Episode 27 – Pulse Pressure

Watch the video version of this Q&A episode on YouTube – https://youtu.be/XTcVc7S8_oQ

A physical therapist determines the pulse pressure for a patient with congestive heart failure. Which of the following blood pressure measurements would represent the HIGHEST pulse pressure?

1. 130/60 mm Hg
2. 145/100 mm Hg
3. 120/75 mm Hg
4. 140/115 mm Hg

Welcome back to the Scorebuilders’ Question and Answer Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

Ready? Let’s go!

A physical therapist determines the pulse pressure for a patient with congestive heart failure. Which of the following blood pressure measurements would represent the HIGHEST pulse pressure?

1. 130/60 mm Hg
2. 145/100 mm Hg
3. 120/75 mm Hg
4. 140/115 mm Hg

Pulse Pressure
Pulse pressure refers to the difference between systolic and diastolic blood pressure. It represents the force that the heart generates each time it contracts and is a measure of arterial stiffness. 

Pulse pressure generally increases in direct proportion to the intensity of exercise since systolic pressure increases with exercise and diastolic pressure tends to stay the same. 

Let’s explore how to calculate pulse pressure.

Sample Pulse Pressure Calculation
If the blood pressure was measured as 124/84 mm Hg, the pulse pressure would be 40 mm Hg (124 mm Hg - 84 mm Hg).

Let’s explore each of the options:

Option 1  - 130/60 mm Hg
A patient with a blood pressure measurement of 130/60 mm Hg would have a pulse pressure of 70 mm Hg (130 mm Hg – 60 mm Hg = 70 mm Hg). This represents the highest pulse pressure of the presented options.

Option 2 - 145/100 mm Hg
A patient with a blood pressure measurement of 145/100 mm Hg would have a pulse pressure of 45 mm Hg (145 mm Hg – 100 mm Hg = 45 mm Hg).
    
Option 3 - 120/75 mm Hg
A patient with a blood pressure measurement of 120/75 mm Hg would have a pulse pressure of 45 mm Hg (120 mm Hg – 75 mm Hg = 45 mm Hg).
     
Option 4 - 140/115 mm Hg
A patient with a blood pressure measurement of 140/115 mm Hg would have a pulse pressure of 25 mm Hg (140 mm Hg – 115 mm Hg = 25 mm Hg).

The correct answer is Option 1

Let’s explore the all student data:
38% of students selected Option 1 - 130/60 mm Hg - the correct response
25% of students selected Option 2 - 145/100 mm Hg
3% of students selected Option 3 - 120/75 mm Hg
34% of students selected Option 4 - 140/115 mm Hg

System Classification
This question is a Cardiovascular and Pulmonary Systems question which represents approximately 14% of all exam items.

Content Outline Classification
This question is a Physical Therapy Examination question which represents approximately 24% of all exam items.

Level Classification
This question is a Level 2 question since the question requires students to integrate numerous pieces of information or to apply knowledge in a given clinical scenario. Remediation of Level 2 questions occurs by increasing flexibility with academic content and by carefully analyzing decision making processes when answering applied examination questions.

Academic Focus Area
Looking to review related academic content? Check out page 42 in PTEXAM: The Complete Study Guide.

Bonus Thought
With only 38% of students answering this Level 1 question correctly, it is clearly a very difficult question. Stated differently, pulse pressure was a term that a reasonable percentage of students were unfamiliar with resulting in many students making an academic mistake. The licensing examination will consist of a robust number of mainstream terms and concepts and a sprinkling of less well known terms and concepts. 

Students will never be satisfied when answering a question incorrectly, but on occasion some solace can be taken when the missed question was extremely difficult.

Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!