A nurse is caring for a client with suspected pulmonary embolism. The client's oxygen saturation drops significantly, and the nurse observes cyanosis of the lips and nail beds. Which term best describes this clinical finding?
Jaundice
Pallor
Erythema
Cyanosis
The Correct Answer is D
A) Incorrect. Jaundice is a yellowing of the skin and sclera due to elevated bilirubin levels, which is not described in the client's symptoms.
B) Incorrect. Pallor refers to paleness of the skin, which is not consistent with the client's cyanosis.
C) Incorrect. Erythema refers to redness of the skin due to increased blood flow, which is not the best description of the client's symptoms.
D) Correct. Cyanosis is the bluish discoloration of the skin, lips, and nail beds due to decreased oxygen saturation in the blood, which is indicative of a severe oxygen deficit often seen in pulmonary embolism.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Incorrect. Chest X-rays can show certain abnormalities but are not the primary diagnostic tool for pulmonary embolism.
B) Incorrect. Electrocardiograms (ECGs) are used to assess heart rhythm and electrical activity but are not used to diagnose pulmonary embolism.
C) Incorrect. Magnetic resonance imaging (MRI) may be used in some cases, but CTPA is the preferred test for diagnosing pulmonary embolism.
D) Correct. Computed tomography pulmonary angiography (CTPA) is the gold standard for diagnosing pulmonary embolism as it can visualize blood clots in the pulmonary arteries.
Correct Answer is D
Explanation
A) Incorrect. Avoiding all physical activity is not recommended. Clients should engage in appropriate physical activity, and the level of activity may be adjusted based on their condition.
B) Incorrect. A diet high in cholesterol is not a preventive measure for blood clots; in fact, it can contribute to cardiovascular risk factors.
C) Incorrect. While excessive caffeine and alcohol intake should be avoided, eliminating them completely is not a specific preventive measure for pulmonary embolism.
D) Correct. Following the healthcare provider's recommendations for anticoagulant therapy is crucial in preventing recurrent pulmonary embolism, especially in individuals with a history of the condition.
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