# Two days after hip surgery, a client develops sudden dyspnea, pleuritic chest pain, oxygen saturation of 86%, and unilateral calf swelling. Complete the priority response. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=395573&lang=en > language: en > subject: Medical Emergencies > category: PA ## Question Two days after hip surgery, a client develops sudden dyspnea, pleuritic chest pain, oxygen saturation of 86%, and unilateral calf swelling. Complete the priority response. The nurse should recognize ::선택::routine postoperative atelectasis without further assessmentstable anemiapossible acute pulmonary embolismexpected incisional pain, first ::선택::massage the swollen calf and encourage walkingstop activity, remain with the client, apply oxygen, and activate urgent helpdelay reporting until the next scheduled roundplace the client unattended in the bathroom, and then ::선택::continue routine discharge teachingapply heat and repeatedly flex the swollen legwithhold monitoring until all symptoms resolveprepare for urgent diagnostic evaluation, hemodynamic monitoring, and prescribed anticoagulation. ## Explanation Sudden dyspnea, pleuritic pain, hypoxemia, and unilateral calf swelling after hip surgery suggest acute pulmonary embolism. Stop activity, support oxygenation, activate urgent evaluation, and prepare for diagnostic testing, hemodynamic monitoring, and prescribed anticoagulation without massaging or ambulating the affected leg. ## In-depth explanation Quick answer Recognize possible acute pulmonary embolism, stop activity and support oxygenation while activating urgent help, then prepare for rapid diagnostic and treatment evaluation. Why this is correct Hip surgery and immobility increase venous thromboembolism risk. The abrupt respiratory symptoms, hypoxemia, pleuritic pain, and unilateral calf swelling form a high-risk pattern rather than routine postoperative discomfort. Easy analogy or mental picture Think of a clot traveling from a swollen leg into the pulmonary circulation and suddenly blocking blood flow through part of the lungs. Memory hook Sudden breathlessness plus one swollen calf after surgery: oxygen, urgent help, no leg massage. NCLEX decision rule Stabilize airway and breathing while escalating the suspected time-sensitive cause. Prepare for urgent evaluation, monitoring, and prescribed anticoagulation; do not create additional embolization risk through massage or ambulation. Why the other choices are wrong Routine pain management, delayed reporting, calf massage, and hallway ambulation do not address severe hypoxemia and can postpone or worsen a suspected embolic emergency. Source 12026 AHA/ACC Multisociety Acute Pulmonary Embolism Guideline 2AHA Acute Pulmonary Embolism Guideline Summary 32026 NCLEX-RN Test Plan ## Clinical scenario The nurse stops the activity and remains with the client. Oxygen and emergency-response resources are available, and the client requires rapid assessment for an acute postoperative cardiopulmonary complication. ## Key concepts - **Pulmonary embolism** — Obstruction of pulmonary arterial blood flow, most often by a thrombus that traveled from a deep vein. - **Pleuritic chest pain** — Sharp chest pain that typically worsens with inspiration or coughing because the pleural surfaces are irritated. - **Venous thromboembolism** — The disease spectrum that includes deep vein thrombosis and pulmonary embolism. ## Related questions - [A nurse is caring for an alert adult client with type 1 diabetes who reports tremors, swea…](https://mymerci.kr/pages/nclex_q.php?qn_id=360524&lang=en) - [A 58-year-old client arrives at the emergency department with crushing substernal chest pa…](https://mymerci.kr/pages/nclex_q.php?qn_id=362976&lang=en) - [A 72-year-old client is brought to the emergency department by family who report that the …](https://mymerci.kr/pages/nclex_q.php?qn_id=363003&lang=en) - [A 79-year-old client is admitted from a long-term care facility with diarrhea, decreased o…](https://mymerci.kr/pages/nclex_q.php?qn_id=363089&lang=en) - [A 68-year-old client is admitted to the emergency department with suspected sepsis from a …](https://mymerci.kr/pages/nclex_q.php?qn_id=363987&lang=en) - [A nurse is caring for an adult client in the emergency department who is suspected to have…](https://mymerci.kr/pages/nclex_q.php?qn_id=363993&lang=en) - [A nurse is teaching a 72-year-old client with chronic heart failure (reduced ejection frac…](https://mymerci.kr/pages/nclex_q.php?qn_id=366202&lang=en) - [A nurse is caring for an adult client admitted with diabetic ketoacidosis. 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