The 95-year-old nursing home resident has a productive cough, fever, chills, and a history of night sweats. The client's PPD test is negative. What is the nurse's best action related to in-fection prevention?

Question

A. Use standard precautions alone because the client does not have tuberculosis.
B. Use standard precautions and airborne precautions because the client has tuber-culosis.
C. Use standard precautions and airborne precautions until a chest x-ray shows the client does not have tuberculosis.
D. Use airborne precautions alone because the client is taking penicillin therapy for another respiratory infection.

Answer 1

C
When clients are very old or have severe immunodeficiency, their PPD tests may be negative, even when active tuberculosis is present, because they have too few immune system cells and cell products to mount an immune response to the test. Therefore, airborne precautions should be used with any older client who presents with clinical manifestations of tuberculosis until other tests rule out tuberculosis.