Progressive Care Nursing Certification (PCCN) Practice Exam

What condition should the nurse suspect in a patient who reports chest pain, hemoptysis, and severe shortness of breath after sustaining a pelvic fracture?

1. Tension pneumothorax

2. A pulmonary embolism

3. Post-intubation laryngeal edema

4. Respiratory failure

The correct answer is: A pulmonary embolism

The presence of chest pain, hemoptysis (coughing up blood), and severe shortness of breath in a patient who has sustained a pelvic fracture suggests a high likelihood of a pulmonary embolism. Pelvic fractures can lead to the release of fat globules or thrombi from the pelvic veins into the systemic circulation, which may travel to the lungs and obstruct pulmonary blood vessels. This obstruction can result in respiratory distress, chest pain, and the potential for hemoptysis due to damaged pulmonary vasculature. When evaluating these symptoms together, they strongly indicate a blockage of blood flow in the pulmonary arteries, which is characteristic of a pulmonary embolism. The risk factors associated with a pelvic fracture, combined with acute respiratory symptoms, align closely with the nature of this condition. Prompt recognition and management are crucial, as a pulmonary embolism can lead to significant morbidity and mortality if left untreated.