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: Potatoes are gluten-free, safe for celiac disease, as they lack wheat, barley, or rye proteins. They provide carbohydrates without triggering villous atrophy in the small intestine, indicating the client’s correct understanding of dietary restrictions, requiring no further teaching for this choice.

Choice B reason: Corn chips, if made from corn, are gluten-free and safe for celiac disease. They avoid gluten-containing grains, preventing intestinal inflammation. This choice reflects proper dietary knowledge, as corn does not contain gliadin, making it appropriate and requiring no additional instruction.

Choice C reason: Fried rice may contain gluten if prepared with soy sauce, which often includes wheat. This choice suggests potential misunderstanding, but oatmeal’s gluten content is more definitive, as rice can be gluten-free if prepared correctly, making this less incorrect than oatmeal.

Choice D reason: Oatmeal often contains gluten due to cross-contamination with wheat during processing, triggering celiac disease’s autoimmune response, damaging intestinal villi. This choice indicates a need for teaching, as gluten-free oats are required, and the client must avoid standard oatmeal to prevent symptoms.