A nurse is teaching a client who has a prosthetic limb due to a right below-the-knee amputation about prosthesis and stump care. Which of the following instructions should the nurse include in the teaching?

Choice A reason:
The Mantoux test, also known as the tuberculin skin test, is used to detect latent TB infection but is not the most reliable for confirming active pulmonary TB. It can indicate if someone has been infected with TB bacteria, but it cannot differentiate between latent and active TB.

Choice B reason:
A sputum culture for acid-fast bacillus is the gold standard for diagnosing active pulmonary TB. It involves culturing a sample of sputum (phlegm) to see if TB bacteria grow, which confirms the diagnosis. This test is the most definitive and reliable method, although it may take several weeks to obtain results.

Choice C reason:
A sputum smear can detect TB bacteria in sputum samples quickly, but it is less sensitive than a culture. It can miss cases, especially if the bacterial load is low. Therefore, while useful for initial screening, it is not as reliable as a culture for confirming active TB.

Choice D reason:
A chest x-ray can show signs suggestive of TB, such as infiltrates or cavities in the lungs, but it cannot confirm the presence of TB bacteria. It is a supportive diagnostic tool but not definitive for active TB diagnosis.

Choice A reason:Scheduling the procedure five days before the expected menses would place it in the late proliferative phase, which risks missing ongoing menstrual bleeding and could coincide with implantation if the client ovulated early. Best practice is to perform the test after menstruation ends but before ovulation—usually within 12 days of the first day of the last period—to ensure the client is not pregnant.

Choice B reason:
Diarrhea is not a common side effect of HSG. The procedure involves the insertion of a dye into the uterine cavity to visualize the fallopian tubes and uterus via X-ray. While some discomfort, cramping, or spotting may occur, diarrhea is not typically expected.

Choice C reason:
There is no requirement for a client to be on a liquid diet following an HSG procedure. The client can usually resume normal activities and diet immediately after the procedure unless otherwise instructed by their healthcare provider.

Choice D reason:
Referred shoulder pain can occur when contrast fluid spills through a patent tube into the peritoneal cavity, irritating the diaphragm’s undersurface and eliciting pain perceived at the shoulder via the phrenic nerve. Clients should be advised this is normal, short-lived, and relieved by positioning or mild analgesics.