Final answer:
The most appropriate nursing action for an elderly client with tuberculosis who cannot cough up secretions is to raise the head of the bed to at least 45 degrees.
Step-by-step explanation:
The question asks for the most appropriate nursing action to aid an elderly client with tuberculosis who has difficulty coughing up secretions for a sputum specimen. The correct action to take in this scenario is to raise the head of the bed to at least 45 degrees. This position will assist in the gravity drainage of secretions, making it easier for the client to expectorate them. Spraying the oropharynx with saline may not directly aid in expectorating sputum and could potentially cause discomfort. Asking the client to drink a warm liquid could help soothe the throat but might not be sufficient to induce coughing for sputum collection. Forcing fluids over the next 8 hours is also unspecific and less immediately effective compared to positioning the patient properly.
The appropriate nursing action for an elderly client with difficulty coughing up secretions for a sputum specimen is to raise the head of the bed to at least 45 degrees (Option D). Raising the head of the bed helps to promote lung expansion and improve the client's ability to cough up secretions. It also helps to prevent aspiration.