While changing a client’s postoperative dressing, the nurse observes purulent drainage at the wound. Before reporting this finding to the healthcare provider (HCP), the nurse should note which of the client’s laboratory values?

Choice A reason: A positive PPD skin test indicates TB exposure but not active disease, as it detects immune response to TB antigens. False positives occur in vaccinated or previously exposed individuals, making it insufficient to confirm active TB, requiring sputum culture for definitive diagnosis.

Choice B reason: Chest x-ray or CT shows lung abnormalities suggestive of TB, like cavitary lesions, but is not confirmatory. Imaging supports diagnosis but cannot identify Mycobacterium tuberculosis, making sputum culture the gold standard for confirming active infection, as imaging lacks specificity.

Choice C reason: Sputum culture positive for Mycobacterium tuberculosis confirms TB, as it directly isolates the pathogen. This test identifies active infection with high specificity, distinguishing TB from other lung diseases, making it the definitive diagnostic tool to review for accurate diagnosis and treatment.

Choice D reason: Hemoccult test on sputum detects blood, indicating hemoptysis, a TB symptom, but not the pathogen. It does not confirm TB, as bleeding can occur in other conditions, making sputum culture essential for identifying Mycobacterium tuberculosis and confirming the diagnosis.

Choice A reason: Daily use of tiotropium via its handihaler is correct, as this long-acting anticholinergic bronchodilator is administered once daily for COPD maintenance. It relaxes airway smooth muscles, improving airflow, and consistent use prevents exacerbations, indicating proper understanding of the medication’s administration schedule.

Choice B reason: Using tiotropium for sudden shortness of breath is incorrect, as it is not a rescue inhaler. Tiotropium provides sustained bronchodilation over 24 hours, not rapid relief. Short-acting beta-agonists like albuterol are used for acute symptoms, indicating a need for further teaching.

Choice C reason: Using another inhaler between tiotropium doses suggests misunderstanding, as tiotropium is a once-daily maintenance therapy. Additional inhalers may be prescribed, but this statement implies incorrect timing or overuse, which could lead to improper COPD management, requiring clarification.

Choice D reason: Expecting thinner sputum is incorrect, as tiotropium does not affect mucus viscosity. It dilates airways, not liquefying secretions, which is the role of mucolytics. This misunderstanding indicates a need for teaching about tiotropium’s bronchodilatory, not mucolytic, effects in COPD.