This question was created from NURS6560-Midterm18.docx

T . is a 39 – year-old male who presents to the hospital emergency room with a chief
complaint of profound substernal chest pain Results of the 12 -lead ECG and cardiac
enzymes test are normal . Vital signs are as follows : temperature 101 9OF pulse 129
bom respirations 26 breaths per minute , and blood pressure 90 / 60 mm Hg . The patient
is pale and clearly unwell , and physical examination reveals a systolic pericardial
crunching sound . Which of the following additional pieces of history would make the
AGACNP suspect acute mediastinitis ?
A . A 48 pack year smoke history B . A 2 -day history of vomiting
C. Aortic valve
regurgitation D Cardiac tamponade