Exhibits

The nurse should plan to first administer 

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B. HbA1c is considered the gold standard for assessing long-term glycemic control in individuals with diabetes. It provides an overall picture of how well blood sugar levels have been controlled over the preceding 2-3 months, helping healthcare providers adjust treatment plans as needed.

A Postprandial (after-meal) blood glucose levels indicate how well blood sugar levels are controlled after eating. While important for immediate assessment of glucose management after meals, it does not provide a comprehensive view of long-term glycemic control.

C. While fasting blood glucose levels are important in daily diabetes management, they do not provide the extended timeframe assessment that HbA1c does for long-term control.

D. OGTT results are not typically used to monitor long-term glycemic control in individuals with established diabetes mellitus. It assesses how the body responds to a glucose load and is not as practical or common for routine monitoring compared to HbA1c.

A Sputum cultures for AFB are used to detect the presence of Mycobacterium tuberculosis, the bacteria causing TB. A negative result means that the sputum samples tested do not contain viable TB bacteria that can be transmitted to others. It indicates that the client's TB treatment has been effective in reducing the bacterial load to non-infectious levels.

B. The Quantiferon-TB Gold test is a blood test used to detect TB infection based on the immune response to TB antigens. A positive result indicates TB infection but does not differentiate between latent TB infection (not infectious) and active TB disease (potentially infectious).

C. The Mantoux tuberculin skin test (TST) is another test used to detect TB infection based on a delayed- type hypersensitivity reaction to TB antigens. An induration of less than 1 mm is considered negative and suggests that the client does not have a significant immune response to TB antigens, which could mean they are not infected with TB or the infection is not significant. This finding does not provide information on the client's infectiousness.

D. This indicates improvement in the client's symptoms, as coughing up blood-tinged sputum (hemoptysis) is a common symptom of active pulmonary TB. While improvement in symptoms is an important aspect of TB treatment, it does not directly indicate whether the client is no longer infectious. Infectiousness is primarily determined by microbiological tests such as sputum cultures for AFB.