A nurse reads a tuberculin skin test on a patient and notes a 6 to 7 mm area of induration. The patient is a young adult who has recently immigrated from a country with a high prevalence of tuberculosis
The patient has no other risk factors. The nurse will expect the provider to:
a. begin treating this patient with a two-drug regimen of isoniazid and rifampin.
b. order a chest radiograph and a sputum culture to assess for active tuberculosis.
c. order a nucleic acid amplification test of the patient's sputum.
d. reassure the patient that this is not considered a positive test result.
ANS: D
This patient has a moderate risk of tuberculosis; the area of induration would have to be 10 mm or greater to be considered a positive skin test result. Without other clinical signs, there is no indication to treat this patient or to perform diagnostic testing, so a chest x-ray or sputum cultures are not recommended.
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