Emergency Medical Technician (EMT) Intermediate Practice Exam

The presence of distended jugular veins that do not collapse, even when the patient is sitting, is consistent with:

1. Pneumothorax

2. Congestive heart failure

3. Cerebrovascular accident

4. Acute coronary syndrome

The correct answer is: Congestive heart failure

The presence of distended jugular veins that do not collapse, even when the patient is in an upright position, is indicative of elevated right atrial pressure, which is commonly associated with congestive heart failure (CHF). In CHF, the heart's ability to pump blood effectively is compromised, leading to increased pressure in the venous system. As a result, the jugular veins become engorged due to the backflow of blood and increased venous pressure, causing distension. In a patient with congestive heart failure, other signs might include peripheral edema, shortness of breath, and fatigue as the body's circulation becomes inefficient. The distended jugular veins serve as a clinical sign of the underlying fluid overload and cardiac dysfunction, making it crucial for assessment and management. In contrast, while conditions like pneumothorax or cerebrovascular accident can present with various symptoms, they do not typically lead to the specific manifestation of jugular vein distension seen in CHF. Acute coronary syndrome can cause significant cardiovascular events, but it primarily presents with chest pain and may not result in chronic venous pressure changes reflected in the jugular veins. Understanding these distinctions reinforces the connection between observed physical signs and underlying pathophysiological processes.