Four employees at a local restaurant have positive purified protein derivative (PPD) tuberculin skin tests and have been diagnosed with latent tuberculosis (TB) infection. Which employee would the nurse predict to be at the greatest risk for contracting active TB disease?

The employee who cooks the food.

The employee who works two jobs.

The employee who vacations in South America.

The employee who takes immunosuppressants.

Answer and Explanation

The Correct Answer is D

Rationale:

A. Occupation alone, such as cooking, does not inherently increase risk for reactivation of latent TB. While TB is transmitted via airborne droplets, the kitchen environment is typically not a high-risk setting unless in close contact with individuals with active TB.

B. Working multiple jobs may contribute to fatigue or stress, which can slightly impact immune function, but it is not a major risk factor for progression from latent to active TB.

C. Travel to endemic regions may increase exposure risk to new TB infections, but the question specifies latent TB infection, so the concern is reactivation, not new exposure.

D. Immunosuppressive medications (e.g., corticosteroids, biologics) weaken the immune system, significantly increasing the risk that latent TB will reactivate into active TB disease. Immunocompromised individuals are the highest-risk population for progression.

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Correct Answer is B

Explanation

Rationale:

A. Red tag is reserved for patients with immediate, life-threatening injuries that require treatment immediately to survive. These patients have the highest priority in triage.

B. Yellow tag is correct. This designation is for patients with serious injuries that are not immediately life-threatening. These individuals need treatment within 1–2 hours to prevent deterioration, but their condition is stable enough to allow red-tagged patients to be treated first.

C. Green tag identifies patients with minor injuries, sometimes called the "walking wounded." These patients can wait longer for care and are generally stable and ambulatory.

D. Black tag is for patients who are deceased or have injuries so severe that survival is unlikely, even with immediate treatment. These patients are considered expectant and are provided comfort or palliative care.

A. The client mentions she has difficulty sleeping. B. Young children are playing with the client. C. The client shares her favorite television program. D. The caregiver appears impatient with the session.

Correct Answer is D

Explanation

Rationale:
A. The client mentions she has difficulty sleeping is incorrect because difficulty sleeping is a common issue among older adults and may result from many benign causes such as age-related changes, stress, or medical conditions. It is not, by itself, a clear indicator of abuse.

B. Young children are playing with the client is incorrect because interactions with children are normal in multigenerational households and do not indicate elder abuse.

C. The client shares her favorite television program is incorrect because this reflects normal social engagement and interest in personal activities, which are positive signs of well-being.

D. The caregiver appears impatient with the session is correct because caregiver impatience, frustration, or hostility can be an early warning sign of potential elder abuse or neglect. Caregiver stress is a known risk factor for mistreatment, and such behaviors during interactions should prompt the nurse to assess further and monitor the safety and well-being of the older adult.

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Four employees at a local restaurant have positive purified protein derivative (PPD) tuberculin skin tests and have been diagnosed with latent tuberculosis (TB) infection. Which employee would the nurse predict to be at the greatest risk for contracting active TB disease?

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Naxlex Comprehensive Predictor Exams

Which of the following is the correct triage color for a patient with major injuries that must be treated in the next 1-2 hours?

Correct Answer is B

Explanation

The home health nurse is meeting with a new older adult client whose primary caregiver has requested additional assistance due to other family obligations. Which finding on the assessment should raise a red flag to the nurse for the potential of elder abuse in this household?

Correct Answer is D

Explanation

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