An occupational health nurse is screening a new employee in a long-term care facility for tuberculosis (TB). The employee questions why purified protein derivative (PPD) testing is done twice. Which is the most appropriate response by the nurse?
A) "Different medication is used in the second PPD."
B) "The treatment for TB is 6 months of medication, and we want to make sure the first results of the first PPD were accurate."
C) "The first PPD was not interpreted in the correct time frame of 48-72 hours."
D) "There is an increased risk for a false-negative response for people who work in long-term care facilities. The two-step is recommended to accurately screen for TB."
Answer: D
PPD testing is done in a two-step process for people who work in long-term care facilities because of the risk of false-negative responses. Treatment for TB for 6 months is not a reason to complete the PPD twice. PPD testing is not done twice because different medication is used. Evaluating the test at the wrong interval is not the reason that the PPD is done twice for long-term care facility employees.
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