# A postoperative client is at increased risk for venous thromboembolism. For each cue or action, select the best classification. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=396186&lang=en > language: en > subject: Postsurgical Complications > category: ROR ## Question A postoperative client is at increased risk for venous thromboembolism. For each cue or action, select the best classification. | | VTE prevention now | Possible DVT requiring prompt evaluation | Possible PE requiring emergency escalation | | --- | --- | --- | --- | | Administer prescribed pharmacologic prophylaxis after confirming there is no new bleeding contraindication | | | | | Apply prescribed compression devices while in bed and mobilize with assistance as clinically appropriate | | | | | New unilateral calf swelling, warmth, and tenderness without chest symptoms | | | | | A 3-cm increase in one calf circumference with new localized pain after reduced mobility | | | | | Sudden dyspnea, pleuritic chest pain, tachycardia, and oxygen saturation of 86% | | | | | New syncope with hypotension and unexplained hypoxemia after reporting leg discomfort earlier | | | | ## Explanation Postoperative VTE prevention is individualized to clotting and bleeding risk and may include prescribed pharmacologic prophylaxis, mechanical prophylaxis, and mobility. New unilateral swelling, warmth, or tenderness suggests possible DVT and requires prompt evaluation without massaging the limb. Sudden dyspnea, pleuritic chest pain, tachycardia, hypoxemia, syncope, or hypotension can indicate PE and requires emergency escalation. ## In-depth explanation Correct Answer Two rows are prevention, two suggest DVT evaluation, and two indicate possible PE requiring emergency action. Why It Fits The cues progress from risk reduction to localized venous obstruction and then cardiopulmonary compromise. Clinical Picture DVT can be subtle and PE can occur despite prophylaxis. The nurse does not delay escalation while trying to prove the diagnosis independently. Memory Link Prevent in bed; evaluate one swollen leg; escalate sudden chest-breathing change. NCLEX Rule Match the response to the highest current instability and avoid manipulating a limb with suspected DVT. Why the Alternatives Fail Prophylaxis is not treatment for a new event. A leg-only cue does not by itself establish PE, while new hypoxemia or hypotension is more urgent than routine DVT workup. Sources 1ASH VTE Prevention in Hospitalized Surgical Patients 2CDC: About Blood Clots 32026 NCLEX-RN Test Plan ## Clinical scenario The client is on postoperative day 2 after major abdominal surgery with limited mobility. Pharmacologic prophylaxis and sequential compression devices are prescribed. New leg or cardiopulmonary findings require the nurse to distinguish prevention from suspected DVT or PE. ## Key concepts - **Venous thromboembolism** — The spectrum that includes deep vein thrombosis and pulmonary embolism. - **Sequential compression device** — A mechanical prophylaxis device that intermittently compresses the legs to support venous flow. ## Related questions - [A 24-year-old patient is brought to the ED with a generalized tonic-clonic seizure that ha…](https://mymerci.kr/pages/nclex_q.php?qn_id=372718&lang=en) - [A 19-year-old college student is admitted from the ED with fever 39.5 °C, severe headache,…](https://mymerci.kr/pages/nclex_q.php?qn_id=372758&lang=en) - [Two hours after abdominal surgery, a client has a saturated dressing, heart rate 126/min, …](https://mymerci.kr/pages/nclex_q.php?qn_id=393732&lang=en) - [A client scheduled for surgery tomorrow says, "I took my warfarin this morning like usual.…](https://mymerci.kr/pages/nclex_q.php?qn_id=394155&lang=en) - [A client is 12 hours postoperative after abdominal surgery. For each finding or nursing re…](https://mymerci.kr/pages/nclex_q.php?qn_id=394748&lang=en) - [A client receiving IV gentamicin has urine output of 18 mL/hr, a rising serum creatinine, …](https://mymerci.kr/pages/nclex_q.php?qn_id=396123&lang=en) - [A client receiving a continuous epidural morphine infusion becomes difficult to arouse. Re…](https://mymerci.kr/pages/nclex_q.php?qn_id=396608&lang=en) - [After a packed red blood cell transfusion, a client develops dyspnea, bilateral crackles, …](https://mymerci.kr/pages/nclex_q.php?qn_id=397167&lang=en) ## Read in another language - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=396186&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=396186&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=396186&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=396186&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=396186&lang=vi) --- More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en) _For study reference only. Always follow current clinical guidelines and your institution’s protocols._