A client is brought to the emergency department after a motorcycle accident. The client is alert, responsive, and diagnosed with a broken leg. The client's vital signs are pulse (P) 72 and respiration (R) 16. After being informed surgery is required for the broken leg, which vital sign readings would be expected?

Choice A rationale A decrease in heart rate (P) and respiratory rate (R) would indicate a state of relaxation or a calming of the nervous system. The client has just been informed of a necessary surgery, a significant stressor that would activate the sympathetic nervous system, leading to an increase in vital signs, not a decrease. This choice is inconsistent with the expected physiological response. Choice B rationale The initial vital signs (P 72, R 16) represent the client's baseline state upon arrival. The new stressor of impending surgery would trigger a physiological response that elevates these values. Therefore, vital signs remaining unchanged after receiving this information is highly unlikely. The sympathetic nervous system would initiate a fight-or-flight response. Choice C rationale The news of impending surgery acts as a significant stressor, activating the sympathetic nervous system. This "fight-or-flight" response releases catecholamines like epinephrine and norepinephrine. These hormones cause an increase in heart rate (tachycardia) and respiratory rate (tachypnea) to enhance oxygen delivery to muscles, preparing the body for a perceived threat. Choice D rationale A decrease in pulse and respiration would indicate a parasympathetic nervous system response, which is associated with "rest and digest" functions. This is the opposite of the expected physiological reaction to the stress of a required surgery. The body's natural response to such a stressor is to increase, not decrease, these vital parameters.