A patient is recounting her experience with a pulmonary embolism. Which of the following is the nurse most likely to hear from the patient?
“I immediately stopped breathing and passed out.”
“I was surprised to be diagnosed with a pulmonary embolism, because I had no signs or symptoms.”
“I knew I had an increased chance for pulmonary embolism, because I take anticoagulants.”
“I know pulmonary embolisms are not serious, so I knew I did not have to worry.”
The correct answer and explanation is :
Correct Answer: “I was surprised to be diagnosed with a pulmonary embolism, because I had no signs or symptoms.”
Explanation:
A pulmonary embolism (PE) is a serious and potentially life-threatening condition that occurs when one or more arteries in the lungs become blocked by a blood clot. These clots typically originate in the deep veins of the legs — a condition known as deep vein thrombosis (DVT) — and travel through the bloodstream to the lungs.
The correct answer reflects the fact that many patients with a PE may be asymptomatic or present with very subtle, nonspecific symptoms. It is not uncommon for individuals to be unaware they have a pulmonary embolism until imaging or diagnostic testing (such as a CT pulmonary angiogram or V/Q scan) reveals the condition. In some cases, a PE may be found incidentally during imaging for another issue.
The incorrect options reflect misunderstandings about PE:
- “I immediately stopped breathing and passed out.”
While severe PEs can cause sudden respiratory distress and even loss of consciousness, this is not the most common presentation. Many PEs are less dramatic and present with symptoms such as shortness of breath, chest pain, cough, or mild hypoxia. - “I knew I had an increased chance for pulmonary embolism, because I take anticoagulants.”
This is contradictory. Anticoagulants are prescribed to reduce the risk of clots and PE, not increase it. A patient on anticoagulants would generally be considered at lower risk for developing a new PE. - “I know pulmonary embolisms are not serious, so I knew I did not have to worry.”
This is incorrect and reflects a dangerous misunderstanding. Pulmonary embolism is a medical emergency and can be fatal, especially if not diagnosed and treated promptly.
Thus, many patients may be surprised by a PE diagnosis due to the subtle or absent symptoms, making this the most realistic statement.