NCLEX Practice Test

Which client should the nurse call back first in an ambulatory surgery center?

1. Client who had a colonoscopy with polypectomy who reports abdominal cramping and a small amount of rectal bleeding

2. Client who had a lumbar laminectomy with spinal fusion 3 days ago who reports straining to have a bowel movement

3. Client who underwent laparoscopic inguinal hernia repair yesterday who reports difficulty urinating

4. Client who underwent placement of an arteriovenous graft who reports a temperature of 100.9 F (38.3 C)

The correct answer is: Client who had a colonoscopy with polypectomy who reports abdominal cramping and a small amount of rectal bleeding

The client who underwent placement of an arteriovenous graft and reports a temperature of 100.9 F (38.3 C) should be prioritized for a callback. This client may be exhibiting signs of an infection, as a fever can indicate an inflammatory or infectious process, especially following a surgical procedure related to vascular access. Prompt assessment and intervention are critical to prevent potential complications related to infection. In an ambulatory surgery center, this situation presents a more urgent concern than the other scenarios. While abdominal cramping and rectal bleeding after a colonoscopy with polypectomy can be common and might not require immediate attention, it is essential to monitor those symptoms closely after the procedure. Additionally, straining to have a bowel movement post-surgery could indicate constipation, which may require management but is not immediately life-threatening. Lastly, difficulty urinating after laparoscopic inguinal hernia repair may warrant attention and evaluation but is often seen within a reasonable range of postoperative discomfort. Therefore, the presence of a fever in the client with the arteriovenous graft necessitates faster intervention to rule out serious complications, making this client the priority for follow-up.