NCLEX-RN Case Study: Deep Vein Thrombosis
(DVT) & Pulmonary Embolism (PE)
Client Scenario (Applies to all items): The nurse is caring for a 61-year-old female client in
the emergency department.
0615 Nurses' Notes: A 61-year-old client comes to the emergency department reporting
shortness of breath. She states that she had to stop and sit down while getting ready for work
this morning because she suddenly felt like she could not catch her breath. She denies any
cough, fever, palpitations, or lightheadedness. She denies any recent sick contacts but notes
that she recently injured her leg in a minor bicycle accident.
Item 1 of 6
Question: Click to highlight below the findings that require immediate follow-up by the
nurse.
Correct Selections:
Pulmonary: ✅ dyspnea; ✅fine crackles in bilateral bases; ✅sharp chest pain on
inspiration
Extremities: ✅ pitting lower extremity edema; ✅ "the pain and swelling are getting
worse"
Rationale: The client's clinical presentation is highly suspicious for a Deep Vein Thrombosis
(DVT) that has dislodged and caused a Pulmonary Embolism (PE). The unilateral pitting
edema and worsening pain/swelling in the lower extremity point to the DVT. The sudden
onset of dyspnea, crackles, and pleuritic (sharp) chest pain on inspiration are classic signs of
a PE, which is a life-threatening medical emergency requiring immediate intervention.
Findings like obesity, a history of hypertension, or being slightly anxious are notable but are
not the acute, life-threatening priorities.