Pulmonary Embolism and Deep-Vein Thrombosis Practice Questions
20 free Pulmonary Embolism and Deep-Vein Thrombosis practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
Which condition is most likely in a patient presenting with sudden onset dyspnea, pleuritic chest pain, tachycardia, and hypoxia?
- A Community-acquired pneumonia
- B Acute pericarditis
- C Pulmonary embolism
- D Acute asthma exacerbation
Correct answer: Pulmonary embolism
Sudden dyspnea, pleuritic chest pain, tachycardia, and hypoxia are classic signs of PE due to obstruction of pulmonary vessels.
Which of the following is a major risk factor for developing a DVT?
- A Engaging in regular aerobic exercise
- B Prolonged immobility such as long-haul travel or bed rest
- C Maintaining a consistently low body weight
- D Frequent daily ambulation and walking
Correct answer: Prolonged immobility such as long-haul travel or bed rest
Immobility contributes to venous stasis, one arm of Virchow’s triad, thereby increasing the risk of DVT.
What lab test is most useful for excluding DVT/PE when clinical probability is low?
- A Troponin
- B D-dimer
- C Creatinine kinase
- D Procalcitonin
Correct answer: D-dimer
A negative D-dimer in a low pre-test probability patient helps rule out venous thromboembolism.
Which clinical prediction tool helps stratify the probability of PE?
- A APGAR score
- B Wells score
- C MELD score
- D Glasgow Coma Scale
Correct answer: Wells score
The Wells score (and revised Geneva score) are validated tools to estimate the probability of PE and guide further testing.
In a patient with confirmed PE, the mainstay of treatment is:
- A Broad-spectrum antibiotic therapy
- B Anticoagulation therapy
- C High-dose intravenous corticosteroids
- D Inhaled bronchodilator therapy
Correct answer: Anticoagulation therapy
Anticoagulation (e.g., heparin or direct oral anticoagulants) is first-line in PE to prevent further clot extension and recurrence.
A patient with DVT complains of unilateral leg swelling, warmth, and pain. Which nursing assessment is most appropriate?
- A Auscultate the heart sounds and lung fields only
- B Measure circumference of both legs and check for pitting edema
- C Assess capillary refill in the fingertips bilaterally
- D Evaluate the patient’s grip strength and reflexes
Correct answer: Measure circumference of both legs and check for pitting edema
Limb measurement and assessment for edema are key in DVT evaluation to compare affected vs unaffected extremities.
Which of the following statements is true regarding PE prevention in at-risk hospitalized patients?
- A Early mobilization with compression devices reduces DVT/PE risk
- B Strict bed rest for at least 72 hours is preferred
- C Pharmacologic prophylaxis suffices without mechanical devices
- D Prophylaxis is started only once symptoms appear
Correct answer: Early mobilization with compression devices reduces DVT/PE risk
Early ambulation and mechanical prophylaxis (e.g., intermittent pneumatic compression) are important preventive strategies for DVT/PE.
Which hemodynamic change is expected in a massive pulmonary embolism?
- A Decreased pulmonary vascular resistance
- B Increased right ventricular afterload
- C Increased left ventricular output immediately
- D Decreased heart rate
Correct answer: Increased right ventricular afterload
A massive PE elevates pulmonary vascular resistance, increasing right ventricular afterload and potentially leading to RV failure.
A patient on therapeutic anticoagulation develops hematuria and drop in hemoglobin. What is the priority nursing action?
- A Continue anticoagulation at the same dose without change
- B Assess for a bleeding source and notify the provider promptly
- C Increase the anticoagulant dose to control symptoms
- D Prepare the patient for immediate discharge home
Correct answer: Assess for a bleeding source and notify the provider promptly
Bleeding is a serious complication of anticoagulation; prompt assessment and provider notification are required.
Which sign in a patient with DVT suggests increased risk for pulmonary embolism?
- A Calf pain present without any visible swelling
- B Isolated numbness limited to a single toe
- C Proximal femoral vein thrombosis seen on ultrasound
- D Intermittent mild twitching of the calf muscle
Correct answer: Proximal femoral vein thrombosis seen on ultrasound
Proximal DVTs (e.g., femoral vein) are more likely to embolize to the lung compared to distal clots.
A post-operative patient shows sudden hypotension, tachycardia, and hypoxia. You suspect PE. Which diagnostic test would be most appropriate next?
- A Abdominal ultrasound of the liver and kidneys
- B CT pulmonary angiography if renal function allows
- C A 12-lead electrocardiogram as the sole test
- D Comprehensive liver function blood tests
Correct answer: CT pulmonary angiography if renal function allows
CT pulmonary angiography is the gold standard imaging for diagnosing PE in suitable patients.
A patient with DVT is prescribed warfarin and asks when they should expect therapeutic effect. The nurse explains:
- A Unilateral lower-leg swelling
- B Localized calf tenderness and pain
- C Sudden dyspnea with pleuritic chest pain
- D General mild tiredness and malaise
Correct answer: Sudden dyspnea with pleuritic chest pain
Warfarin takes several days (usually ~5-7) to reach therapeutic INR; until then, bridging with heparin is often used.
Which clinical finding is more specific for PE rather than DVT alone?
- A Almost immediately, within about one hour of the first dose
- B After roughly 5–7 days once the INR becomes therapeutic
- C Only after taking it consistently for a full month
- D Within a few minutes, similar to intravenous heparin
Correct answer: After roughly 5–7 days once the INR becomes therapeutic
While DVT presents with leg signs, PE more typically presents with sudden respiratory distress and chest pain due to pulmonary artery obstruction.
Which of the following is a contraindication to thrombolytic therapy in PE?
- A Hemodynamically stable small PE
- B Recent intracranial hemorrhage
- C Age under 50
- D Recent surgery >30 days ago
Correct answer: Recent intracranial hemorrhage
Active or recent intracranial hemorrhage is a major contraindication to thrombolysis because of bleeding risk.
When educating a patient on long-term anticoagulation after DVT, the nurse should include which instruction?
- A Stop taking warfarin as soon as you start feeling better
- B Avoid all green leafy vegetables completely from your diet
- C Keep vitamin K intake consistent and monitor INR regularly
- D Routine follow-up blood tests are no longer necessary
Correct answer: Keep vitamin K intake consistent and monitor INR regularly
Warfarin’s effect is influenced by vitamin K intake; consistent diet and regular INR monitoring are key for safe therapy.
A patient on low-molecular-weight heparin (LMWH) for DVT asks why compression stockings are recommended. The nurse responds:
- A They are worn mainly for cosmetic appearance
- B They reduce venous stasis and help prevent further clots
- C They eliminate the need for any anticoagulant medication
- D They are intended to be worn only during the night
Correct answer: They reduce venous stasis and help prevent further clots
Graduated compression stockings increase venous return and reduce stasis, thus helping in DVT prevention and management.
Which electrocardiogram (EKG) change may be seen in acute PE?
- A ST-segment elevation confined to leads V1–V4
- B Marked sinus bradycardia with a junctional escape
- C S1Q3T3 pattern (S in lead I, Q and inverted T in lead III)
- D A new right bundle branch block from right heart strain
Correct answer: S1Q3T3 pattern (S in lead I, Q and inverted T in lead III)
The S1Q3T3 pattern is a classic but not always present EKG finding in acute PE indicating right heart strain.
In the nursing care plan for a patient with PE, one appropriate goal is:
- A Keep the patient on strict bed rest for seven days
- B Maintain oxygen saturation above 92% and prevent further thrombus
- C Permanently eliminate all forms of physical activity
- D Plan discharge before any anticoagulation teaching is given
Correct answer: Maintain oxygen saturation above 92% and prevent further thrombus
Goals include maintaining adequate oxygenation and preventing further clot extension or embolism through anticoagulation and mobility/supportive care.
A patient with PE complains of anxiety and chest tightness. The nurse recognizes that anxiety may exacerbate hypoxia because:
- A Anxiety actively improves oxygenation and gas exchange
- B Anxiety raises sympathetic tone and oxygen demand, worsening gas exchange
- C Anxiety exerts no measurable physiologic effect on the body
- D Anxiety lowers the heart rate while leaving breathing unchanged
Correct answer: Anxiety raises sympathetic tone and oxygen demand, worsening gas exchange
Anxiety raises sympathetic activity, increasing heart and respiratory rate and oxygen demand; in PE where oxygenation is already compromised, this can worsen hypoxia.
A patient with a recent DVT is undergoing surgery and anticoagulation needs to be paused. What intervention may be used to reduce PE risk during this period?
- A Stop all prophylaxis and permit continued immobility
- B Apply intermittent pneumatic compression or graduated stockings
- C Rely solely on a low daily dose of aspirin
- D Provide standard care, as no specific intervention is needed
Correct answer: Apply intermittent pneumatic compression or graduated stockings
When anticoagulation is interrupted for surgery, mechanical prophylaxis such as IPC devices helps prevent clot extension or embolism.