Which of the following manifestations are most consistent with a pulmonary embolism?
Bradypnea and slow heart rate
Bilateral peripheral edema and generalized weakness
Sudden onset of dyspnea and sharp chest pain
Gradual onset of a productive cough with thick sputum
The Correct Answer is C
A. Bradypnea and slow heart rate is incorrect because pulmonary embolism (PE) usually triggers tachypnea and tachycardia, not slow breathing or bradycardia. These responses occur as the body attempts to compensate for hypoxemia and reduced pulmonary blood flow.
B. Bilateral peripheral edema and generalized weakness is incorrect because bilateral leg swelling is more characteristic of heart failure or systemic venous congestion. While a PE may result from deep vein thrombosis (DVT), edema is usually unilateral and not the defining manifestation of an acute PE.
C. Sudden onset of dyspnea and sharp chest pain is correct because a pulmonary embolism occurs when a blood clot obstructs a pulmonary artery, causing abrupt impairment of blood flow to the lung. This leads to sudden shortness of breath, sharp or pleuritic chest pain (worsening with inspiration), tachypnea, and sometimes hemoptysis. Other signs may include anxiety, diaphoresis, and hypoxemia. Rapid recognition is essential, as PE can be life-threatening if untreated.
D. Gradual onset of a productive cough with thick sputum is incorrect because this pattern is more typical of pneumonia or chronic bronchitis, not pulmonary embolism. PE symptoms are typically acute and sudden rather than gradual.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Generalized skin redness is incorrect because this is not a hallmark of vaso-occlusive crises. Skin redness may occur with infection or inflammation, but it does not specifically indicate sickle-cell complications.
B. Bleeding gums is incorrect because bleeding tendencies are not typical of sickle-cell anemia. Bleeding gums are more commonly associated with platelet disorders or vitamin C deficiency, not vaso-occlusion.
C. Joint pain is correct because a vaso-occlusive crisis occurs when sickle-shaped red blood cells obstruct small blood vessels, leading to reduced blood flow, ischemia, and tissue hypoxia. This results in severe pain, often in the joints, bones, chest, or abdomen, which is the hallmark symptom of a crisis. Other accompanying signs may include fever, swelling, and tenderness in affected areas. These pain episodes can be sudden, severe, and recurrent.
D. Bradycardia is incorrect because vaso-occlusive crises do not typically cause bradycardia. In fact, patients may develop tachycardia as a compensatory response to anemia or pain.
Correct Answer is ["A","B","C","E"]
Explanation
A. Pallor is correct because anemia results in reduced red blood cell count or hemoglobin levels, which decreases the blood’s oxygen-carrying capacity. Pallor is most noticeable in areas where the skin is thin or highly vascularized, such as the face, conjunctiva, lips, nail beds, and mucous membranes. This is a classic and often early sign of anemia.
B. Fatigue is correct because tissues and organs receive less oxygen, which is necessary for cellular metabolism and energy production. The reduced oxygen delivery leads to muscle weakness, low endurance, and a persistent feeling of tiredness, even after rest. Fatigue is one of the most common and debilitating symptoms of anemia.
C. Dyspnea is correct because the body tries to compensate for the reduced oxygen-carrying capacity of the blood by increasing respiratory rate and depth. This can cause shortness of breath, especially during exertion or activity, as the lungs attempt to supply more oxygen to the tissues. Chronic anemia can also lead to exertional dyspnea at relatively low levels of activity.
D. Bradycardia is incorrect because anemia typically causes tachycardia, not bradycardia. The heart beats faster to maintain adequate oxygen delivery to vital organs when hemoglobin levels are low. Bradycardia would not be a compensatory response to anemia and may indicate a separate cardiac issue.
E. Dizziness is correct because the brain may receive insufficient oxygen, especially during sudden position changes or physical activity, leading to lightheadedness, vertigo, or fainting (syncope). Dizziness is a reflection of the central nervous system’s sensitivity to hypoxia caused by anemia.
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