A patient is kept off food and fluids for 10 hours before surgery. His oral temperature at 8 a.m. is 99.8°F (37.7°C). This temperature reading probably indicates:

Correct Answer: D

Rationale: A patient being kept off food and fluids before surgery can lead to dehydration. Dehydration can cause a slight increase in body temperature, which could explain the elevated oral temperature reading of 99.8°F (37.7°C) in this scenario. Infections are more likely to cause higher fevers, hypothermia would present with a lower temperature, and anxiety typically does not directly affect body temperature in this manner.

Correct Answer: D

Rationale: The axillary temperature of 99.6°F (37.6°C) is mildly elevated, as normal axillary temperature typically ranges from 97.6°F (36.4°C) to 98.1°F (36.7°C). While this alone may not always warrant immediate reporting, it becomes significant when paired with other abnormal findings. The respiratory rate of 30 breaths per minute is notably high, as the normal range for adults is 12–20 breaths per minute. Tachypnea (elevated respiratory rate) often indicates respiratory distress, infection, or metabolic disturbances, making it a critical finding that must be reported. The pulse rate of 88 falls within the normal range (60–100 beats per minute) and does not raise immediate concern. **Why D is correct:** Both the elevated temperature and the significantly increased respiratory rate are abnormal and clinically significant. Together, they suggest a potential underlying condition such as infection, sepsis, or respiratory compromise, necessitating prompt evaluation. Reporting these findings ensures timely intervention. **Why A is incorrect:** While the respiratory rate is abnormal and should be reported, ignoring the elevated temperature overlooks a key piece of clinical data. Fever can indicate infection or inflammation, and when combined with tachypnea, it strengthens the case for further assessment. **Why B is incorrect:** Reporting the temperature alone neglects the more urgent finding of tachypnea. A mildly elevated temperature without other symptoms may not always require immediate action, but the respiratory rate of 30 is a red flag that demands attention. **Why C is incorrect:** The pulse rate is normal and does not require reporting. While the temperature is slightly elevated, it is less concerning without additional abnormal findings. Pairing it with the normal pulse rate does not provide enough clinical significance to prioritize reporting over the respiratory rate. The combination of temperature and respiratory rate provides a clearer picture of potential physiological stress or pathology, making D the most appropriate choice for reporting. Ignoring either of these findings could delay diagnosis and treatment of a potentially serious condition.

Correct Answer: D

Rationale: Tachycardia is an increased heart rate, and it can be caused by various factors such as fever, exercise, and sympathetic nervous system stimulation, all of which tend to increase heart rate. However, parasympathetic nervous system stimulation typically slows the heart rate, making it the exception among the choices provided. Thus, parasympathetic nervous system stimulation is not a cause of tachycardia.

Correct Answer: D

Rationale: Palpating the midclavicular line is the correct technique for assessing the apical pulse. The apical pulse is located at the point of maximal impulse (PMI), which is typically at the fifth intercostal space at the midclavicular line. This technique allows healthcare providers to accurately assess the heart rate and rhythm by listening to the heart sounds directly at this point.

Correct Answer: C

Rationale: The absence of the pedal pulse may not be significant if the patient has poor peripheral circulation or if the healthcare provider is focused on other pulse points. The pedal pulse is often weaker and may not always be palpable due to various factors, making its absence less concerning in certain situations. However, the absence of other pulses like radial or femoral pulses may indicate more critical conditions and require immediate attention.