A patient presents with severe chest pain and shortness of breath and is diagnosed with pulmonary embolism. The embolism most likely originated from the:

Superficial veins of the arm.

Left ventricle.

Deep veins of the leg.

Systemic arteries.

Answer and Explanation

The Correct Answer is C

Choice A reason: The superficial veins of the arm are not a common source of emboli that cause pulmonary embolism. While blood clots can form in the superficial veins, they are less likely to travel to the lungs compared to clots formed in the deep veins of the legs.

Choice B reason: Emboli originating from the left ventricle typically travel to systemic circulation, potentially causing strokes or other systemic embolic events, rather than pulmonary embolism. Pulmonary embolism results from a clot traveling to the pulmonary arteries, which is more likely to originate from the venous system, specifically the deep veins.

Choice C reason: Deep veins of the leg, such as those in the calf and thigh, are the most common source of emboli that cause pulmonary embolism. Blood clots, known as deep vein thrombosis (DVT), can form in these veins and dislodge, traveling through the venous system and the right side of the heart to the pulmonary arteries. This can result in a pulmonary embolism, causing symptoms such as severe chest pain and shortness of breath.

Choice D reason: Systemic arteries do not typically lead to pulmonary embolism, as emboli from these arteries would travel to various parts of the systemic circulation, not the pulmonary arteries. Pulmonary embolism is primarily associated with emboli originating from the venous system, particularly the deep veins of the legs.

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Correct Answer is D

Explanation

Choice A reason: Preventing constipation is not the primary reason for prescribing metoprolol alongside nifedipine. While managing side effects is important in patient care, metoprolol does not have a notable effect on gastrointestinal motility to address constipation.

Choice B reason: Reducing flushing is not the main purpose of metoprolol. Flushing can sometimes be a side effect of vasodilatory medications, but it is not the specific reason for adding a beta-blocker like metoprolol to a treatment regimen involving a calcium channel blocker like nifedipine.

Choice C reason: Minimizing gingival hyperplasia is not the intended effect of metoprolol. Gingival hyperplasia can be a side effect of certain medications, such as calcium channel blockers like nifedipine, but metoprolol does not specifically counteract this effect.

Choice D reason: Preventing reflex tachycardia is the primary reason for prescribing metoprolol alongside nifedipine. Nifedipine, a calcium channel blocker, can cause vasodilation, which may lead to a reflex increase in heart rate (tachycardia) as the body tries to maintain blood pressure. Metoprolol, a beta-blocker, helps prevent this reflex tachycardia by slowing the heart rate and reducing the workload on the heart, thus complementing the antihypertensive effect of nifedipine.

A. Risk for infection B. Need for sunblock C. Need for an eye examination D. Risk for developing esophagitis

Correct Answer is A

Explanation

Choice A reason: Methotrexate is an immunosuppressive drug commonly used to treat rheumatoid arthritis. One of the most important topics to address when teaching a patient about methotrexate is the risk for infection. Methotrexate can suppress the immune system, making patients more susceptible to infections. Patients should be educated on the signs and symptoms of infection, the importance of maintaining good hygiene, avoiding contact with sick individuals, and reporting any signs of infection to their healthcare provider promptly. This helps in early detection and management of infections, which can be severe in immunocompromised patients.

Choice B reason: The need for sunblock is important for patients taking certain medications that cause photosensitivity, but methotrexate is not typically associated with a high risk of photosensitivity. While sun protection is generally advisable, it is not the most critical teaching point for methotrexate.

Choice C reason: The need for an eye examination is crucial for patients taking medications like hydroxychloroquine, which can affect the eyes. However, methotrexate does not commonly require routine eye examinations, making this a lower priority in patient education.

Choice D reason: The risk for developing esophagitis is more relevant for patients taking medications that can cause irritation or damage to the esophagus, such as bisphosphonates. While methotrexate can cause gastrointestinal side effects, esophagitis is not a primary concern, making this less critical compared to the risk of infection.

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A patient presents with severe chest pain and shortness of breath and is diagnosed with pulmonary embolism. The embolism most likely originated from the:

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Naxlex Comprehensive Predictor Exams

A patient begins taking the calcium channel blocker, nifedipine [Procardia], along with metoprolol, to treat hypertension. The nurse understands that metoprolol is used to:

Correct Answer is D

Explanation

The nurse provides teaching about methotrexate to a client with rheumatoid arthritis. It is most important to address which topic regarding this drug?

Correct Answer is A

Explanation

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