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Author Question: A primary care NP sees a 5-year-old child for a tuberculin skin test. The child lives in a high-risk ... (Read 77 times)

torybrooks

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A primary care NP sees a 5-year-old child for a tuberculin skin test. The child lives in a high-risk community, and a grandparent who babysits has active TB. The PPD shows a 6-mm area of induration. A chest radiograph is normal.
 
  The NP will refer this patient to an infectious disease specialist and should expect the patient to be on _____ for _____ months. a. isoniazid; 6
  b. ethambutol; 3
  c. isoniazid and rifapentine; 3
  d. ethambutol and amikacin; 6

Question 2

A patient comes to the clinic to have a Mantoux tuberculin skin test read after 48 hours. The primary care NP notes a 6-mm area of induration. The patient is a young adult with no known contacts and has never traveled abroad. The NP should:
 
  a. repeat the test.
  b. order a chest radiograph.
  c. tell the patient the test is negative.
  d. refer to an infectious disease specialist.



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k2629

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Answer to Question 1

C
This child has a positive PPD with no pulmonary signs, so a 3-month course of isoniazid and rifapentine is indicated. Ethambutol is not recommended in children younger than 13 years.

Answer to Question 2

B
A chest x-ray should be obtained on all patients who have a positive purified protein derivative tuberculin test (PPD). The test was read in the appropriate time frame, so repeating the test is not necessary. This patient has a positive PPD. Referral to an infectious disease specialist should be made when the diagnosis is confirmed.



torybrooks

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Both answers were spot on, thank you once again




 

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