A nurse is reviewing the medical history on a client who is preoperative for surgery. Which of the following findings places the client at risk for a postoperative complication?

Choice A rationale A glucose level of 75 mg/dL falls within the established normal reference range of 70 to 100 mg/dL for a fasting adult. Stable glycemic control is essential for minimizing the risk of intraoperative fluctuations and supporting effective postoperative wound healing. Because this value is normal, it does not represent an independent risk factor for complications such as delayed healing or infection that would be associated with hyperglycemia or significant hypoglycemia in the preoperative phase. Choice B rationale A Body Mass Index (BMI) of 24 is situated within the healthy or normal weight range, which is typically defined as 18.5 to 24.9. Clients within this range generally face fewer risks related to anesthesia administration, surgical access, and postoperative mobility compared to those who are underweight or obese. Since this measurement indicates a healthy physiological state, it is not considered a finding that increases the client's risk for postoperative complications or poor outcomes. Choice C rationale A fractured ankle is the likely indication for the surgery itself rather than a systemic risk factor for postoperative complications. While it affects mobility, it does not inherently impair the body's global ability to recover from anesthesia or surgery in the same way a chronic systemic condition does. The surgical team will manage the local trauma, and as long as there are no underlying comorbidities, the fracture does not pose a generalized risk to the client. Choice D rationale Obstructive sleep apnea (OSA) is a significant risk factor because it increases the likelihood of perioperative airway obstruction and severe hypoxemia. Anesthesia and postoperative opioids further relax the upper airway muscles and depress the respiratory drive, which can exacerbate OSA. This condition requires careful monitoring, specific positioning, and potentially the use of continuous positive airway pressure (CPAP) during recovery to prevent life-threatening respiratory failure or cardiac strain following the surgical procedure.