A nurse is caring for a client in the ICU. The client's ECG monitor tracing reveals sinus bradycardia and ST-segment elevation. The client reports shortness of breath and feeling dizzy and faint. Which of the following medications should the nurse administer?

Choice A reason: Clearing items from the client's surrounding area is important, but it is not the first action a nurse should take. The priority is to prevent injury to the client, and while removing potential hazards is part of this, it comes after ensuring the client's immediate safety.

Choice B reason: Loosening restrictive clothing can help the client breathe more easily and prevent further injury. However, this is not the first step in seizure first aid. The initial focus should be on preventing injury by controlling the client's fall.

Choice C reason: Lowering the client to the floor is the first and most critical action to take. This prevents a fall that could result in serious injury. Once on the floor, the client should be turned gently onto one side to help maintain an open airway and allow any fluids to drain, which can help prevent aspiration.

Choice D reason: Obtaining the client's vital signs is a secondary action after the seizure has ended. During a seizure, the primary concern is the client's immediate safety, which includes preventing injury and maintaining an open airway.

Choice A reason: The Mantoux skin test, also known as the tuberculin skin test, measures the immune response to the tuberculin purified protein derivative (PPD) injected under the skin. An induration of less than 1 mm is not necessarily an indication of non-infectiousness; it may indicate a lack of infection or an inadequate immune response. This test does not reflect the current infectious status as it measures a delayed hypersensitivity reaction and can remain positive for life once someone has been exposed to TB or has received the BCG vaccine.

Choice B reason: Negative sputum cultures for acid-fast bacillus are a strong indication that the client is no longer infectious. Pulmonary tuberculosis is diagnosed and monitored through sputum cultures to detect the presence of Mycobacterium tuberculosis. A series of negative cultures typically indicates that the client is not excreting the bacteria and is, therefore, not contagious.

Choice C reason: While the cessation of coughing up blood-tinged sputum is a positive sign of clinical improvement, it does not conclusively indicate that the client is no longer infectious. The absence of blood in the sputum may simply mean that the damage to lung tissues is healing, but the client could still be harboring and potentially spreading TB bacteria.

Choice D reason: The Quantiferon-TB Gold test is a blood test that measures the immune system's response to TB bacteria. A positive result indicates TB infection, but it does not distinguish between latent infection and active disease, nor does it provide information on infectiousness. The parenthetical "negative" is confusing and should be clarified in the context of the test results.