A nurse is caring for a 55-year-old male client in an outpatient clinic. Click to highlight the finding that requires immediate follow-up. To deselect a finding, click on the finding again. A. Coughing up mucopurulent sputum B. Joint pain C. Anorexia D. Night sweats E. Purified protein derivative (PPD) test 11 mm

Choice A rationale: Persistent coughing with mucopurulent sputum suggests an ongoing respiratory infection or inflammation. Mucopurulent sputum indicates the presence of neutrophils and bacteria, often seen in bacterial pneumonia or tuberculosis. While significant, coughing alone is not an immediate life-threatening finding but rather a symptom requiring monitoring and further diagnostic follow-up to confirm the cause. Choice B rationale: Joint pain in a patient receiving infliximab for rheumatoid arthritis may reflect an autoimmune flare or side effects of immunosuppression. Although uncomfortable and significant for quality of life, joint pain does not usually require immediate intervention compared to respiratory or infectious signs that may threaten life or transmission risk. Choice C rationale: Anorexia, or decreased appetite, is a common systemic symptom in chronic infections like tuberculosis. It reflects the body’s inflammatory response and catabolic state but is a nonspecific finding. It requires addressing nutritional support but is not immediately life-threatening or requiring urgent intervention compared to active infectious disease signs. Choice D rationale: Night sweats are a classic systemic symptom of tuberculosis caused by cytokine-mediated thermoregulatory dysfunction during infection. Although important in clinical suspicion, night sweats themselves do not necessitate immediate intervention but support the need for further diagnostic workup and infection control precautions. Choice E rationale: An 11 mm induration on the purified protein derivative (PPD) test is considered positive in this patient due to immunosuppression with infliximab, which increases TB risk. The normal cutoff varies by risk factors, but 5 mm or greater is positive in immunosuppressed patients. This finding requires urgent follow-up to initiate treatment and prevent active disease and transmission, making it the most critical.