Tuberculosis (TB) screening at a federal prison reveals that two inmates have a positive skin test. Which action is most important for the nurse to take?

Rescreen the entire prison population in 6 weeks.

Start the two inmates on antitubercular medications.

Refer the two Inmates for chest x-rays.

Screen the prison guards for TB.

Answer and Explanation

The Correct Answer is C

A. Rescreen the entire prison population in 6 weeks:
While rescreening may be necessary at some point, it is not the immediate priority. The focus should be on diagnosing and managing the individuals who have already tested positive.

B. Start the two inmates on antitubercular medications:
Starting antitubercular medications is important, but it should only be done after confirming that the individuals have active TB. The positive skin test indicates exposure but does not confirm active TB disease.

C. Refer the two inmates for chest x-rays:
A chest x-ray is crucial to determine whether the positive skin test indicates active TB disease or latent TB infection. This step is essential for accurate diagnosis and appropriate management. It helps distinguish between active TB, which requires treatment, and latent TB, which may require different management strategies.

D. Screen the prison guards for TB:
While screening the prison guards could be a part of a broader infection control plan, it is not the most immediate priority. The focus should be on further evaluating and managing the inmates who have tested positive.

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Correct Answer is A

Explanation

A) Gather information about the client's recent exposure to pesticides:
This action is the highest priority because the symptoms described—dizziness, headaches, abdominal cramps, and difficulty breathing—are consistent with pesticide poisoning, which is a common risk for migrant farm workers. Gathering information about recent pesticide exposure will help in identifying if this is the cause of the client's symptoms and guide appropriate treatment or intervention.

B) Obtain a blood sample to assess for possible lead paint exposure:
While lead exposure could be a concern, particularly in older mobile homes, the symptoms described are more immediately suggestive of pesticide poisoning. Prioritizing assessment related to pesticide exposure is more relevant to the client's current symptoms.

C) Ask about the length of his workday and frequency of rest breaks:
While understanding work conditions is important for overall health, the acute symptoms the client is experiencing are more directly linked to chemical exposure. Addressing the potential for pesticide exposure is a more urgent concern.

D) Determine the number and age of persons living in the mobile home:
This information is useful for understanding the living conditions but does not directly address the acute symptoms the client is experiencing. The priority is to identify potential causes of the symptoms, such as pesticide exposure.

A. Contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year. B. Send notices home with the children on the first day of class advising that MMR vaccine series must be completed. C. Note in student records that the second dose of the MMR vaccine should be administered prior to entering first grade. D. Speak at the next parent-teacher association meeting to teach parents the benefits of immunizing their children.

Correct Answer is A

Explanation

A) Contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year:
Directly contacting parents before the school year begins is the most effective intervention for ensuring that students receive the necessary immunizations. By reminding parents ahead of time, the school nurse can help ensure that the second dose of the MMR vaccine is administered before the start of kindergarten, which is crucial for meeting school entry requirements and protecting public health.

B) Send notices home with the children on the first day of class advising that MMR vaccine series must be completed:
Sending notices on the first day of class might be too late for many parents to act on promptly. Ensuring that children have received the second dose of the MMR vaccine before the school year starts is important for compliance and preventing potential outbreaks.

C) Note in student records that the second dose of the MMR vaccine should be administered prior to entering first grade:
While noting the requirement in student records is important for long-term tracking, it does not address the immediate need to ensure that students are up-to-date with their vaccinations before starting kindergarten. Immediate action is necessary to ensure compliance at the beginning of the school year.

D) Speak at the next parent-teacher association meeting to teach parents the benefits of immunizing their children:
While educating parents about the benefits of immunization is valuable, it does not directly address the immediate need for the second dose of the MMR vaccine. Direct reminders and actions to ensure vaccinations are up-to-date are more effective in achieving timely compliance.

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Tuberculosis (TB) screening at a federal prison reveals that two inmates have a positive skin test. Which action is most important for the nurse to take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A migrant farm worker who lives in a mobile home with several other workers visits the Migrant Health Care Center. The client reports Increasing episodes of dizziness, headaches, abdominal cramps, and difficulty breathing. Which nursing action has the highest priority?

Correct Answer is A

Explanation

The school nurse who is reviewing immunization records of students who will start kindergarten within the next month notes that most of the students have only received one dose of the measles, mumps, rubella (MMR) vaccine. Which intervention should the nurse implement?

Correct Answer is A

Explanation

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