The health care provider writes an order for bacteriologic testing for a patient who has a positive tuberculosis skin test.
Which action should the nurse take?

Choice A rationale

A blood pressure of 124/79 mm Hg is not within the expected reference range for normotension. The expected reference range for normal blood pressure is typically defined as systolic blood pressure less than 120 mm Hg AND diastolic blood pressure less than 80 mm Hg, reflecting optimal cardiovascular health and minimal risk.

Choice B rationale

Stage 1 hypertension is defined by a systolic blood pressure between 130-139 mm Hg OR a diastolic blood pressure between 80-89 mm Hg. The client's blood pressure of 124/79 mm Hg does not meet these criteria, as both values are below the threshold for stage 1 hypertension.

Choice C rationale

A blood pressure of 124/79 mm Hg falls into the category of "elevated blood pressure.”. This classification is defined by a systolic blood pressure between 120-129 mm Hg AND a diastolic blood pressure less than 80 mm Hg, indicating a higher risk for developing hypertension.

Choice D rationale

Stage 2 hypertension is characterized by a systolic blood pressure of 140 mm Hg or higher OR a diastolic blood pressure of 90 mm Hg or higher. The client's blood pressure of 124/79 mm Hg is significantly below these thresholds, thus ruling out a diagnosis of stage 2 hypertension.

Choice A rationale

Hypothyroidism, particularly if untreated, can contribute to bone loss, but levothyroxine therapy typically normalizes thyroid function, mitigating this risk. While age is a risk factor, other choices present more significant and direct risks for accelerated bone demineralization and osteoporosis development.

Choice B rationale

Estrogen plays a crucial role in bone density maintenance by inhibiting osteoclast activity and promoting osteoblast activity. A bilateral salpingo-oophorectomy removes the primary source of estrogen, leading to premature menopause and rapid bone loss, significantly increasing osteoporosis risk if hormone therapy is refused.

Choice C rationale

Prednisone, a corticosteroid, is a potent cause of secondary osteoporosis. It directly inhibits osteoblast function, promotes osteoclast activity, and impairs calcium absorption, leading to significant bone density loss. Long-term use post-transplant makes this patient at exceptionally high risk.

Choice D rationale

Excessive alcohol intake (more than 2-3 drinks daily) is a risk factor for osteoporosis by impairing bone formation and nutrient absorption. Limiting sun exposure can cause vitamin D deficiency, also contributing to reduced bone density. However, this patient's alcohol intake is moderate, and vitamin D deficiency is more easily corrected.