Advanced Patient Assessment Practice Exam

During a physical exam, which would be an expected finding in a patient with right-sided heart failure?

1. Crackles in the lung bases

2. Elevated blood pressure

3. Hepatomegaly

4. Decreased jugular venous pressure

The correct answer is: Hepatomegaly

In the context of right-sided heart failure, hepatomegaly is a significant finding that relates to the pathology of the condition. Right-sided heart failure leads to an accumulation of blood in the systemic venous system, which often results in congestion of organs such as the liver. This congestion causes the liver to enlarge (hepatomegaly), as increased pressure in the hepatic veins leads to increased blood volume within the liver itself. This phenomenon reflects the heart's inability to effectively pump blood forward, resulting in a backup of pressure throughout the venous system. Consequently, the liver becomes engorged with blood, which can be palpated during a physical examination as an enlarged or tender liver. Understanding this concept is crucial in assessing patients with heart failure as it can lead to further complications and helps in managing the patient's overall condition. The other findings, while they may be associated with various cardiovascular conditions, do not directly reflect the classic presentation of right-sided heart failure in the same way that hepatomegaly does.