The nurse is caring for a client with a history of Parkinson’s disease. Which intervention should the nurse prioritize?

Choice A reason: Weight-bearing exercises, like walking, stimulate bone formation by increasing osteoblast activity, improving bone density in osteoporosis. This reduces fracture risk, making it a key intervention to strengthen bones and enhance balance, preventing falls, which is critical for osteoporosis management.

Choice B reason: Restricting calcium-rich foods is inappropriate, as calcium is essential for bone health in osteoporosis. Dietary calcium supports bone mineralization, reducing fracture risk. Weight-bearing exercises are prioritized, as they directly enhance bone strength, unlike dietary restrictions that weaken bones.

Choice C reason: Limiting vitamin D supplementation is incorrect, as vitamin D enhances calcium absorption, supporting bone health in osteoporosis. Weight-bearing exercises are the priority, as they mechanically stimulate bone remodeling, improving density and reducing fracture risk more directly than supplements.

Choice D reason: Promoting bed rest increases bone loss in osteoporosis by reducing mechanical stress, which stimulates bone formation. Weight-bearing exercises are essential, as they enhance bone density and strength, preventing fractures, making bed rest counterproductive to osteoporosis management.

Choice A reason: Hemoccult tests detect blood in sputum, indicating hemoptysis, a TB symptom, but do not confirm Mycobacterium tuberculosis infection. Sputum culture is required for definitive diagnosis, as hemoccult only identifies bleeding, which is nonspecific and can occur in other respiratory conditions.

Choice B reason: Chest x-ray or CT scans show pulmonary abnormalities like cavitary lesions in TB but are not confirmatory. Radiographic findings suggest TB but require microbiological confirmation via sputum culture, as similar patterns occur in other lung diseases, making imaging supportive but not diagnostic.

Choice C reason: Sputum culture positive for Mycobacterium tuberculosis is the gold standard for TB diagnosis. It directly identifies the pathogen, confirming active infection. Other tests like skin tests or imaging are suggestive but not definitive, as they cannot distinguish active TB from latent or other conditions.

Choice D reason: A positive PPD skin test indicates TB exposure or latent infection but does not confirm active disease. False positives occur with prior BCG vaccination or nontuberculous mycobacteria. Sputum culture is needed to verify active TB, making the skin test less definitive.