The nurse admits a patient with a diagnosis of abdominal aortic aneurysm. Which signs and symptoms would suggest that the aneurysm has ruptured?

A. Rapid onset of shortness of breath and hemoptysis: These symptoms suggest a pulmonary etiology, such as pulmonary embolism or pneumonia, rather than an abdominal aortic aneurysm (AAA). They do not indicate aneurysm rupture. B. Gradually increasing substernal chest pain and diaphoresis: This presentation is more typical of acute coronary syndrome or myocardial infarction. While cardiac events can coexist, these findings do not reflect the classic signs of AAA rupture. C. Sudden, patchy blue mottling on the feet and toes and pain at rest: These symptoms suggest peripheral arterial embolism or severe peripheral vascular disease. Although vascular in origin, they are not indicative of a ruptured AAA. D. Sudden, severe low back pain and bruising along the flank area: Ruptured abdominal aortic aneurysms classically present with acute, severe abdominal or low back pain, hypotension, and retroperitoneal bleeding, which can manifest as flank ecchymosis (Grey-Turner sign). These findings are hallmarks of AAA rupture and require immediate surgical intervention.