A nurse is caring for a client diagnosed with pulmonary embolism.
Which new-onset assessment finding should a nurse expect in a client diagnosed with a pulmonary embolism?

Episodes of apnea.

Wet cough.

Dull chest pain.

Tachypnea.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Apnea, defined as a temporary cessation of breathing, is not a typical new-onset finding in pulmonary embolism. While severe pulmonary embolism can lead to respiratory compromise, the initial physiological response is usually hyperventilation and tachypnea as the body attempts to compensate for impaired gas exchange and hypoxemia. Apnea suggests a more profound central nervous system or respiratory center depression.

Choice B rationale

A wet cough, characterized by the production of mucus or sputum, is more commonly associated with conditions causing fluid accumulation in the airways, such as pneumonia, bronchitis, or heart failure. In pulmonary embolism, the primary issue is obstruction of pulmonary arteries, leading to V/Q mismatch and hypoxemia, which typically presents with a dry cough or hemoptysis if infarction occurs.

Choice C rationale

Dull chest pain is a less specific symptom and can be associated with various conditions. While chest pain can occur in pulmonary embolism due to pleural irritation or myocardial ischemia from increased right ventricular workload, it is often described as sharp, pleuritic, and sudden in onset. Dull pain might be more indicative of musculoskeletal issues or stable angina.

Choice D rationale

Tachypnea, an abnormally rapid rate of breathing, is a hallmark and early clinical sign of pulmonary embolism. The presence of a pulmonary embolus obstructs blood flow to a portion of the lung, leading to ventilation-perfusion (V/Q) mismatch and hypoxemia. The body compensates by increasing the respiratory rate to improve oxygen uptake and carbon dioxide elimination.

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Correct Answer is B

Explanation

Choice A rationale

Hand washing is highly effective against the common cold virus. The rhinovirus, responsible for most common colds, is primarily transmitted through direct contact with contaminated surfaces or respiratory droplets. Proper hand hygiene physically removes or inactivates the virus, significantly reducing its spread by disrupting the transmission pathway and minimizing self-inoculation from contaminated fomites.

Choice B rationale

The common cold virus can be highly communicable because individuals can shed the virus and transmit it before or during the onset of symptoms (the incubation and prodromal phases). This asymptomatic or mildly symptomatic shedding allows for widespread dissemination of the virus before the infected person is aware of their illness, contributing significantly to community transmission.

Choice C rationale

Mistaking common cold symptoms for seasonal allergies might delay appropriate hygiene measures and increase viral transmission. While symptoms can overlap, allergies are immune responses to allergens, whereas colds are viral infections. Incorrect self-diagnosis means individuals might not isolate or practice proper cough/sneeze etiquette, inadvertently spreading the virus to others in their environment.

Choice D rationale

The use of over-the-counter cold products does not inherently reduce immune resistance to the common cold virus. These medications primarily target symptom relief, such as decongestants or analgesics, and do not directly interfere with the body's immunological response or viral replication. Immune resistance remains dependent on the individual's overall health and prior exposure.

A. "I am happy to have a mild sense of taste despite no sense of smell.”. B. "My sense of smell is taking a long time to return.”. C. "I can't smell what I eat, but hope to enjoy eating in the future.”. D. "Breathing through my stoma has diminished my sense of smell.”.

Correct Answer is B

Explanation

Choice A rationale

The sense of taste is primarily mediated by taste buds on the tongue, which detect dissolved chemicals. While olfaction (smell) significantly contributes to the perception of flavor, taste itself is a separate chemosensory system. A client with a laryngectomy, while losing olfaction due to altered airflow, can retain some basic taste sensation as the neural pathways for taste remain intact.

Choice B rationale

A total laryngectomy involves the removal of the larynx, which permanently alters the upper airway. Air no longer passes through the nasal cavity to reach the olfactory epithelium, the specialized tissue containing olfactory receptors. This anatomical change results in a permanent loss of the sense of smell (anosmia), and it will not return.

Choice C rationale

Olfaction plays a crucial role in the perception of food flavor by detecting volatile organic compounds. Without the ability to smell, the nuanced enjoyment of food is diminished, as flavor is a complex integration of taste, smell, and somatosensory inputs. However, the client can still perceive basic tastes and tactile sensations, allowing for some future enjoyment of eating.

Choice D rationale

Breathing through a stoma, an opening in the neck that connects directly to the trachea, bypasses the nasal passages entirely. This redirection of airflow means that odor molecules cannot reach the olfactory receptors located in the upper part of the nasal cavity. Consequently, the sense of smell is significantly diminished or completely lost due to the altered respiratory pathway.

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A nurse is caring for a client diagnosed with pulmonary embolism. Which new-onset assessment finding should a nurse expect in a client diagnosed with a pulmonary embolism?

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A nurse is caring for a client diagnosed with pulmonary embolism.
Which new-onset assessment finding should a nurse expect in a client diagnosed with a pulmonary embolism?