A nurse is preparing to administer purified protein derivative (PPD) skin test to another healthcare worker. Which of the following statements about the test is incorrect?

You will need to return in 48-72 hours to have the test read

A positive skin test will mean you need to have a follow up a chest x-ray

"induration of greater than or equal to 10 millimeters means you have been exposed

"induration of greater than or equal to 10 millimeters means you have active tuberculosis

Answer and Explanation

The Correct Answer is D

A. You will need to return in 48-72 hours to have the test read:
This statement is correct. The purified protein derivative (PPD) skin test, also known as the tuberculin skin test (TST), must be read within 48-72 hours after administration. If the test is not read within this timeframe, the results may not be valid, and the test may need to be repeated. The test evaluates the presence of induration (swelling) at the injection site, which indicates a delayed-type hypersensitivity reaction to the tuberculosis antigen.

B. A positive skin test will mean you need to have a follow-up chest x-ray:
This statement is correct. A positive PPD skin test indicates exposure to Mycobacterium tuberculosis (the bacteria that causes tuberculosis). However, a positive result does not necessarily mean the person has active tuberculosis. A follow-up chest x-ray is typically recommended to determine whether active TB disease is present. The chest x-ray helps to assess for signs of active infection, such as lung lesions.

C. "Induration of greater than or equal to 10 millimeters means you have been exposed":
This statement is correct. In the context of a PPD skin test, induration (raised area of the skin) of 10 millimeters or more is generally considered a positive result, indicating exposure to tuberculosis. However, the exact threshold for what is considered positive can vary based on individual risk factors. A positive test means the person has been exposed to the tuberculosis bacteria, but it does not confirm active disease.

D. "Induration of greater than or equal to 10 millimeters means you have active tuberculosis":
This statement is incorrect. A positive PPD skin test result indicates exposure to Mycobacterium tuberculosis, but it does not confirm active tuberculosis (TB) infection. The induration reflects prior exposure or latent infection. To determine if the individual has active TB, additional diagnostic tests such as a chest x-ray, sputum cultures, and possibly a molecular test are required. A positive PPD result does not differentiate between latent TB infection and active TB disease.

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Correct Answer is B

Explanation

A. 2-6 hours before meals:
This timeframe is too long for rapid-acting insulin like Lispro. Rapid-acting insulins, such as Lispro, begin to work quickly after administration, typically within 15 minutes, and peak around 1 to 2 hours after injection. Administering it 2-6 hours before meals would not align with the timing of food intake and would likely lead to hypoglycemia before the meal. Timing of rapid-acting insulin should be closer to the meal to match the rise in blood glucose levels that occurs after eating.

B. Lispro lasts 24 hours and does not have to be timed with meals:
This statement is incorrect. Lispro is a rapid-acting insulin, and its duration of action is much shorter than 24 hours, typically lasting about 3-5 hours. It is crucial to time the administration of Lispro with meals to match its peak action with the rise in blood glucose levels after eating. A long-acting insulin would be the type that lasts for 24 hours, but that is not the case with Lispro.

C. 15-30 minutes before meals:
Lispro is a rapid-acting insulin, and its onset of action occurs within 15 minutes after injection. It is most effective when administered within 15-30 minutes before the start of a meal, as it peaks in about 1-2 hours and works to regulate blood glucose levels during and after the meal. This timing ensures that insulin works in concert with the rise in blood glucose following food intake, helping prevent hyperglycemia.

D. 60 minutes before meals:
Administering Lispro 60 minutes before a meal is too early. Rapid-acting insulins, such as Lispro, begin working quickly and reach peak action within 1-2 hours. If administered too far in advance, there is a risk that the insulin may have peaked before the meal, leading to a potential drop in blood glucose levels before the meal is consumed. This could result in hypoglycemia. Therefore, administering it closer to the meal, within 15-30 minutes, is the optimal timing.

A. Remove the traction when the client wants to ambulate B. Provide pin site care for skin traction. C. Check the weights to ensure that they are hanging freely D. Adjust the amount of weight depending on the clients preference

Correct Answer is C

Explanation

A) Remove the traction when the client wants to ambulate:
Traction is a therapeutic treatment used to immobilize bones, joints, or soft tissues, often after fractures or orthopedic procedures. Removing traction to allow ambulation is not appropriate unless directed by a healthcare provider. Traction must be maintained to ensure proper alignment and healing of the affected body part. Premature removal can cause complications such as malalignment, delayed healing, or further injury.

B) Provide pin site care for skin traction:
Pin site care is required for skeletal traction, not skin traction. Skin traction uses adhesive strips or other external devices to apply force to the body, and no pins are involved. Skeletal traction, on the other hand, uses pins, screws, or wires that are inserted directly into the bone. It’s important to provide proper pin site care to prevent infection in skeletal traction, but this is not relevant to skin traction, which doesn’t involve direct penetration of the skin.

C) Check the weights to ensure that they are hanging freely:
It is essential to check that the weights in traction are hanging freely and not in contact with the floor or any other surface. Weights should be unobstructed to provide continuous, even force that maintains the proper alignment of the injured body part. Any obstruction or improper positioning of the weights can compromise the effectiveness of the traction and delay healing.

D) Adjust the amount of weight depending on the client’s preference:
The amount of weight used in traction is determined by the healthcare provider based on the specific injury or condition being treated. Adjusting the weight based on the client's preference could lead to inappropriate tension, worsening the injury or hindering the healing process. The nurse should not adjust the weight without a physician’s order, as it is critical to follow the prescribed treatment plan for optimal healing and safety.

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A nurse is preparing to administer purified protein derivative (PPD) skin test to another healthcare worker. Which of the following statements about the test is incorrect?

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