Progressive Care Nursing Certification (PCCN) Practice Exam

In which situation would you anticipate an increase in right ventricular pressure?

1. Cardiac tamponade

2. Pulmonary embolism

3. Myocardial ischemia

4. Aortic stenosis

The correct answer is: Pulmonary embolism

An increase in right ventricular pressure is expected in cases of pulmonary embolism. This condition involves the blockage of one or more pulmonary arteries, typically due to blood clots that travel to the lungs from the legs or other parts of the body (deep vein thrombosis). When a pulmonary embolism occurs, the right ventricle must work harder to pump blood through the obstructed arteries, leading to increased pressure within the right ventricle. This situation can result in signs of right heart strain or failure, which may be observed through clinical symptoms or imaging studies. In contrast, other conditions such as cardiac tamponade primarily affect the filling of the heart chambers due to fluid accumulation, myocardial ischemia generally affects coronary blood flow and may not directly elevate right ventricular pressure, and aortic stenosis mainly impacts the left ventricle due to obstruction outflow from the heart to the aorta. Therefore, pulmonary embolism is directly linked to increased right ventricular pressure due to the nature of the obstruction in the pulmonary circulation.