A nurse is caring for a client who has developed pulmonary embolism (PE). Which of the following diagnostic tests should the nurse anticipate the provider to prescribe to confirm the client's condition?(Select All that Apply.)

D-dimer blood test

Complete blood count (CBC)

CT scan

Chest x-ray

Lung ventilation and perfusion scan (VQ scan)

Answer and Explanation

Correct Answer : A,C,E

A. D-dimer blood test - A D-dimer test measures clot breakdown products in the blood. Elevated levels suggest the presence of an abnormal blood clot, such as in PE, although it is not specific.

B. Complete blood count (CBC) - A CBC is not typically used to diagnose PE. It may be ordered to check for other conditions or as part of the overall health assessment, but it doesn't confirm PE.

C. CT scan - A CT pulmonary angiography is the gold standard for diagnosing PE. It provides detailed images of the blood vessels in the lungs.

D. Chest x-ray - A chest x-ray is not diagnostic for PE. It is often performed to rule out other causes of the client’s symptoms (e.g., pneumonia, pneumothorax) but does not confirm the presence of a pulmonary embolism.

E. Lung ventilation and perfusion scan (VQ scan)
A VQ scan is another diagnostic tool for PE, especially in clients who cannot tolerate contrast dye required for CT scans. It assesses the ventilation and perfusion of the lungs and identifies mismatches suggestive of PE.

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Correct Answer is A

Explanation

A. Scatter rugs are present in the kitchen - Scatter rugs can cause tripping and slipping, posing a significant fall risk for someone with vision impairment.

B. Handrails are present in the bathroom - Handrails provide support and help prevent falls, making them a safety feature, not a risk.

C. Electrical cords are placed along the walls - This helps prevent tripping over cords, thus reducing fall risk.

D. Uses a microwave for cooking - A microwave is generally safer than a stove as it reduces the risk of burns and fires, making it a safety feature.

A. “I need something for the pain in my eye. I can't stand it." B. "It’s hard to see with a patch on one eye. I'm afraid of falling" C. "My eye really itches, but I'm trying not to rub it." D. "The bright light in this room is really bothering me."

Correct Answer is A

Explanation

A. “I need something for the pain in my eye. I can't stand it." Severe pain after cataract surgery is unusual and could indicate complications such as increased intraocular pressure or infection. This should be reported immediately to the provider for further evaluation.

B. "It’s hard to see with a patch on one eye. I'm afraid of falling": This is a common concern and relates to mobility safety, not a sign of a surgical complication.

C. "My eye really itches, but I'm trying not to rub it.": Itching can be a normal response post-surgery due to healing. Patients should avoid rubbing the eye, and this does not necessarily indicate a complication.

D. "The bright light in this room is really bothering me.": Photophobia or sensitivity to light can be common postoperatively and is usually not a sign of a serious issue.

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