A nurse is caring for a client who has a suspected pulmonary embolism. The nurse anticipates that the physician will order which of the following diagnostic tests as the gold standard for confirming the diagnosis?
Compression ultrasound
CT pulmonary angiography
Ventilation-perfusion scan
Chest x-ray
The Correct Answer is B
CT pulmonary angiography (CTPA) is the new reference standard for the diagnosis of pulmonary embolism (PE). It is a non-invasive imaging test that uses contrast dye and X-rays to visualize the pulmonary arteries and detect blood clots.
Choice A is wrong because compression ultrasound is used to diagnose deep vein thrombosis (DVT), not PE. However, if a DVT is found in a patient with clinical suspicion for PE, the diagnosis of PE can be accepted without further testing.
Choice C is wrong because ventilation-perfusion scan is an alternative test for PE when CTPA is contraindicated or unavailable. It uses radioactive tracers to measure the airflow and blood flow in the lungs and detect any mismatch that suggests a PE.
Choice D is wrong because chest X-ray cannot diagnose PE directly.
It can only show nonspecific signs of PE such as atelectasis, pleural effusion, or elevated hemidiaphragm. It can also help rule out other causes of chest pain or dyspnea.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Crossing the legs when sitting.
This is because crossing the legs can impair blood circulation and increase the risk of clot formation in the lower extremities.
Choice A is wrong because wearing compression stockings can help prevent deep vein thrombosis by applying pressure to the legs and improving blood flow.
Choice B is wrong because elevating the legs when sitting can also improve blood circulation and reduce swelling and pain in the legs.
Choice C is wrong because drinking plenty of fluids can prevent dehydration and blood viscosity, which are risk factors for deep vein thrombosis.
Normal ranges for blood clotting tests are:
• Prothrombin time (PT): 11 to 13.5 seconds
• International normalized ratio (INR): 0.8 to 1.2
• Activated partial thromboplastin time (aPTT): 25 to 35 seconds
• D-dimer: less than 0.5 mcg/mL
Correct Answer is C
Explanation
Activated partial thromboplastin time (aPTT) is a test that measures how long it takes for blood to clot.It is used to monitor the effectiveness of heparin therapy, which is an anticoagulant (blood thinner) that prevents the formation of blood clots.Heparin affects one set of clotting factors that are measured by the aPTT test.The normal range of aPTT is 30-40 seconds, but in patients receiving heparin therapy, the range is 1.5-2.5 times the control value in seconds.
Choice A is wrong because prothrombin time (PT) is another test that measures how long it takes for blood to clot, but it is used to monitor the effectiveness of warfarin therapy, which is another anticoagulant that affects a different set of clotting factors than heparin.
Choice B is wrong because international normalized ratio (INR) is a standardized way of reporting the PT results, which are affected by warfarin therapy, not heparin therapy.
Choice D is wrong because platelet count is a test that measures the number of platelets in the blood, which are cells that help with clotting.Platelet count is not affected by heparin therapy and does not reflect its effectiveness.
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