While administering a tuberculin (TB) skin test, a client who is HIV positive asks, "I heard from my friends, this test may not work on me since I have HIV." The health care provider's best response would be:
A) "This test is 99.9% specific, so it will give us an accurate result."
B) "Sometimes immunocompromised clients will have negative results if you are unable to mount a normal immune reaction."
C) "Most of the time, with HIVpositive clients, we see more false-positive results since you may have a similar infection in your body."
D) "If your test comes back positive, we will send a blood test off to a special lab to confirm you really have TB before we start treatment."
Ans: B
Feedback:
Hypersensitivity response to the tuberculin test depends on cell-mediated immunity. Inherent anergy in persons with HIV infection and other immunocompromised states causes a false-negative test result, which can mean that the person has a true lack of exposure to tuberculosis or is unable to mount an immune response to the test. False-positive results can also occur—for example, in persons who have nontuberculosis mycobacterial infection or who have received the Bacillus Calmette-Guérin (BCG) vaccine for tuberculosis prevention.
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