The nurse is assessing a client with possible pulmonary embolism (PE). What findings support this diagnosis? (Select all that apply.)

Choice A rationale Dizziness and syncope (fainting) are findings that support a diagnosis of pulmonary embolism (PE) because a large PE can severely obstruct pulmonary blood flow, causing a drop in cardiac output and systemic hypotension. This reduction in blood pressure and subsequent decreased cerebral perfusion can quickly lead to feelings of lightheadedness or a complete loss of consciousness, particularly in massive PE cases. Choice B rationale Shortness of breath (SOB) is a common symptom of pulmonary embolism, but the onset is typically sudden and acute, not worsening gradually over two weeks. PE is an acute obstruction of the pulmonary vasculature, which causes acute hypoxemia, tachypnea, and sudden dyspnea due to ventilation-perfusion mismatch and activation of J-receptors in the lung tissue. Choice C rationale Inspiratory chest pain, often described as pleuritic, is a finding consistent with pulmonary embolism. This sharp pain worsens with a deep breath and is caused by lung tissue ischemia and inflammation (infarction) near the pleural surface, which is innervated by sensory nerves, making it a key clinical presentation of PE. Choice D rationale A productive cough is generally associated with infections such as pneumonia or bronchitis. While a cough can occur with PE due to lung irritation, it is typically dry or may occasionally produce blood-tinged sputum due to pulmonary infarction, not the thick, purulent sputum that characterizes a productive cough. Choice E rationale Pink, frothy sputum is a classic sign of severe pulmonary edema, typically caused by acute decompensated heart failure due to high capillary hydrostatic pressure. While severe, large PE can lead to right heart strain, it does not commonly cause the left ventricular failure and high pulmonary capillary wedge pressure necessary to produce this specific type of foamy, blood-tinged sputum. Choice F rationale Tachycardia (a heart rate greater than 100 beats per minute) is a very common finding in pulmonary embolism. The heart rate increases as a compensatory mechanism to try and maintain cardiac output against the increased pulmonary vascular resistance and the resulting systemic hypotension and hypoxemia caused by the lodged clot. —.