Question 1

A patient develops a pulmonary embolism (PE) after surgery and shows signs of right-sided heart failure. Which drug will be administered to this patient?&#10;A) Low molecular heparin&#10;B) Tissue plasminogen activator&#10;C) Unfractionated heparin&#10;D) Warfarin

Accepted Answer

Tissue plasminogen activator (tPA) is a thrombolytic agent that can rapidly dissolve the clot causing the pulmonary embolism. This can improve the patient's symptoms and prevent further right-sided heart failure. Low molecular weight heparin may also be given initially to prevent new clots from forming, but tPA is the best choice for treating an existing clot causing acute right-sided heart failure. Unfractionated heparin and warfarin are not effective for dissolving clots and are used for long-term anticoagulation.

Question 2

A patient who has undergone surgical immobilization for a femur fracture reports dyspnea and chest pain associated with inspiration. The patient has a heart rate of 120 beats per minute. Which diagnostic test will confirm the presence of a pulmonary embolism (PE)?

A) Arterial blood gases (ABGs)
B) Computed tomography (CT) angiography
C) D-dimer
D) Electrocardiogram (ECG)

B

Accepted Answer

Computed tomography (CT) angiography is the gold standard diagnostic test for confirming the presence of a pulmonary embolism (PE). It provides detailed images of the pulmonary blood vessels and can help identify the location and size of the clot. Arterial blood gases (ABGs) can be helpful in assessing oxygenation but are not a specific diagnostic test for PE. D-dimer is a blood test that can indicate the presence of a clot, but it is not specific to PE and can be elevated in other conditions. An electrocardiogram (ECG) can help identify signs of right heart strain or ischemia, which can be associated with PE, but it is not a specific diagnostic test for PE.

Question 3

Which clinical sign is especially worrisome in a patient with a pulmonary embolism (PE)?&#10;A) Abnormal lung sounds&#10;B) Dyspnea&#10;C) Hypotension&#10;D) Tachycardia

Accepted Answer

Hypotension is especially worrisome in a patient with a pulmonary embolism because it suggests that the patient is experiencing a massive PE, which can be life-threatening. Abnormal lung sounds, dyspnea, and tachycardia are common symptoms of a PE but do not necessarily indicate a more severe or life-threatening presentation.

Deck 95: Pulmonary Embolism