A nurse is caring for a client with a suspected pulmonary embolism. Which diagnostic test is most likely to confirm this diagnosis?

Chest X-ray

Electrocardiogram (ECG)

CT pulmonary angiography

Arterial blood gas (ABG)

Answer and Explanation

The Correct Answer is C

Choice A reason: A chest X-ray may show secondary signs like atelectasis in pulmonary embolism but is not specific for diagnosis. It primarily rules out other conditions like pneumonia. Pulmonary embolism requires visualization of a clot, which X-rays cannot provide, making them insufficient for confirming the diagnosis.

Choice B reason: An ECG may show tachycardia or right heart strain in pulmonary embolism but is not diagnostic. It detects cardiac changes secondary to the embolism, not the clot itself. Specific imaging, like CT angiography, is needed to visualize the pulmonary artery obstruction for confirmation.

Choice C reason: CT pulmonary angiography is the gold standard for diagnosing pulmonary embolism, as it directly visualizes thrombi in pulmonary arteries using contrast-enhanced imaging. It confirms the presence, location, and extent of the clot, enabling rapid diagnosis and treatment to prevent life-threatening complications like right heart failure.

Choice D reason: Arterial blood gas may show hypoxemia or respiratory alkalosis in pulmonary embolism due to impaired gas exchange but is not diagnostic. It reflects physiological changes, not the clot itself. Imaging, like CT angiography, is required to confirm the presence of a pulmonary artery obstruction.

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Correct Answer is A

Explanation

Choice A reason: Hypomagnesemia, low magnesium (normal 1.7–2.2 mg/dL), is indicated by the 0.8 mEq/L value. Magnesium is vital for muscle, nerve, and cardiac function. Low levels can cause tremors, seizures, and arrhythmias. The other values (sodium, chloride, potassium) are within normal ranges, making hypomagnesemia the primary imbalance.

Choice B reason: Hyponatremia, low sodium (normal 135–145 mEq/L), is not indicated, as the sodium level is 140 mEq/L, within normal limits. Hyponatremia can cause neurological symptoms like confusion, but the lab values do not support this diagnosis, and magnesium imbalance is the clear abnormality.

Choice C reason: Hyperchloremia, high chloride (normal 98–106 mEq/L), is not present, as the chloride level is 107 mEq/L, just above normal and not clinically significant. Elevated chloride may occur in dehydration or renal issues, but the primary concern here is the significantly low magnesium level.

Choice D reason: Hypokalemia, low potassium (normal 3.5–5.0 mEq/L), is not indicated, as the potassium level is 3.6 mEq/L, within normal range. Hypokalemia causes muscle weakness and arrhythmias, but the lab values point to hypomagnesemia as the primary electrolyte imbalance in this case.

A. Sensible water loss B. Major magnesium losses C. Insensible water loss D. Low potassium levels

Correct Answer is C

Explanation

Choice A reason: Sensible water loss refers to measurable fluid loss, like urine or sweat. The client’s symptoms, including high serum sodium (153 mEq/L), suggest hypernatremia due to water loss, but sensible losses like urine are reduced (decreased urine output). Insensible losses better explain the unmeasurable fluid deficit in this scenario.

Choice B reason: Major magnesium losses cause hypomagnesemia, leading to tremors or arrhythmias, not typically confusion or hypernatremia. The client’s high sodium and dehydration symptoms point to water loss, not magnesium. Magnesium levels are not provided, and the symptoms align more with fluid imbalance than magnesium deficiency.

Choice C reason: Insensible water loss, from skin and respiration, is unmeasurable and can lead to hypernatremia (serum sodium 153 mEq/L) due to concentrated blood. Dry mucous membranes, decreased urine output, and confusion indicate dehydration from water loss, consistent with insensible losses in elderly patients with reduced thirst perception.

Choice D reason: Low potassium levels (hypokalemia) cause muscle weakness and arrhythmias, not hypernatremia or confusion. The client’s high sodium and dehydration symptoms point to water loss, not potassium imbalance. Potassium levels are not provided, but the clinical picture supports insensible water loss as the primary issue.

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A nurse is caring for a client with a suspected pulmonary embolism. Which diagnostic test is most likely to confirm this diagnosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

As the nurse assesses a client’s laboratory values, the following are noted: Sodium 140 mEq/L, Magnesium 0.8 mEq/L, Chloride 107 mEq/L, Potassium 3.6 mEq/L. What electrolyte imbalance is indicated?

Correct Answer is A

Explanation

A 73-year-old hospitalized client demonstrates the following symptoms: dry mucous membranes, decreased urine output, confusion, a serum sodium of 153 mEq/L, and a serum condition difficult to measure. This is indicative of?

Correct Answer is C

Explanation

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