A patient had no skin reaction to a purified protein derivative (PPD) screen. When discussing this result, the patient tells the nurse that she is HIV positive

Question

What information should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "As this is the first PPD you have ever had, you should have it repeated in 2 weeks.".
2. "You have not contracted TB.".
3. "Your skin test may not be valid.".
4. "You should have a chest X-ray.".
5. "Additional laboratory tests are indicated.".

Answer 1

3,4,5
Rationale 1: Two-step PPD tests are commonly done but are not indicated for this patient.
Rationale 2: In a patient diagnosed with HIV, the PPD test will likely be negative. The immune system must be intact for the classic response to occur.
Rationale 3: The patient's immune system is involved in the response to a PPD. Patients diagnosed with HIV may not respond.
Rationale 4: A screening chest X-ray should be done for patients who are HIV positive and who are exposed to TB.
Rationale 5: Acid-fast bacillus testing or sputum, blood, or cerebral spinal fluid may be used to diagnose the presence of TB.