What action should a person take to prevent the development of a pulmonary embolism?
Change positions frequently after surgery.
Start taking oral contraceptive medication.
Reduce the amount of fluid consumed.
Apply cold packs to both legs every day.
The Correct Answer is A
Choice A rationale
Changing positions frequently and early ambulation are essential postoperative interventions to prevent venous stasis. Venous stasis is a major component of Virchow's triad, which contributes to the formation of deep vein thrombosis in the lower extremities. If a thrombus dislodges, it can travel through the venous system to the pulmonary vasculature, causing an embolism. Physical movement promotes the skeletal muscle pump, which enhances venous return and maintains healthy circulatory flow.
Choice B rationale
Oral contraceptive medications containing estrogen and progestin are known to increase the risk of thromboembolic events. Estrogen increases the plasma concentration of clotting factors and decreases the levels of natural anticoagulants like antithrombin III. Therefore, starting these medications would increase the likelihood of developing a pulmonary embolism rather than preventing it. Patients at risk for clots are typically advised to avoid hormonal contraceptives to maintain a more balanced coagulation profile.
Choice C rationale
Reducing fluid intake can lead to dehydration and increased blood viscosity, which are significant risk factors for thrombus formation. Hemoconcentration makes the blood more prone to clotting because the ratio of formed elements to plasma increases. Adequate hydration is necessary to maintain blood volume and prevent the sludging of blood in the peripheral veins. For prevention, patients are encouraged to maintain a sufficient fluid intake unless they have a contraindication like heart failure.
Choice D rationale
Applying cold packs to the legs is not a recognized method for preventing pulmonary embolism and could potentially be harmful. Cold causes peripheral vasoconstriction, which might further slow down blood flow and increase the risk of stasis. Standard preventative care involves the use of sequential compression devices, anti-embolism stockings, and pharmacological prophylaxis. Cold therapy is generally reserved for reducing localized inflammation or swelling and does not address the systemic or mechanical risks of thromboembolism.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
Choice A rationale
Joint contractures are a common complication of prolonged immobility. When joints are not moved through their full range of motion, the connective tissues, including muscles, tendons, and ligaments, begin to shorten and harden. This permanent shortening leads to a loss of joint mobility and can result in fixed deformities. Regular passive and active range of motion exercises are necessary to maintain tissue elasticity and prevent the functional limitations associated with these debilitating contracture formations.
Choice B rationale
Pressure ulcers, or decubitus ulcers, occur when prolonged pressure on bony prominences compromises blood flow to the skin and underlying tissues. This localized ischemia leads to tissue hypoxia and eventual necrosis. Patients who are immobile cannot shift their weight to relieve this pressure. Consistent turning schedules every two hours and the use of pressure-relieving devices are critical interventions to prevent the breakdown of skin integrity and the development of these painful, infection-prone wounds.
Choice C rationale
Polyuria is not a result of immobility. Immobility is more likely to cause urinary stasis because the lack of gravity-assisted drainage from the kidneys to the bladder allows urine to pool in the renal pelvis. This stasis increases the risk of urinary tract infections and the formation of renal calculi. Polyuria is typically associated with endocrine disorders like diabetes or the use of diuretic medications rather than a lack of physical movement or activity.
Choice D rationale
Increased calcium levels, or hypercalcemia, can result from prolonged immobility because the lack of weight-bearing activity leads to bone demineralization. When bones do not experience the stress of movement and gravity, osteoclast activity increases, causing calcium to be released from the bone matrix into the bloodstream. This can lead to serum calcium levels rising above the normal range of 8.5 to 10.5 mg/dL, potentially causing kidney stones and further weakening the skeleton.
Choice E rationale
Diarrhea is not a standard complication of immobility. In fact, the opposite is true; immobility significantly increases the risk of constipation. Reduced physical activity slows down gastrointestinal motility and peristalsis. Furthermore, being in a recumbent position makes it more difficult for patients to have effective bowel movements. This slowing of the digestive tract often leads to fecal impaction or chronic constipation rather than the frequent, loose stools characterized by diarrhea.
Correct Answer is C
Explanation
Choice A rationale
A body mass index of 23 is within the normal range of 18.5 to 24.9. This indicates a healthy weight relative to height, which generally supports optimal metabolic function. Maintaining a normal body mass index reduces the risk of insulin resistance, as excessive adipose tissue, particularly visceral fat, releases inflammatory cytokines that interfere with insulin signaling pathways and glucose uptake in peripheral tissues like skeletal muscle.
Choice B rationale
A diet low in saturated fats is a protective factor rather than a risk factor. Saturated fats can contribute to systemic inflammation and lipotoxicity, which are known to impair the sensitivity of insulin receptors. By keeping saturated fat intake low, the lipid profile remains favorable, often resulting in lower low-density lipoprotein levels and improved vascular health, which indirectly supports efficient transport and regulation of blood glucose.
Choice C rationale
A sedentary lifestyle is a significant risk factor because physical inactivity reduces the expression of glucose transporter type 4 (GLUT4) in muscle cells. Exercise naturally stimulates glucose uptake through insulin-independent pathways. Without regular movement, the body requires higher levels of insulin to move glucose into cells, eventually leading to hyperinsulinemia and decreased pancreatic beta-cell efficiency. This lack of muscle contraction prevents the burning of stored glycogen.
Choice D rationale
A high-fiber diet is considered a lifestyle modification that improves glucose regulation. Soluble fiber slows the rate of gastric emptying and delays the absorption of carbohydrates in the small intestine. This results in a more gradual rise in postprandial blood glucose levels, preventing the sharp insulin spikes that can lead to receptor desensitization over time. Fiber also promotes a healthy gut microbiome, which is linked to better metabolic health.
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