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:
Age 45 years is incorrect. While age is a significant factor in osteoporosis risk, 45 years old isn't inherently considered a high-risk age for developing osteoporosis. However, bone density tends to decrease gradually with age, and after menopause in women, there's a more significant decline due to hormonal changes.
Choice B Reason:
Regular aerobic exercise is incorrect. Regular exercise, particularly weight-bearing and muscle-strengthening activities, is typically beneficial for bone health. It can help maintain or improve bone density and strength, reducing the risk of osteoporosis. Therefore, regular aerobic exercise is generally considered a protective factor against osteoporosis, rather than a risk factor.
Choice C Reason:
Uses NSAIDs for pain relief is incorrect. While long-term use of certain medications, such as glucocorticoids (steroids), can increase the risk of osteoporosis due to their impact on bone density, the use of NSAIDs (nonsteroidal anti-inflammatory drugs) for pain relief isn't directly linked to osteoporosis as a significant risk factor. However, chronic use of certain medications might have implications for bone health and should be assessed on an individual basis.
Choice D Reason:
Smoking is a known risk factor for osteoporosis. It can have detrimental effects on bone health by interfering with the body's ability to absorb calcium, decreasing estrogen levels, and impairing bone-forming cells. Consequently, smokers have a higher risk of developing osteoporosis compared to non-smokers.

Choice A Reason:

"I can have clear liquids up to 3 hours before the procedure." This is incorrect. Clients are usually instructed to be NPO (nothing by mouth) for a certain period before the procedure, typically 6-8 hours, to reduce the risk of aspiration.

Choice B Reason:

"I can eat as soon as the procedure is completed." This is incorrect. Clients should not eat or drink until the gag reflex returns, which can take a few hours after the procedure.

Choice C Reason:

"I will receive an injection of radioactive material prior to having the procedure.” This is incorrect. An injection of radioactive material is not part of a bronchoscopy. This might be confused with a different diagnostic procedure, such as a PET scan.

Choice D Reason:

"I might have blood-tinged sputum after the procedure." This statement indicates an understanding of the teaching. It is common for clients to have a small amount of blood-tinged sputum following a bronchoscopy due to the irritation caused by the procedure.