Progressive Care Nursing Certification (PCCN) Practice Exam

When evaluating a patient with sudden back pain, which clinical finding supports the presence of a ruptured aortic aneurysm?

1. Fever and chills

2. Cool and clammy skin

3. Hypotension and tachycardia

4. Chest tightness

The correct answer is: Hypotension and tachycardia

The presence of hypotension and tachycardia is highly indicative of a ruptured aortic aneurysm. When the aneurysm ruptures, it can lead to significant internal bleeding, causing the blood pressure to drop drastically due to the loss of circulating volume. This drop in blood pressure, or hypotension, can trigger the body’s compensatory mechanisms, which often results in an increased heart rate, or tachycardia, as the heart tries to maintain adequate perfusion to vital organs despite the low blood volume. In the context of a ruptured aortic aneurysm, these clinical signs are crucial for prompt diagnosis and management. The combination of hypotension and tachycardia can indicate hemorrhagic shock—a life-threatening condition that requires immediate medical attention. Recognizing these findings can lead to timely interventions, such as fluid resuscitation or surgical intervention, to minimize complications and improve outcomes for the patient. Other options, while they may suggest different clinical conditions, do not specifically correlate with the acute hemodynamic changes seen in a ruptured aortic aneurysm. For example, fever and chills may suggest an infectious process; cool, clammy skin could indicate shock but is more nonspecific; and chest tightness could suggest cardiac issues