Venous thromboembolic events

Question 1

A patient presents to the emergency department with leg pain in the left more than the right. The left calf is warm to touch. Their vital signs are as follows: HR 103, BP 127/86, O2 95% on RA. What is your initial recommendation?
A. Chest CT angiogram
B. Lower extremity ultrasound
C. Lower extremity CT scan
D. Chest radiography

Answer 1

B. Lower extremity ultrasound

Rationale:
The patient’s unilateral leg pain, warmth, and possible swelling, along with tachycardia (HR 103), are concerning for deep vein thrombosis (DVT). The initial diagnostic test of choice for suspected DVT is a lower extremity venous ultrasound with Doppler to assess for venous thrombosis and obstruction.

Question 2

In a massive pulmonary embolism, which complication leads to rapid hemodynamic collapse?
A. Left atrial dilation
B. Right ventricular failure and shock
C. Chronic mild dyspnea
D. Intermittent palpitations

Answer 2

B. Right ventricular failure and shock

Rationale:
A massive pulmonary embolism (PE) causes acute right ventricular (RV) failure, leading to hemodynamic collapse due to increased pulmonary vascular resistance. The RV cannot effectively pump blood into the lungs, resulting in decreased cardiac output, systemic hypotension, and shock. This can rapidly progress to cardiac arrest if not treated immediately.

Question 3

Which test is typically elevated in suspected acute VTE, aiding in deciding whether imaging is needed?
A. Hemoglobin
B. D-dimer
C. CK-MB
D. Lipase

Answer 3

B. D-dimer

Rationale:
D-dimer is a fibrin degradation product that is elevated in acute venous thromboembolism (VTE) due to clot breakdown. It is highly sensitive but not specific, meaning that while a normal D-dimer can rule out VTE in low-risk patients, an elevated D-dimer does not confirm VTE and requires further imaging (e.g., venous ultrasound for DVT or CT pulmonary angiography for PE)

Question 4

2. Which condition is most commonly associated with a prothrombotic state leading to VTE?
   A. Hyperthyroidism
   B. Factor V Leiden mutation
   C. Hypotension
   D. Iron deficiency anemia

Answer 4

o Answer: B
o Rationale: Inherited thrombophilias such as Factor V Leiden mutation increase the risk of VTE by promoting a hypercoagulable state.

Question 5

4. What is the approximate annual number of deaths related to pulmonary embolism in the United States?
   A. 10,000–20,000
   B. 30,000–50,000
   C. 100,000–180,000
   D. Over 300,000

Answer 5

o Answer: C
o Rationale: Pulmonary embolism is responsible for approximately 100,000–180,000 deaths per year in the United States.

Question 5

3. Which of the following is a common modifiable risk factor for VTE?
   A. Genetic predisposition
   B. Immobilization
   C. Gender
   D. Age over 80

Answer 5

o Answer: B
o Rationale: Immobilization (e.g., after surgery or during long flights) is a modifiable risk factor that promotes venous stasis.

Question 6

5. Which of the following is a key clinical feature of deep vein thrombosis (DVT) in the lower extremity?
   A. Intermittent claudication
   B. Calf swelling, tenderness, and redness
   C. Chronic leg fatigue without pain
   D. Persistent fever with rash

Answer 6

Answer: B
o Rationale: DVT in the leg typically presents with unilateral swelling, tenderness, and erythema.

Question 7

7. Which laboratory test is most sensitive for detecting VTE but lacks specificity?
   A. Troponin
   B. D-dimer assay
   C. C-reactive protein
   D. Prothrombin time

Answer 7

o Answer: B
o Rationale: The D-dimer test is very sensitive for fibrin degradation products but is nonspecific, as it can be elevated in many conditions.

Question 8

6. A patient with DVT is at risk for developing which life‐threatening complication?
   A. Myocardial infarction
   B. Pulmonary embolism
   C. Stroke
   D. Aortic dissection

Answer 8

o Answer: B
o Rationale: Clot fragments can embolize from the deep veins to the lungs, causing pulmonary embolism—a potentially fatal event.

Question 9

8. In the diagnostic workup of suspected pulmonary embolism (PE), which imaging modality is considered first-line?
   A. Ventilation–perfusion (V/Q) scan
   B. Chest X-ray
   C. CT pulmonary angiography (CTPA)
   D. MRI of the chest.

Answer 9

o Answer: C
o Rationale: CT pulmonary angiography is the imaging modality of choice for diagnosing PE in most patients

Question 10

9. A normal D-dimer test in a patient with low clinical probability effectively:
   A. Confirms VTE
   B. Rules out VTE
   C. Indicates a need for immediate anticoagulation
   D. Suggests the presence of a thrombus

Answer 10

o Answer: B
o Rationale: In patients with low pretest probability, a normal D-dimer can rule out VTE and avoid further imaging.

Question 11

10. Which clinical decision rule is commonly used to assess the probability of PE?
    A. CHADS2 score
    B. Wells criteria
    C. TIMI score
    D. Glasgow Coma Scale

Answer 11

o Answer: B
o Rationale: The Wells criteria are widely used to assess pretest probability for pulmonary embolism.

Question 12

11. Which of the following signs on physical examination is a “red flag” for acute limb ischemia due to DVT complications?
    A. Mild calf tenderness
    B. Sudden loss of distal pulses
    C. Gradual onset of leg cramping
    D. Bilateral ankle edema

Answer 12

o Answer: B
o Rationale: Sudden loss of pulses suggests acute arterial occlusion from an embolus, a life-threatening scenario

Question 13

12. In patients with suspected VTE, what does the presence of a patent foramen ovale (PFO) imply?
    A. Reduced risk of embolization
    B. Potential for paradoxical embolism
    C. No clinical significance
    D. Increased risk for DVT only

Answer 13

o Answer: B
o Rationale: A PFO can allow a venous thrombus to bypass the pulmonary circulation and cause systemic emboli (paradoxical embolism).

Question 14

13. Which risk factor is common to both VTE and atherosclerotic cardiovascular disease?
    A. Hypercoagulability due to Factor V Leiden
    B. Inflammation from conditions like rheumatoid arthritis
    C. Chronic obstructive pulmonary disease
    D. Anemia

Answer 14

o Answer: B
o Rationale: Systemic inflammation contributes to both atherosclerosis and hypercoagulability, increasing the risk of VTE and cardiovascular events.

Question 15

16. Which of the following treatments is considered first-line for acute DVT?
    A. Thrombolytic therapy
    B. Anticoagulation with low-molecular-weight heparin (LMWH)
    C. Immediate surgical thrombectomy
    D. High-dose aspirin alone

Answer 15

o Answer: B
o Rationale: Anticoagulation with LMWH is the standard initial treatment for DVT to prevent clot propagation and embolization.

Question 15

14. Massive pulmonary embolism is defined by which of the following features?
    A. Minimal symptoms and normal hemodynamics
    B. Hemodynamic instability, including systemic hypotension
    C. Only imaging findings without clinical signs
    D. Mild dyspnea with tachycardia

Answer 15

o Answer: B
o Rationale: Massive PE is characterized by hemodynamic instability, such as hypotension and shock, and is life-threatening.

Question 16

15. A “submassive” pulmonary embolism is characterized by:
    A. Normal right ventricular function
    B. Right ventricular dysfunction despite normal blood pressure
    C. Severe hypotension and cardiogenic shock
    D. Complete resolution of symptoms

Answer 16

o Answer: B
o Rationale: Submassive PE involves right ventricular dysfunction without systemic hypotension, but patients remain at risk for deterioration.

Question 17

17. In patients with contraindications to anticoagulation, what prophylactic measure may be used to prevent PE?
    A. High-dose statins
    B. Inferior vena cava (IVC) filter placement
    C. Beta-blocker therapy
    D. Compression stockings only

Answer 17

o Answer: B
o Rationale: IVC filters are indicated when anticoagulation is contraindicated to prevent thrombus migration to the pulmonary circulation.

Question 18

18. Which of the following represents an iatrogenic harm (“what will harm your patient”) in VTE management?
    A. Appropriate use of anticoagulation
    B. Under-dosing of heparin resulting in subtherapeutic anticoagulation
    C. Early mobilization
    D. Use of compression devices in high-risk patients

Answer 18

o Answer: B
o Rationale: Under-dosing heparin may fail to prevent clot propagation, leading to further embolization and harm.

Question 19

19. What is the main goal of initial management in patients with massive pulmonary embolism?
    A. Rapidly reduce blood pressure
    B. Restore pulmonary blood flow and support hemodynamics
    C. Lower cholesterol levels
    D. Increase heart rate

Answer 19

o Answer: B
o Rationale: In massive PE, the priority is to rapidly restore blood flow (often via thrombolysis or embolectomy) and stabilize the patient hemodynamically.

Question 20

20. Which thrombolytic agent is commonly used in the treatment of massive pulmonary embolism?
    A. Streptokinase
    B. Alteplase
    C. Tenecteplase
    D. Both B and C

Answer 20

o Answer: D
o Rationale: Both alteplase and tenecteplase are used as thrombolytic agents in massive PE to dissolve clots quickly.

Question 21

21. In the setting of VTE, what does an elevated D-dimer level indicate?
    A. Specific localization of a clot
    B. Active clot formation and breakdown
    C. Normal physiology
    D. A false-negative result

Answer 21

o Answer: B
o Rationale: Elevated D-dimer levels indicate fibrinolysis (clot breakdown) but do not specify the clot’s location.

Question 22

22. Which clinical presentation is most common (“what is really common”) in low-risk pulmonary embolism?
    A. Sudden collapse and shock
    B. Mild dyspnea with chest discomfort
    C. Syncope and cyanosis
    D. Severe hypotension

Answer 22

o Answer: B
o Rationale: Most PEs (65%–75%) are low risk and present with mild symptoms like dyspnea and chest discomfort.

Question 23

23. What is the typical role of cardiac biomarkers in the evaluation of pulmonary embolism? A. To diagnose myocardial infarction exclusively B. To assess right ventricular strain/dysfunction in PE C. To measure left ventricular ejection fraction D. To guide anticoagulation dosage

Answer 23

o Answer: B o Rationale: Elevated cardiac biomarkers (troponin, BNP) in PE suggest right ventricular strain and can help risk stratify patients.

Question 24

24. Which imaging study is considered the gold standard for diagnosing DVT in the extremities? A. Venous ultrasound B. CT angiography C. MRI D. X-ray

Answer 24

o Answer: A o Rationale: Venous ultrasound is the first-line, noninvasive diagnostic tool for detecting DVT.

Question 25

25. A patient with suspected PE and high clinical probability should proceed directly to which test? A. D-dimer assay B. CT pulmonary angiography C. V/Q scan D. Plain chest X-ray

Answer 25

o Answer: B o Rationale: In patients with high pretest

Question 26

26. Which of the following is a major complication (“what will kill your patient”) of untreated or suboptimally treated PE? A. Chronic cough B. Right ventricular failure and cardiogenic shock C. Mild tachypnea D. Low-grade fever

Answer 26

Answer: B o Rationale: Untreated PE can lead to severe right ventricular overload, resulting in shock and death.

Question 27

27. Which patient population is at an increased risk for VTE due to an underlying inflammatory condition? A. Patients with osteoarthritis B. Patients with inflammatory bowel disease C. Patients with seasonal allergies D. Patients with tension headaches

Answer 27

o Answer: B o Rationale: Inflammatory bowel disease is associated with increased inflammation and hypercoagulability, raising VTE risk.

Question 28

28. Why is obesity a risk factor for venous thromboembolic events? A. It directly damages the endothelial lining B. It promotes venous stasis and systemic inflammation C. It increases platelet production exclusively D. It has no impact on VTE risk

Answer 28

o Answer: B o Rationale: Obesity contributes to venous stasis, systemic inflammation, and hypercoagulability, all of which predispose to VTE.

Question 29

29. In VTE management, which type of anticoagulant is now generally preferred for long-term therapy? A. Unfractionated heparin B. Vitamin K antagonists (warfarin) C. Direct oral anticoagulants (DOACs) D. Antiplatelet agents alone

Answer 29

o Answer: C o Rationale: DOACs (e.g., rivaroxaban, apixaban) are often preferred over warfarin due to ease of use, fewer monitoring requirements, and similar efficacy.

Question 30

30. In the acute setting of VTE, which parenteral agent may be used as a bridge to long-term oral anticoagulation? A. Low-molecular-weight heparin (LMWH) B. Oral aspirin C. Clopidogrel D. Statins

Answer 30

o Answer: A o Rationale: LMWH is commonly used initially while transitioning patients to long-term oral anticoagulation.

Question 31

31. What is a potential iatrogenic harm (“what will harm your patient”) when managing VTE? A. Over-anticoagulation leading to bleeding complications B. Early mobilization C. Use of compression stockings D. Routine D-dimer testing

Answer 31

o Answer: A o Rationale: Excessive anticoagulation increases bleeding risk and can harm the patient if not carefully managed.

Question 32

32. Which of the following clinical signs is common (“what is really common”) in patients with DVT? A. Bilateral leg edema B. Unilateral leg swelling and pain C. Bilateral calf cramps during sleep D. Cold intolerance in the extremities

Answer 32

o Answer: B o Rationale: Unilateral leg swelling and pain are classic presentations of DVT.

Question 33

33. What role does an inferior vena cava (IVC) filter play in the management of VTE? A. It dissolves clots in the deep veins B. It prevents clots from traveling to the lungs C. It is used as first-line therapy for DVT D. It reduces the need for anticoagulation

Answer 33

o Answer: B o Rationale: IVC filters act as a mechanical barrier to prevent embolization of clots from the lower extremities to the pulmonary circulation.

Question 34

34. Which imaging modality is especially useful in patients with contraindications to CT contrast for diagnosing PE? A. Ventilation–perfusion (V/Q) scan B. Chest X-ray C. PET scan D. Echocardiogram

Answer 34

o Answer: A o Rationale: A V/Q scan is an alternative imaging modality for diagnosing PE when contrast CT is contraindicated.

Question 35

35. Which of the following best describes ventilation–perfusion mismatch in the setting of PE? A. Decreased ventilation and increased perfusion B. Increased ventilation with decreased perfusion in affected lung segments C. Uniform ventilation and perfusion throughout the lung D. Increased perfusion in areas with normal ventilation

Answer 35

o Answer: B o Rationale: PE causes obstruction of blood flow, resulting in areas with normal ventilation but reduced perfusion, creating a V/Q mismatch.

Question 36

36. Which of the following best describes the mechanism of hypoxemia in pulmonary embolism? A. Pure ventilation failure B. Shunting and increased physiologic dead space C. Primary alveolar hypoventilation D. Diffusion limitation only

Answer 36

o Answer: B o Rationale: PE leads to increased dead space and shunting (due to ventilation-perfusion mismatch), resulting in hypoxemia.

Question 37

37. In patients with suspected VTE, which factor would prompt you to skip D-dimer testing and proceed directly to imaging? A. Low Wells score B. High clinical probability based on risk factors and symptoms C. Recent surgery D. History of asthma

Answer 37

o Answer: B o Rationale: In patients with a high pretest probability for VTE, imaging is indicated without D-dimer testing.

Question 38

38. What is the significance of an elevated alveolar–arterial (A–a) gradient in the context of PE? A. It confirms the diagnosis of DVT B. It indicates impaired gas exchange due to vascular obstruction C. It is specific for heart failure D. It rules out pulmonary embolism

Answer 38

o Answer: B o Rationale: An elevated A–a gradient reflects impaired oxygen exchange, which is common in PE due to ventilation-perfusion mismatch

Question 39

39. Which patient group is at higher risk for VTE due to malignancy? A. Patients with skin cancer only B. Patients with active or advanced cancer C. Patients with benign tumors D. Patients with no history of cancer

Answer 39

o Answer: B o Rationale: Active or advanced malignancy is a well-known risk factor for VTE because of tumor-related procoagulant factors.

Question 40

40. What is the most common long-term complication of VTE if not properly managed? A. Chronic venous insufficiency and post-thrombotic syndrome B. Immediate myocardial infarction C. Pulmonary fibrosis D. Acute renal failure

Answer 40

o Answer: A o Rationale: Post-thrombotic syndrome and chronic venous insufficiency are common long-term sequelae of untreated or inadequately managed VTE.

Question 41

41. Which of the following statements is true regarding the relationship between VTE and cardiovascular disease? A. VTE decreases the risk of myocardial infarction B. Patients with VTE have an increased risk of subsequent cardiovascular events C. VTE is unrelated to systemic atherosclerosis D. Only arterial thrombosis is linked with cardiovascular risk

Answer 41

o Answer: B o Rationale: VTE is associated with an increased risk of cardiovascular events, possibly due to shared inflammatory and prothrombotic pathways.

Question 42

42. Which of the following is a common precipitating factor for VTE in hospitalized patients? A. Prolonged immobilization B. Excessive fluid intake C. High levels of physical activity D. Routine antibiotic use

Answer 42

o Answer: A o Rationale: Immobilization is a major precipitant of VTE in hospitalized patients, as it promotes venous stasis.

Question 43

43. What is a key component in the nonpharmacologic prevention of VTE in hospitalized patients? A. Early ambulation and intermittent pneumatic compression devices B. Complete bed rest C. High-dose vitamin C supplementation D. Prolonged use of sedatives

Answer 43

o Answer: A o Rationale: Early mobilization and mechanical prophylaxis (compression devices) reduce venous stasis and lower VTE risk.

Question 44

44. When evaluating a patient for PE, which physical finding might indicate right ventricular strain? A. Clear lung fields on auscultation B. Elevated jugular venous pressure and a loud P2 component C. Bradycardia with regular rhythm D. Normal blood pressure

Answer 44

o Answer: B o Rationale: Signs of right ventricular strain, such as elevated JVP and a loud P2, suggest increased pulmonary pressures from PE.

Question 45

45. Which of the following best describes a “massive” pulmonary embolism? A. PE with normal blood pressure and minimal symptoms B. PE associated with hemodynamic instability, including hypotension and shock C. PE confined to segmental arteries with no RV dysfunction D. PE that is asymptomatic on presentation

Answer 45

o Answer: B o Rationale: Massive PE is defined by hemodynamic instability (e.g., hypotension, shock) and poses an immediate threat to life.

Question 46

46. What is the primary goal of initial therapy in a patient with acute VTE? A. To reverse the thrombus completely within minutes B. To prevent clot propagation and embolization C. To increase the patient’s heart rate D. To induce hypercoagulability for wound healing

Answer 46

o Answer: B o Rationale: The immediate therapeutic goal is to prevent further clot extension and embolization through anticoagulation.

Question 47

47. Which of the following complications (“what will harm your patient”) may result from inappropriate anticoagulant dosing? A. Reduced risk of bleeding B. Over-anticoagulation causing hemorrhage or under-anticoagulation causing recurrent thrombosis C. Improved clot stability D. Enhanced exercise tolerance

Answer 47

o Answer: B o Rationale: Incorrect dosing can lead to bleeding complications if over-anticoagulated or recurrent VTE if under-anticoagulated.

Question 48

48. In patients with VTE, why might cardiac biomarkers be elevated? A. Due to direct myocardial infarction B. Secondary to right ventricular strain from pulmonary embolism C. Because of systemic infection only D. They are not typically elevated in VTE

Answer 48

o Answer: B o Rationale: Cardiac biomarkers (e.g., troponin, BNP) may rise due to right ventricular strain caused by increased pulmonary arterial pressures in PE.

Question 49

49. Which of the following is a common pitfall in the transition of care for patients with VTE? A. Timely follow-up with outpatient anticoagulation monitoring B. Inadequate patient education about medication adherence and warning signs C. Early mobilization in the hospital D. Routine D-dimer testing after discharge

Answer 49

o Answer: B o Rationale: Poor patient education and inadequate follow-up can lead to nonadherence, increasing the risk of recurrence and complications.

Question 50

50. Which statement best summarizes the critical management principles for venous thromboembolic events? A. Rapid diagnosis using clinical probability and imaging, prompt initiation of appropriate anticoagulation (or thrombolysis in massive PE), and aggressive risk factor modification and follow-up B. Sole reliance on D-dimer testing for diagnosis C. Immediate surgical intervention for all patients D. Avoidance of all physical activity indefinitely .

Answer 50

o Answer: A o Rationale: Effective VTE management includes timely diagnosis, risk stratification, initiation of anticoagulation (or thrombolysis in high-risk cases), and addressing underlying risk factors with proper follow-up

Question 51

1. Which inherited thrombophilia is most commonly associated with VTE? A. Protein C deficiency B. Antithrombin deficiency C. Factor V Leiden mutation D. Lupus anticoagulant

Answer 51

o Answer: C o Rationale: Factor V Leiden is the most common inherited thrombophilia and is frequently associated with VTE.

Question 52

2. In a patient with suspected pulmonary embolism and moderate clinical probability, which step should be taken next? A. Directly perform a CT pulmonary angiography B. Order a D-dimer assay and proceed based on the result C. Immediately start thrombolytic therapy D. Schedule an echocardiogram

Answer 52

o Answer: B o Rationale: In moderate-risk patients, a D-dimer test is used to help rule out PE. A negative result can avoid unnecessary imaging.

Question 53

3. What is the main reason for increased VTE risk in patients with cancer? A. Increased physical activity B. Tumor cells releasing procoagulant factors C. Decreased body weight D. Enhanced immune surveillance

Answer 53

o Answer: B o Rationale: Cancer cells secrete substances that promote coagulation, significantly increasing the risk of VTE.

Question 54

4. Which clinical feature is most indicative of a submassive PE? A. Severe hypotension B. Right ventricular dysfunction on imaging without systemic hypotension C. Normal cardiac biomarkers D. Absence of dyspnea

Answer 54

o Answer: B o Rationale: Submassive PE is characterized by RV dysfunction (e.g., on echocardiogram) without overt hemodynamic collapse.

Question 55

5. What is the most common long-term complication after an episode of DVT? A. Recurrent myocardial infarction B. Post-thrombotic syndrome C. Stroke D. Aortic aneurysm

Answer 55

o Answer: B o Rationale: Post-thrombotic syndrome, including chronic leg pain, swelling, and skin changes, is a common sequelae of DVT.

Question 56

6. For patients with VTE, which direct oral anticoagulant (DOAC) is typically initiated without a heparin bridge? A. Dabigatran B. Rivaroxaban C. Edoxaban D. Warfarin

Answer 56

o Answer: B o Rationale: Rivaroxaban can generally be started without initial heparin bridging, unlike dabigatran or edoxaban.

Question 57

7. Which of the following best explains the mechanism behind the elevated A–a gradient in pulmonary embolism? A. Increased ventilation leading to hyperoxia B. Impaired pulmonary blood flow causing ventilation-perfusion mismatch C. Enhanced diffusion capacity of the alveoli D. Reduced oxygen consumption in peripheral tissues.

Answer 57

o Answer: B o Rationale: PE causes a ventilation-perfusion mismatch, leading to an elevated A–a gradient due to impaired oxygen transfer

Question 58

8. Which of the following is a common pitfall (“what will harm your patient”) in the management of PE? A. Over-reliance on clinical decision rules without confirming imaging B. Use of direct oral anticoagulants when contraindicated C. Routine use of compression stockings D. Early mobilization in stable patients

Answer 58

o Answer: A o Rationale: Sole reliance on clinical decision rules without confirmatory imaging can lead to misdiagnosis or missed PE, thereby harming the patient.

Question 59

9. Which risk factor is considered non-modifiable for VTE? A. Smoking B. Obesity C. Age D. Immobility

Answer 59

o Answer: C o Rationale: Age is non-modifiable; however, smoking, obesity, and immobility are modifiable risk factors.

Question 60

10. What is the primary therapeutic mechanism of low-molecular-weight heparin (LMWH) in VTE management? A. Inhibiting vitamin K-dependent clotting factors B. Activating antithrombin, thereby inhibiting factor Xa C. Directly dissolving clots D. Blocking platelet aggregation

Answer 60

o Answer: B o Rationale: LMWH primarily works by activating antithrombin, which then inhibits factor Xa (and to a lesser extent, thrombin).

Question 61

11. In patients with submassive PE, which additional therapy might be considered if there is evidence of worsening right ventricular function? A. High-dose aspirin B. Catheter-directed thrombolysis C. Routine use of beta-blockers D. Insertion of an IVC filter

Answer 61

o Answer: B o Rationale: In submassive PE with worsening RV dysfunction, catheter-directed thrombolysis may be indicated to improve outcomes.

Question 62

12. Which clinical sign is most indicative of right ventricular strain in the setting of PE? A. Bradycardia B. Elevated jugular venous pressure C. Warm extremities D. Clear lung auscultation.

Answer 62

o Answer: B o Rationale: Elevated jugular venous pressure suggests increased RV pressures and strain from a PE

Question 63

13. A patient with a history of recent surgery and prolonged immobilization presents with sudden dyspnea and pleuritic chest pain. Which is the most likely diagnosis? A. Pneumonia B. Pulmonary embolism C. Asthma exacerbation D. Chronic obstructive pulmonary disease

Answer 63

o Answer: B o Rationale: The history of recent surgery and immobility, along with sudden dyspnea and chest pain, is highly suggestive of a PE.

Question 64

14. What is the role of intermittent pneumatic compression devices in VTE prevention? A. They dissolve existing clots B. They reduce venous stasis by enhancing blood flow in the lower extremities C. They increase coagulation factors D. They serve as an alternative to thrombolytic therapy

Answer 64

o Answer: B o Rationale: Pneumatic compression devices help prevent VTE by mechanically promoting venous return and reducing stasis.

Question 65

15. Which of the following best summarizes the importance of early mobilization in hospitalized patients at risk for VTE? A. It improves muscle strength but has no effect on clot prevention B. It reduces venous stasis and helps lower the risk of clot formation C. It is contraindicated in patients with a high risk of bleeding D. It only benefits patients with chronic venous insufficiency o Answer: B o Rationale: Early mobilization is crucial in reducing venous stasis, thereby decreasing the risk of VTE in hospitalized patients.

Answer 65

o Answer: B o Rationale: Early mobilization is crucial in reducing venous stasis, thereby decreasing the risk of VTE in hospitalized patients.