The nurse is reinforcing discharge instructions to the client with pulmonary sarcoidosis. The nurse knows that the client understands the information if the client verbalizes which early sign of exacerbation?

A. The client who has renal failure: Renal failure can lead to hypocalcemia due to the kidneys' reduced ability to convert vitamin D to its active form, leading to decreased calcium absorption.

B. The client who is postoperative following a thyroidectomy: Hypocalcemia can occur after thyroidectomy if the parathyroid glands are inadvertently damaged or removed, as they regulate calcium levels.

C. The client who has hyperparathyroidism: Hyperparathyroidism typically leads to hypercalcemia, not hypocalcemia, as excessive parathyroid hormone (PTH) increases calcium levels in the blood.

D. The client who has vitamin D deficiency: Vitamin D is essential for calcium absorption in the intestines, so a deficiency can lead to hypocalcemia.

E. The client who is receiving bisphosphonate medications: Bisphosphonates inhibit bone resorption, which can lead to a decrease in calcium levels, potentially causing hypocalcemia.

F. The client who has Addison's disease: Addison's disease is primarily associated with electrolyte imbalances like hyponatremia and hyperkalemia, not hypocalcemia.

A. Sputum culture: A sputum culture is the definitive diagnostic test for tuberculosis (TB). It involves collecting a sample of the patient’s sputum and testing it for the presence of Mycobacterium tuberculosis, the bacterium that causes TB. This test confirms active TB infection and is critical in guiding treatment.

B. Chest x-ray: A chest x-ray can show abnormalities in the lungs that may suggest TB, such as infiltrates or cavities, but it cannot confirm the diagnosis. It is often used as a supporting diagnostic tool alongside other tests.

C. Tuberculin skin test: The tuberculin skin test (TST) is used to identify latent TB infection, not active TB. A positive result indicates that a person has been exposed to TB bacteria, but it does not confirm active disease.

D. Bronchoscopy: Bronchoscopy allows for direct visualization of the airways and collection of samples, but it is not the standard diagnostic test for confirming TB. Sputum culture remains the gold standard for diagnosis.