A nurse is assessing a patient who has been diagnosed with cardiac tamponade. Which of the following findings would the nurse expect to observe during the assessment?

Cardiac tamponade occurs when fluid accumulates in the pericardial sac, compressing the heart and impeding ventricular filling. The classic presentation is described by Beck's triad: hypotension, jugular venous distension, and muffled heart sounds. Paradoxical pulse — a drop in systolic blood pressure of more than 10 mmHg during inspiration — is another hallmark finding. During inspiration, right ventricular filling increases, causing the interventricular septum to shift leftward and further restrict left ventricular output, exaggerating the normal inspiratory decline in blood pressure. Hypotension results from markedly decreased cardiac output as the compressed ventricles cannot fill adequately. Together, paradoxical pulse and hypotension are the expected assessment findings, making that option correct. A rapidly increasing heart rate with hypertension would be more consistent with a compensatory response to hemorrhage or early shock, not tamponade. Increased cardiac output with normal vital signs is inconsistent with tamponade, which always reduces cardiac output. Elevated blood pressure with bradycardia suggests a Cushing reflex associated with raised intracranial pressure, not pericardial tamponade. Recognizing tamponade early is life-saving because emergent pericardiocentesis may be required.