For which patient is the nurse most likely to request an order for a preoperative chest X-ray?
1. A 22-year-old with Down syndrome
2. A 50-year-old with a history of gallbladder disease
3. A 16-year-old with a history of abdominal pain
4. A 55-year-old current smoker with a recent productive cough
4
Rationale 1: Down syndrome by itself is not a reason to request a chest X-ray.
Rationale 2: The 50-year-old with a history of gallbladder disease has no past medical history of pulmonary or cardiac complications that would warrant a chest X-ray.
Rationale 3: The 16-year-old with a history of abdominal pain has no past medical history of pulmonary or cardiac complications that would warrant a chest X-ray.
Rationale 4: The 55-year-old smoker with a recent productive cough would have the greatest need for a preoperative chest X-ray due to the potential for preoperative pneumonia or infiltrates or postoperative pulmonary complications.
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