For which client would it be most important to receive a preoperative chest x-ray?
1. A 55-year-old current smoker with a recent productive cough
2. A 16-year-old with a history of abdominal pain
3. A 22-year-old with Down syndrome
4. A 50-year-old with skin cancer and history of gallbladder disease
A 55-year-old current smoker with a recent productive cough
Rationale: 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 postoperative pulmonary complications and possibility of preoperative pneumonia or infiltrates. The 16-year-old with a history of abdominal pain, the 22-year-old with Down syndrome, and the 50-year-old with skin cancer and a history of gallbladder disease have no past medical history of pulmonary or cardiac complications that would warrant a chest x-ray. However, the 50-year-old client might be asked to have a preoperative chest x-ray, depending upon the type of skin cancer and the length of time the client has had it, if there is a chance of metastasis to the lungs.
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