Certified Registered Nurse Anesthetist (CRNA) Practice Exam

Which of the following findings is associated with left-sided heart failure?

1. Racoon eyes

2. Increased PAOP

3. Peripheral edema

4. Hepatomegaly

The correct answer is: Increased PAOP

The finding associated with left-sided heart failure is increased pulmonary artery occlusion pressure (PAOP). Left-sided heart failure leads to a backlog of blood in the pulmonary circulation due to the left ventricle's inability to effectively pump blood out to the body. As a result, pressure increases in the pulmonary capillaries, which can be measured indirectly through PAOP. An increase in PAOP indicates elevated pressures in the left atrium and pulmonary circulation, reflecting the hemodynamic changes that occur in left-sided heart failure. Other choices, while they may indicate different forms of heart failure or other medical conditions, do not correlate specifically with the primary hemodynamic changes observed in left-sided heart failure. For instance, peripheral edema is more characteristically associated with right-sided heart failure, while hepatomegaly can occur in various conditions but is more commonly linked to congestive heart failure originating from right-sided dysfunction. Racoon eyes may indicate a separate pathophysiological process, such as trauma or certain types of cancers, rather than being directly related to heart function.