidly reduce the levels of digoxin in the system, counteracting the toxic effects. Checking a potassium level (A) may be important but not the priority when severe toxicity is present. Changing the dosing schedule (C) or giving a potassium supplement (D) will not address the immediate life-threatening effects of severe digoxin toxicity. Digibind is the most appropriate and urgent action to take in this scenario.