LEIK Family Nurse Practitioner (FNP) Practice Exam 2025 – The Complete All-in-One Guide to Master Your FNP Certification!

The most likely diagnosis for a patient presenting with sharp chest pain that worsens when lying down and is associated with a precordial rub is pericarditis. This condition is characterized by inflammation of the pericardium, which can cause chest pain that is typically sharp and pleuritic in nature.

The unique feature of pericarditis is that the pain often intensifies when the patient is in a supine position and may relieve when sitting up or leaning forward, which aligns with the symptoms described. Furthermore, the presence of a precordial rub is a classic finding in pericarditis, as it is the sound made when inflamed pericardial surfaces rub against each other during the cardiac cycle.

The other conditions listed may present with chest pain but do not typically feature both the positional exacerbation of pain and a precordial rub. For instance, pulmonary embolism usually presents with sudden-onset pain that may not necessarily worsen when lying down, while a dissecting aneurysm presents acutely with severe, tearing pain often radiating to the back and does not involve a specific rub. Esophageal reflux causes burning pain that can worsen when reclining, but it lacks the sharp, localized nature and protective posture associated with