A nurse manager is providing teaching to a newly licensed nurse about Mantoux testing. Which of the following clients should the nurse manager include as an example of a client who might manifest a false-positive reading?
A client who has undergone radiation therapy within the last 3 years
A client who has received the bacille Calmette-Guerin vaccine within the last 10 years
A client who has acquired immune deficiency syndrome
A client who has lived in a country where tuberculosis is endemic
The Correct Answer is B
A. A client who has undergone radiation therapy within the last 3 years: Radiation therapy may suppress the immune response, potentially leading to a false-negative rather than a false-positive Mantoux test due to reduced ability to mount a reaction.
B. A client who has received the bacille Calmette-Guerin vaccine within the last 10 years: The BCG vaccine can cause a false-positive Mantoux result because the vaccine uses a strain of Mycobacterium bovis, which can trigger a reaction similar to TB exposure in skin testing.
C. A client who has acquired immune deficiency syndrome: Clients with AIDS are immunocompromised, which increases the likelihood of a false-negative Mantoux result, as their immune systems may not respond sufficiently to the test.
D. A client who has lived in a country where tuberculosis is endemic: This client is at higher risk for true TB exposure, and a positive result is more likely to reflect actual infection rather than a false-positive reaction.
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Related Questions
Correct Answer is B
Explanation
A. Consulting with the provider throughout a client's course of treatment: Consulting with providers is a collaborative practice that supports coordinated care and is a standard professional responsibility, not typically a liability concern for case managers.
B. Providing recommendations to a client about alternatives to treatments prescribed by their provider: Making treatment recommendations without proper authorization or outside the scope of practice can lead to liability issues. Case managers must avoid advising clients to alter prescribed treatments and instead facilitate communication between clients and providers.
C. Verifying a provider's licensure before referring the client to them: Verifying licensure ensures the provider’s credentials are valid and protects clients from unqualified practitioners. This is a standard safety practice and does not pose liability for the case manager.
D. Determining a client's literacy level before providing advance directive documents:
Assessing literacy helps tailor education and ensures client understanding, which supports informed decision-making and reduces liability risks related to inadequate communication. This is a prudent nursing action, not a liability concern.
Correct Answer is D
Explanation
A. Refer the clients for financial assistance to receive medications: While financial support is important for accessing treatment, it is not the immediate priority during an active outbreak. The nurse must first assess the scope and potential cause of the diarrhea to prevent further spread and guide appropriate interventions.
B. Arrange for the clients to see a health care provider: Medical evaluation is essential, especially if symptoms worsen or complications arise. However, this step should follow a thorough assessment of exposure to identify patterns, potential sources, and the need for urgent containment or broader screening efforts.
C. Provide teaching about hand washing for the clients: Hand hygiene is critical in preventing the transmission of infectious diarrhea. However, client education should come after identifying the exposure route to ensure teaching is targeted and effective in addressing the specific mode of transmission.
D. Obtain an individual client exposure history: The nurse’s first priority should be to gather detailed information about each client's symptoms, recent meals, travel, and contacts. This assessment helps identify common exposures, guides immediate containment efforts, and directs appropriate medical or public health responses to control a potential outbreak.
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