A patient has been compliant with drug therapy for tuberculosis (TB) and has returned as instructed for follow-up. Which result indicates that the patient is no longer infectious or communicable?
Negative chest x-ray.
No clinical symptoms.
Three negative sputum cultures.
Negative skin test.
The Correct Answer is C
Choice A rationale
A negative chest x-ray, while indicative of resolving lung pathology, does not definitively confirm the absence of viable Mycobacterium tuberculosis. Radiographic resolution can lag behind bacteriologic clearance, meaning granulomas might still be present even if the active infection has been eliminated, and thus transmissibility cannot be excluded solely based on imaging.
Choice B rationale
The absence of clinical symptoms, such as cough, fever, or weight loss, suggests clinical improvement but does not guarantee bacteriologic cure or non-infectiousness. A patient can be asymptomatic yet still shed viable mycobacteria, posing a risk of transmission to others. Bacteriological confirmation is essential.
Choice C rationale
Three negative sputum cultures, typically collected on separate days, are the gold standard for confirming that a patient with tuberculosis is no longer infectious. This indicates the absence of viable Mycobacterium tuberculosis in respiratory secretions, significantly reducing the risk of transmission to others due to the inability to aerosolize infectious particles.
Choice D rationale
A negative skin test, or tuberculin skin test (TST), indicates the absence of a delayed-type hypersensitivity reaction to M. tuberculosis antigens. It primarily reflects exposure and immune response, not active infection or infectiousness. A previously positive TST usually remains positive even after successful treatment, so a negative result in a treated patient is not a measure of non-infectiousness.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While nutrition is important, Meals on Wheels primarily addresses food insecurity and nutritional support for homebound individuals. For tuberculosis, the most critical long-term need is adherence to a complex medication regimen, which is not directly addressed by meal delivery services.
Choice B rationale
Occupational therapy focuses on helping individuals return to work or daily activities, and while long-term illness can impact this, it's not the immediate priority for ensuring effective treatment and preventing drug resistance in tuberculosis management.
Choice C rationale
Physical therapy is concerned with mobility and physical function. While a client with a chronic illness might experience deconditioning, it is not the primary or most critical referral for successful long-term tuberculosis therapy, which heavily relies on medication adherence.
Choice D rationale
Directly observed therapy (DOT) by visiting nurses is crucial for ensuring medication adherence in tuberculosis treatment. This strategy significantly improves treatment completion rates, reduces the development of drug-resistant strains, and prevents further transmission by directly observing clients taking their medications, which is vital for a successful outcome.
Correct Answer is D
Explanation
Choice A rationale
Treatment for pulmonary tuberculosis with rifampin is typically prolonged, lasting for several months, often 6 to 9 months, not just 1 month. Shortening the treatment duration significantly increases the risk of drug resistance and recurrence of the infection. Adherence to the full regimen is critical for eradication.
Choice B rationale
Rifampin is not typically associated with causing insomnia. Common side effects include gastrointestinal upset, hepatotoxicity, and discoloration of body fluids. Insomnia is more commonly linked to other medications or underlying conditions, not a characteristic side effect of rifampin directly impacting sleep architecture.
Choice C rationale
Taking rifampin with meals is generally not recommended as food can impair its absorption, reducing its bioavailability and therapeutic effectiveness. It is typically advised to take rifampin on an empty stomach, either 1 hour before or 2 hours after meals, to ensure optimal drug absorption and efficacy.
Choice D rationale
Rifampin causes a harmless but noticeable orange-red discoloration of urine, sweat, tears, and other body secretions. This is due to the drug's inherent color and its excretion pathways. Clients should be informed of this expected side effect to prevent anxiety and ensure adherence to the medication regimen.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.