A healthcare worker who is asymptomatic has a screening TST ...

[Mr3Hunna]

A healthcare worker who is asymptomatic has a screening TST result of 10 mm of induration during a pre-employment physical. What will the nurse reading this test tell the patient?
 
  a. This is a negative test, so you are cleared for employment.
  b. You have latent TB and will need to take isoniazid for 6 to 9 months.
  c. You need to have a chest radiograph and a sputum culture.
  d. You will begin taking a four-drug regi-men to treat tuberculosis.

Question 2

A patient who is hospitalized for an acute gout attack has received several doses of hourly oral colchicine but still reports moderate to severe pain. As the nurse prepares to administer the next dose, the patient begins vomiting.
 
  What will the nurse do? a. Contact the provider to discuss giving a lower dose of colchicine.
  b. Hold the medication and notify the pre-scriber.
  c. Explain that this is a common side effect that will soon stop.
  d. Request an order for an antiemetic so that the next dose of colchicine may be given.

[makaylafy]

Answer to Question 1

C
This patient has a moderate risk and a positive skin test result. Before beginning treatment for latent TB, active TB must be ruled out with chest X-rays and sputum cultures. This is not a nega-tive test result in a moderate-risk individual. Latent TB needs to be confirmed with diagnostic testing. Treatment will not begin until tests have confirmed the diagnosis.

Answer to Question 2

B
Colchicine should be discontinued immediately, regardless of the status of the joint pain, if ga-strointestinal (GI) symptoms occur. The patient's symptoms indicate injury to the GI endothe-lium. Once damage begins to occur, lowering the dose is not indicated. GI toxicity will not abate over time. An antiemetic may be useful for stopping the vomiting; however, continued adminis-tration of the drug can lead to further damage to the GI endothelium.

[Mr3Hunna]

Excellent

[alvinum]

TYSM