Progressive Care Nursing Certification (PCCN) Practice Exam

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A patient recently underwent gastric bypass surgery and reports shortness of breath and chest pain. What is the likely cause?

  1. Pulmonary embolism

  2. Anastomotic leak

  3. NSTEMI

  4. Cardiac tamponade

The correct answer is: Pulmonary embolism

The likely cause of the patient's shortness of breath and chest pain after gastric bypass surgery is a pulmonary embolism. This condition occurs when a blood clot travels to the lungs, blocking a pulmonary artery, which can lead to significant respiratory distress and chest pain. Patients who undergo surgical procedures, particularly abdominal surgeries like gastric bypass, are at increased risk for venous thromboembolism due to factors such as immobility during recovery, dehydration, and potential changes in blood flow. In the context of recent surgery, the signs of shortness of breath and chest pain raise concerns for this serious complication, which requires immediate evaluation and intervention to prevent further complications and ensure the safety of the patient. Although other conditions like an anastomotic leak, NSTEMI, and cardiac tamponade could also present with similar symptoms, they are less likely based on the immediate post-operative timeframe and the specific symptoms described. For instance, an anastomotic leak typically presents with abdominal pain and can include gastrointestinal symptoms, which are not indicated here. NSTEMI usually arises from cardiac ischemia and may have different risk factors and symptoms, while cardiac tamponade would generally involve additional signs of hemodynamic instability or muffled heart sounds.