Advanced Patient Assessment Practice Exam

Which of the following is the most common cause of jugular venous distention?

1. Auto-positive end-expiratory pressure (auto-PEEP)

2. Pneumothorax

3. Pneumonia

4. Right heart failure

The correct answer is: Right heart failure

Jugular venous distention (JVD) is an important clinical sign that often indicates increased central venous pressure, which can be associated with a number of cardiovascular and respiratory conditions. Right heart failure is the most common cause of JVD because it leads to impaired filling of the right atrium and subsequent congestion in the venous system, which manifests as distension of the jugular veins. When the right heart is unable to efficiently pump blood, venous return increases, and the excess fluid builds up in the systemic circulation, leading to observable JVD. In cases of right heart failure, conditions such as left heart failure and pulmonary hypertension can also contribute to increased central venous pressure, exacerbating the appearance of JVD. This makes it a classic clinical finding in patients with right-sided heart dysfunction. Understanding this association is key for accurately diagnosing conditions related to heart failure, monitoring the progression of disease, and informing treatment decisions.