An occupational health nurse is interpreting the results of a tuberculin skin test for a group of clients who received the test 48 hr ago. Which of the following clients should the nurse identify as having a positive test result?

Choice A Reason:

The client's fingers are cool to the touch is correct. Coolness of the fingers within a short time after a cast application can indicate compromised circulation or potential compartment syndrome, which requires urgent attention to prevent tissue damage or loss of function. It suggests impaired blood flow to the fingers, which is a serious concern requiring immediate evaluation by the provider.

Choice B Reason:

The client reports severe itching under the cast is incorrect. While itching can be uncomfortable, it might not pose an immediate threat. Itching can commonly occur as the skin heals and can be managed through non-invasive means.

Choice C Reason:

The client's capillary refill is 3 seconds is incorrect. A capillary refill of 3 seconds is slightly prolonged but doesn't typically indicates an immediate emergency. However, if this finding worsens or if combined with other concerning symptoms, it might warrant further assessment.

Choice D Reason:

The client reports increased pain at the area of the fracture is incorrect. Increased pain after a cast application can be expected initially, especially within 2 hours of the procedure. However, persistent or severe pain could indicate issues like poor alignment, swelling, or other complications. While it's important to address pain, it might not require immediate reporting unless accompanied by other concerning symptoms.

Choice A Reason:
"I will perform breast exams the day my period begins." This statement is incorrect because performing breast exams just before or during your period might not be ideal. Breasts can be more tender or swollen during this time, which could make it harder to detect any abnormalities.
Choice B Reason:
"I will perform breast exams every other month." This statement is incorrect. Regular breast self-exams are important, but doing them every other month might not be frequent enough. It's generally recommended to perform breast self-exams once a month, ideally around the same time each month, to detect any changes or abnormalities early.
Choice C Reason:
"It is common for the skin on my breasts to dimple." This statement is incorrect. Dimpling or puckering of the skin on the breasts can sometimes be a sign of an underlying issue, such as breast cancer. It's not considered a normal or common occurrence, so this statement doesn't indicate an understanding of what to look for during a breast self-exam. If a person notices skin changes like dimpling, it's recommended to seek medical advice.
Choice D Reason:
"It is common for one breast to be larger than the other." This statement reflects an understanding that breast asymmetry, where one breast is slightly larger than the other, is a common and normal occurrence.