A nurse is collecting data from a client who is 4 hr postoperative following abdominal surgery. The client's blood pressure is 90/60 mm Hg. Which of the following actions should the nurse take first?

Choice A reason: Taking the medication right before eating breakfast is not an appropriate instruction, as it can reduce the absorption and effectiveness of alendronate, which is a bisphosphonate drug that inhibits bone resorption and increases bone density. The client should take the medication at least 30 min before eating or drinking anything other than water.

Choice B reason: Drinking milk with the medication is not an appropriate instruction, as it can interfere with the absorption and effectiveness of alendronate, which can bind to calcium and other minerals and form insoluble complexes that are excreted in feces. The client should avoid consuming dairy products or supplements that contain calcium, iron, magnesium, or aluminum for at least 30 min after taking the medication.

Choice C reason: Staying upright for 30 to 60 min after taking the medication is an appropriate instruction, as it can prevent esophageal irritation or ulceration that can be caused by alendronate, which can be corrosive to the mucosa if it remains in contact with it for too long. The client should not lie down or bend over until after their first food of the day.

Choice D reason: Chewing the tablets thoroughly is not an appropriate instruction, as it can increase the risk of esophageal irritation or ulceration that can be caused by alendronate, which can be abrasive to the mucosa if it is not swallowed whole with a full glass of water. The client should not crush, break, or dissolve the tablets in any liquid.

Choice A reason: Nonpalpable area of redness, less than 5 mm (0.2 in) in diameter is a negative result for the tuberculin skin test, which means that the client does not have tuberculosis infection or exposure.

Choice B reason: Palpable area of induration, greater than 10 mm (0.4 in) in diameter is a positive result for the tuberculin skin test, which means that the client has tuberculosis infection or exposure and needs further testing, such as chest x-ray or sputum culture, to confirm the diagnosis and rule out active disease.

Choice C reason: Area of ecchymosis, greater than 12 mm (0.5 in) in diameter is not a relevant finding for the tuberculin skin test, as it indicates bruising or bleeding under the skin that may be caused by trauma or coagulation disorder.

Choice D reason: Tenderness at the injection site is not a relevant finding for the tuberculin skin test, as it indicates inflammation or irritation of the skin that may be caused by needle insertion or allergic reaction.