Which clinical manifestations are indicative of right ventricular failure? (Select all that apply.)
Crackles upon auscultation of the lungs
Hepatomegaly
Jugular venous distention
Orthopnea
Peripheral edema
Correct Answer : B,C,E
Rationale:
A. Crackles are more commonly associated with left ventricular failure, which leads to pulmonary congestion.
B. Hepatomegaly, or an enlarged liver, is a sign of right ventricular failure due to blood backing up in the systemic circulation.
C. Jugular venous distention is a classic sign of right ventricular failure as blood accumulates in the venous system.
D. Orthopnea, or difficulty breathing while lying down, is more indicative of left ventricular failure.
E. Peripheral edema is a hallmark of right ventricular failure, resulting from increased venous pressure.
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Correct Answer is D
Explanation
Rationale:
A. CK-MB is a cardiac enzyme that rises in response to myocardial injury, but it is less specific and takes longer to rise than troponin.
B. BNP is associated with heart failure, not myocardial infarction.
C. Myoglobin is an early marker but is non-specific, as it rises with any muscle damage.
D. Troponin is the most specific and sensitive biomarker for myocardial infarction. It rises within 3-4 hours after myocardial injury and remains elevated for days, making it the most useful test for confirming an MI.
Correct Answer is B
Explanation
Rationale:
A. While a CVP catheter might be in place for an extended period, its purpose is not directly related to heart healing.
B. The CVP catheter is used to monitor central venous pressure, which helps guide fluid management and assess right heart function.
C. The CVP catheter does not extend into the left ventricle; it is typically positioned in the superior vena cava or right atrium.
D. The CVP catheter may have multiple lumens for administering fluids, but its primary purpose is hemodynamic monitoring, not just providing IV access.