A patient is hospitalized with active tuberculosis (TB). Which assessment finding indicates to the nurse that prescribed airborne precautions are likely to be discontinued?

Mantoux testing shows an induration of 10 mm.

TB medications have been taken for 6 months.

Sputum smears for acid-fast bacilli are negative.

Chest x-ray shows no upper lobe infiltrates.

Answer and Explanation

The Correct Answer is C

Choice A reason: Mantoux induration of 10 mm indicates TB exposure, not active infection status. It’s a diagnostic tool, not a marker for contagiousness, so it doesn’t guide discontinuation of airborne precautions in treatment.

Choice B reason: Six months of TB meds suggests treatment progress, but contagiousness persists until sputum clears. Duration alone isn’t enough; microbiologic evidence is required to lift precautions, per infection control standards.

Choice C reason: Negative sputum smears for acid-fast bacilli (three consecutive) confirm non-infectiousness in TB. This microbiological clearance allows discontinuation of airborne precautions, as the patient no longer spreads viable bacteria via droplets.

Choice D reason: Clear x-ray (no infiltrates) shows healing, but sputum can remain infectious. Radiologic improvement lags behind contagiousness, so negative smears, not imaging, determine when precautions can safely end.

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Correct Answer is A

Explanation

Choice A reason: Community-acquired pneumonia (CAP) fits symptoms like cough or fever from pathogens outside hospitals. It’s the most likely without hospital exposure history, aligning with typical outpatient respiratory infection patterns.

Choice B reason: Cor pulmonale involves right heart failure from lung disease, not primary infection. Maria’s acute symptoms suggest pneumonia, not chronic pulmonary hypertension, making this less probable without supporting cardiac findings.

Choice C reason: Hospital-acquired pneumonia requires recent hospitalization, not indicated here. Maria’s presentation lacks nosocomial context, favoring community-acquired pneumonia as the diagnosis based on typical outpatient symptom onset.

A. The patient’s blood pressure is 164/98. B. The patient’s oxygen saturation is 90%. C. The patient reports feeling weak. D. The patient appears somnolent and difficult to arouse.

Correct Answer is D

Explanation

Choice A reason: Blood pressure of 164/98 mmHg is elevated but not immediately life-threatening in respiratory failure. It may reflect stress or chronic hypertension, less urgent than neurologic changes signaling CO2 narcosis.

Choice B reason: Oxygen saturation of 90% is low but manageable with oxygen therapy in respiratory failure. It’s concerning, yet less critical than somnolence, which indicates severe CO2 retention requiring urgent intervention.

Choice C reason: Weakness is nonspecific in respiratory failure, possibly from hypoxia or fatigue. It’s not as immediately alarming as somnolence, which directly reflects brain suppression from high PaCO2, needing prompt reporting.

Choice D reason: Somnolence and difficulty arousing signal CO2 narcosis from hypercapnia (high PaCO2), a medical emergency. It indicates respiratory acidosis impairing brain function, requiring immediate provider notification for ventilatory support.

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A patient is hospitalized with active tuberculosis (TB). Which assessment finding indicates to the nurse that prescribed airborne precautions are likely to be discontinued?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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