Progressive Care Nursing Certification (PCCN) Practice Exam

A patient one day post-surgery is experiencing shortness of breath and a low-grade fever. What is the most likely diagnosis?

1. Atelectasis

2. Myocardial infarction

3. Pulmonary embolism

4. Pneumonitis

The correct answer is: Pulmonary embolism

In this scenario, the patient’s shortness of breath and low-grade fever, following surgery, suggest a significant respiratory concern. The most likely diagnosis is pulmonary embolism due to the increased risk of thromboembolic events in post-operative patients, especially those with reduced mobility or those who have had major surgeries. Pulmonary embolism can manifest with acute shortness of breath, chest pain, and sometimes fever. The symptom profile fits the context of recent surgery, as conditions leading to venous stasis (such as prolonged bed rest) can precipitate blood clots that travel to the pulmonary circulation. While atelectasis, myocardial infarction, and pneumonitis could also lead to respiratory symptoms, they typically present with different characteristics or timelines related to recent surgical procedures. Atelectasis is common after surgery, especially in the absence of deep breathing exercises, but it is less likely to present with fever. Myocardial infarction is generally characterized by chest pain and might not be directly related to the surgical procedure in terms of timing and symptoms. Pneumonitis can occur due to aspiration or exposure to irritants, but the acute development of shortness of breath and fever post-surgery lends more credence to the diagnosis of a pulmonary embol