The nurse assesses a client in the local neighborhood clinic. He ...

[sammy]

The nurse assesses a client in the local neighborhood clinic. He exhibits signs and symptoms of tuberculosis (TB) yet has a negative tuberculin skin test result. The nurse suspects that the physician may further test the client because he:
 
  A) Visited Central America recently
  B) Is recovering from jet lag
  C) Is HIV positive
  D) Works in a factory setting

Question 2

A man who lives in a homeless shelter is diagnosed with active tuberculosis (TB). The shelter keeps a list of those who are assigned beds, and the majority of those sleeping there are regulars.
 
  Which finding would indicate a positive tuberculin skin test result using a two-step process?
  A) 4-mm induration
  B) 2-mm induration
  C) 6-mm induration
  D) 3-mm induration

[akemokai]

Answer to Question 1

Ans: C
Feedback:
Active TB infection is characterized by a chronic productive cough, low-grade fever, night sweats, and weight loss, along with a positive purified protein derivative (PPD) tuberculin skin test result. People with active TB are contagious. However, certain people who are anergic (lack an immune response to an antigen) may not have a positive PPD (e.g., persons with HIV). Having visited Central America recently, recovering from jet lag, and working in a factory setting would not produce a false negative result on the tuberculin skin test.

Answer to Question 2

Ans: C
Feedback:
All high- and medium-priority contacts who do not have a documented previous positive tuberculin skin test result or previous TB disease should receive a baseline purified protein derivative (PPD) tuberculin skin test. The reaction to the intracutaneously injected PPD tuberculin skin test is the classic example of a delayed (cellular) hypersensitivity reaction, which induces induration. Induration of 5 mm is considered a positive result in people who have an initial induration of 0 mm.