A nurse is assessing a client who has a pulmonary embolism.

The nurse should expect to find which of the following signs and symptoms? (Select all that apply)

The correct answer is choice A, B and E. A pulmonary embolism (PE) is a blood clot that blocks an artery in the lung and reduces blood flow and oxygen levels.

The common symptoms of PE are:

• Dyspnea(sudden, unexplained shortness of breath)

• Pleuritic chest pain(dull pain that gets worse with deep breathing)

• Hemoptysis(coughing up blood)

Choice C is correct because hemoptysis is a possible symptom of PE, although it is less common than dyspnea and chest pain.Hemoptysis occurs when the blood clot damages the lung tissue and causes bleeding

Choice D is wrong because bradycardia (slow heart rate) is not a typical symptom of PE.In fact, most people with PE have tachycardia (fast heart rate) due to the increased strain on the heart and the reduced oxygen levels

Choice E is correct because hypoxemia (low oxygen levels in the blood) is a common complication of PE.

Hypoxemia can cause pale, clammy or bluish skin, excessive sweating, anxiety, lightheadedness or fainting.Hypoxemia can also worsen the heart strain and lead to heart failure or cardiac arrest

Normal ranges for oxygen saturation are 95% to 100%.Normal ranges for heart rate are 60 to 100 beats per minute

The correct answer is choice A, B and E.A D-dimer test is a blood test that measures D-dimer, which is a protein fragment that your body makes when a blood clot dissolves in your body.A positive or elevated D-dimer test result may indicate that you have a blood clotting condition, such as:

• Deep vein thrombosis (DVT): a blood clot that develops in a vein deep in your body, usually in the legs.

• Pulmonary embolism (PE): a blockage in an artery in the lung caused by a blood clot that travels from another part of the body, such as the leg.

• Disseminated intravascular coagulation (DIC): a condition that prevents the blood from clotting normally and causes excessive bleeding or clotting throughout the body.

Choice C and D are wrong because:

• Myocardial infarction (MI): a heart attack caused by a blockage in one of the coronary arteries that supply blood to the heart muscle.A D-dimer test is not used to diagnose MI because other blood tests, such as troponin and CK-MB, are more specific and sensitive for detecting heart muscle damage.

• Stroke: a brain attack caused by a blockage or rupture of a blood vessel in the brain.A D-dimer test is not used to diagnose stroke because other imaging tests, such as CT scan or MRI, are more accurate and reliable for detecting brain damage.

The normal range of D-dimer levels varies depending on the laboratory and the method used, but it is usually less than 0.5 mg/L or 500 ng/mL.However, the normal range may also depend on other factors, such as age, pregnancy, inflammation, infection, trauma, surgery or cancer.

Therefore, a D-dimer test result should always be interpreted in the context of the clinical situation and other test results.