A nurse in a provider's office is assessing a client.
The nurse should identify that which of the following findings are manifestations of pulmonary tuberculosis? (Select all that apply.)

Choice A rationale

Dementia is a neurodegenerative disorder characterized by a progressive and irreversible decline in cognitive function, including memory, thinking, and reasoning. This deterioration is due to widespread neuronal loss and brain atrophy, leading to increasing dependence over time as the disease advances.

Choice B rationale

Dementia is not characterized by a sudden onset of confusion. Instead, its onset is typically insidious, with a gradual decline in cognitive abilities over months to years. A sudden onset of confusion is more indicative of delirium, which is an acute and often reversible state.

Choice C rationale

An altered level of consciousness is not typically associated with dementia. Clients with dementia generally maintain a clear level of consciousness, although they may experience confusion, disorientation, or difficulty with attention. Altered consciousness is a hallmark feature of delirium.

Choice D rationale

While high fever or dehydration can exacerbate cognitive impairment in individuals with underlying dementia, they do not trigger the development of dementia itself. These factors are more commonly associated with delirium, which is an acute confusional state, rather than the chronic progressive nature of dementia.

Choice A rationale

Instructing the client to blow their nose should be avoided during epistaxis, as it can dislodge any forming clots, exacerbate bleeding, and potentially increase intracranial pressure temporarily, particularly if associated with hypertension. The primary goal is to promote vasoconstriction and clot formation.

Choice B rationale

Tilting the client's head backward is contraindicated during epistaxis because it can cause blood to flow down the posterior pharynx, leading to swallowing of blood, which can irritate the stomach and induce nausea or vomiting. Aspiration of blood is also a potential risk.

Choice C rationale

Applying ice to the bridge of the client's nose causes local vasoconstriction, which helps to reduce blood flow to the area and promote hemostasis. The cold temperature induces reflex vasoconstriction in the nasal vasculature, thereby helping to slow or stop the bleeding.

Choice D rationale

Moving the client into a high-Fowler's position is beneficial as it reduces venous pressure in the head and neck, thereby decreasing blood flow to the nasal vasculature and minimizing bleeding. Gravity assists in lowering hydrostatic pressure in the affected vessels, facilitating clot formation.

Choice E rationale

Applying direct pressure to the nares (soft part of the nose) for at least 10-15 minutes is a fundamental and highly effective first-line intervention for epistaxis. This direct pressure helps to compress the bleeding vessels, allowing for clot formation and cessation of hemorrhage.