A nurse is assessing a client who received a Mantoux skin test 72 hours ago for tuberculosis screening. Which of the following findings indicates a positive test result?
A blister-like area.
An area of ecchymosis.
A cool, blanched area.
An elevated, hardened area.
The Correct Answer is D
Choice A reason: A blister-like area is not indicative of a positive Mantoux test, which shows induration; blisters suggest irritation. Assuming blisters are positive risks misdiagnosis, potentially missing tuberculosis exposure, critical to avoid in ensuring accurate screening and follow-up in clients tested for TB.
Choice B reason: Ecchymosis (bruising) is not a positive Mantoux result; induration indicates exposure. Assuming ecchymosis is positive risks incorrect interpretation, potentially overlooking tuberculosis risk, critical to prevent in ensuring proper screening, diagnosis, and follow-up for clients undergoing TB skin testing.
Choice C reason: A cool, blanched area suggests no reaction, not a positive Mantoux test, which requires induration. Assuming blanching is positive risks missing exposure, critical to avoid in ensuring accurate tuberculosis screening, guiding appropriate diagnostic follow-up, and protecting client and public health.
Choice D reason: An elevated, hardened area (induration) at 72 hours indicates a positive Mantoux test, suggesting TB exposure, requiring further evaluation. This is critical for accurate screening, ensuring timely diagnosis, preventing disease spread, and guiding follow-up in clients tested for tuberculosis exposure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Indirect lighting aids visual impairment, not hearing loss, where attention-getting is key. Assuming lighting is relevant risks ineffective communication, potentially frustrating the client, critical to avoid in ensuring clear, respectful interaction for clients with total hearing loss in care settings.
Choice B reason: Speech therapists address speech, not hearing loss communication, where attention-getting is essential. Assuming therapist collaboration is primary risks overlooking direct communication strategies, critical to prevent in ensuring effective, tailored interaction for clients with total hearing loss in healthcare settings.
Choice C reason: Getting the client’s attention before speaking (e.g., tapping or waving) ensures effective communication for total hearing loss, facilitating lip-reading or sign language. This is critical for clarity, promoting inclusion, and ensuring accurate information exchange, essential for care delivery in hearing-impaired clients.
Choice D reason: Using a loud tone is ineffective for total hearing loss, where visual cues are needed. Assuming loudness helps risks miscommunication, potentially isolating the client, critical to avoid in ensuring respectful, effective communication strategies for clients with complete hearing loss in care.
Correct Answer is B
Explanation
Choice A reason: A direct approach may overwhelm a toddler, who needs simple, visual explanations like diagrams to reduce fear. Assuming a direct approach is best risks anxiety, critical to avoid in ensuring a toddler’s emotional comfort and cooperation during preparation for medical procedures.
Choice B reason: Explaining the procedure with simple diagrams is age-appropriate for toddlers, reducing fear and enhancing understanding through visuals. This is critical for cooperation, supporting emotional well-being, ensuring effective preparation, and promoting a positive experience during medical procedures in young children.
Choice C reason: Preparing a toddler 1 day in advance may increase anxiety due to limited time comprehension; same-day preparation is better. Assuming advance preparation is ideal risks distress, critical to prevent in ensuring emotional readiness and cooperation for toddlers undergoing medical procedures.
Choice D reason: Demonstrating equipment may scare toddlers without context; simple diagrams are more effective for preparation. Assuming demonstration is best risks increasing fear, critical to avoid in ensuring a toddler’s comfort and understanding during preparation for medical procedures in healthcare settings.
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