A nurse is educating a client who presents with a pulmonary embolism. Which of the following information should the nurse provide?

Treatment is not needed if the client is hemodynamically stable.

Treatment is not needed if the client is asymptomatic.

Treatment is needed for all clients who have a pulmonary embolism.

Treatment is not needed if the pulmonary embolism is intermediate.

Answer and Explanation

The Correct Answer is C

A. Treatment is not needed if the client is hemodynamically stable. Even if a client is hemodynamically stable, a pulmonary embolism still poses a serious risk of progression or recurrence and requires anticoagulation or other appropriate interventions to prevent complications or death.
B. Treatment is not needed if the client is asymptomatic. An asymptomatic pulmonary embolism is still clinically significant. Without treatment, clots can enlarge or lead to future embolic events. Thus, treatment is still warranted regardless of symptom presence.
C. Treatment is needed for all clients who have a pulmonary embolism. All clients with a diagnosed pulmonary embolism should receive prompt treatment, such as anticoagulants or thrombolytics depending on severity, to prevent morbidity and mortality from clot progression or recurrence.
D. Treatment is not needed if the pulmonary embolism is intermediate. Intermediate-risk pulmonary embolisms require medical management and close monitoring. Treatment decisions may vary, but anticoagulation is still generally indicated to avoid complications like right ventricular failure.

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Correct Answer is D

Explanation

A. The glomerular filtration rate decreases because there is a reduction of blood flow to the kidneys:
Reduced renal perfusion causes prerenal acute kidney injury, not acute tubular necrosis (ATN). In ATN, the injury is intrarenal, specifically within the tubules, rather than being due to reduced blood flow to the kidneys.
B. The glomerular filtration rate decreases because there is obstruction leading to the filtration system backing up and eventually shutting the kidneys down: This describes postrenal acute kidney injury, typically due to obstruction in the urinary tract, such as stones or enlarged prostate. It is not the underlying mechanism in acute tubular necrosis, which is a type of intrarenal injury.
C. The glomerular filtration rate decreases because inflammatory cells invade the already damaged kidneys: While inflammation may be present in certain renal conditions, acute tubular necrosis primarily involves ischemic or toxic injury to tubular epithelial cells, not immune cell invasion. Inflammatory cell infiltration is more characteristic of interstitial nephritis.
D. The glomerular filtration rate decreases because there is injury to the renal tubular cells:
In acute tubular necrosis, the primary damage is to the tubular epithelial cells, leading to cellular death and sloughing. This impairs the kidney’s ability to reabsorb and filter properly, resulting in a drop in glomerular filtration rate due to tubular dysfunction and obstruction.

A. Decreased cardiac output B. Dilated ventricles C. Respiratory alkalosis D. Increased venous return

Correct Answer is A

Explanation

A. Decreased cardiac output: In tension pneumothorax, intrathoracic pressure builds up and shifts mediastinal structures, including the trachea and heart. This pressure compresses the vena cava and heart, reducing venous return and ultimately decreasing cardiac output, which can lead to shock if untreated.
B. Dilated ventricles: Ventricular dilation is not a typical response to tension pneumothorax. In fact, the compression caused by increased pressure limits ventricular filling rather than causing dilation.
C. Respiratory alkalosis: Although initial hyperventilation may lead to respiratory alkalosis, it is not a direct or consistent result of tracheal deviation. The condition can progress to respiratory acidosis as ventilation is impaired.
D. Increased venous return: Venous return is actually decreased in tension pneumothorax due to compression of the great veins. This contributes to hypotension and impaired cardiac output, not an increase in venous return.

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A nurse is educating a client who presents with a pulmonary embolism. Which of the following information should the nurse provide?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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