Certified Registered Nurse Anesthetist (CRNA) Practice Exam

What symptom is typically observed in right-sided heart failure?

1. Increased stroke volume

2. Decreased ejection fraction

3. Rales or wheezing

4. Jugular venous distension (JVD)

The correct answer is: Jugular venous distension (JVD)

Jugular venous distension (JVD) is a hallmark sign of right-sided heart failure and occurs due to the increased pressure in the right atrium and subsequent backup of blood into the systemic venous circulation. In cases where the right side of the heart is unable to effectively pump blood to the lungs for oxygenation, fluid congestion can develop, leading to increased central venous pressure manifested as distended veins in the neck. Monitoring for JVD is an essential part of assessing a patient with suspected heart failure, as it provides insights into the right atrial pressure and overall volume status of the patient. The degree of distension can indicate the severity of right-sided heart failure and guide further management. The other symptoms and signs listed do not typically correlate with right-sided heart failure. While decreased ejection fraction can be observed in heart failure broadly, it is not exclusive to right-sided heart failure and can be present in left-sided heart failure as well. Rales or wheezing are more associated with pulmonary congestion from left-sided heart failure. Increased stroke volume is generally inconsistent with heart failure conditions, where the heart is compromised in its ability to pump effectively.