How DVT and PE are tested on the NCLEX-RN
Items cover Reduction of Risk Potential (post-op prevention) and Physiological Adaptation (emergency response).
Recognize cues: DVT and PE
A DVT can travel to the lungs as a PE.
| Test | Purpose |
|---|---|
| Duplex ultrasound | Confirms DVT |
| D-dimer | A normal result helps rule out clot in low-risk clients; a high result is nonspecific |
| CT pulmonary angiography | Confirms PE |
| ABG | Often shows hypoxemia and respiratory alkalosis from rapid breathing |
The provider uses risk scores to choose tests.
Take action: suspected PE
Act on breathing and circulation first.
Treatment and prevention
Anticoagulants prevent clot growth; the body breaks down the existing clot over time.
| Intervention | Nursing point |
|---|---|
| Heparin or enoxaparin | Monitor aPTT or anti-Xa as ordered, platelets, bleeding |
| Warfarin or DOAC (long-term) | INR for warfarin; adherence and bleeding teaching |
| SCDs | Apply to legs without known DVT; remove only briefly |
| Early ambulation and leg exercises | Foot pumps and ankle circles every hour while awake |
| Hydration | Prevents hemoconcentration |
| Travel teaching | Walk and stretch every 1–2 hours; avoid tight clothing |
Activity orders after a new DVT follow the provider's plan; early walking is usually allowed once anticoagulation starts.
NGN-style case
Post-op prioritization is common.
functions Clinical judgment case — post-op day 3
A client on post-op day 3 after hip replacement suddenly reports sharp chest pain and shortness of breath. HR 122, RR 30, SpO₂ 87%. What is the nurse's first action?
- Recognize cues: sudden dyspnea, pleuritic pain, tachycardia, hypoxemia after orthopedic surgery.
- Analyze: likely pulmonary embolism.
- Stay with the client, raise the head of the bed, and apply oxygen.
- Call the rapid response team and prepare for diagnostic testing and anticoagulation.
Answer. Raise the head of the bed and give oxygen while calling for help; this is a likely PE.