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 72 and respiration 16. After being informed surgery is required for the broken leg, which vital sign readings would be expected?

Choice A rationale When an individual is faced with a stressful situation, such as an impending surgery, the sympathetic nervous system is activated, initiating the "fight or flight" response. This response involves the release of catecholamines, primarily adrenaline and noradrenaline. These hormones increase the heart rate (tachycardia) and respiratory rate (tachypnea) to prepare the body for a perceived threat. Choice B rationale The sympathetic nervous system activation due to anxiety and stress from the impending surgery would cause an increase in both pulse and respiratory rate. A normal adult pulse rate is 60-100 beats per minute, and a normal respiratory rate is 12-20 breaths per minute. A pulse of 90 and respiration of 22 are elevated and consistent with the physiological stress response. Choice C rationale A pulse of 58 and a respiration rate of 14 are within or below the normal ranges. A decrease in heart rate (bradycardia) and respiratory rate (bradypnea) is not a typical response to acute stress. These vital signs would indicate a parasympathetic nervous system response, which promotes rest and relaxation, not the physiological stress response seen before surgery. Choice D rationale While a pulse of 70 and a respiration of 16 are within the normal range, they do not reflect the expected physiological response to acute stress. The client's initial baseline vitals were a pulse of 72 and respiration of 16. A stressful event like an impending surgery would trigger a sympathetic response, causing an increase in these values, not a maintenance of the baseline.