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.
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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Related Questions
Correct Answer is D
Explanation
A) Collaborate with local schools in screening children:
While screening children in local schools is an important step in controlling the spread of tuberculosis (TB), it is a more specific action that should come after a broader community assessment. Identifying high-risk groups and areas within the community is crucial before targeting specific populations for screening. This ensures that resources are allocated effectively and that screening efforts are well-directed.
B) Develop a community educational program:
Developing a community educational program is essential for raising awareness about TB, its transmission, and prevention strategies. However, before implementing such a program, it is important to conduct a community health assessment to understand the current level of knowledge, the prevalence of the disease, and the specific needs of the community. This assessment will provide valuable information to tailor the educational program appropriately.
C) Provide referrals for home health care follow up:
Providing referrals for home health care follow-up is crucial for managing and monitoring individuals with TB. However, this action is more focused on individual care rather than addressing the community-wide impact of the disease. Before setting up individual follow-ups, a community health assessment will help in understanding the overall scope of the TB outbreak and guide the development of more comprehensive intervention strategies.
D) Perform a community health assessment:
Conducting a community health assessment is the most appropriate initial action. This step involves evaluating the overall health status of the community, identifying the extent of the TB outbreak, and determining the community’s needs and resources. The assessment will provide a foundation for implementing targeted interventions, such as educational programs, screening efforts, and follow-up care. Understanding the community's health status and needs is essential for planning effective responses and controlling the spread of TB.
Correct Answer is A
Explanation
A) Review current epidemiological population data that might document a low immunization rate:
The first step in addressing low immunization rates is to gather and review current epidemiological data to confirm the extent of the problem. This data will provide a clear picture of the immunization rates in the area and help identify the specific gaps that need to be addressed. Accurate data is essential for designing targeted interventions and measuring their effectiveness.
B) Call a meeting of citizens to inform them of the importance of having their children immunized:
Informing the community about the importance of immunizations is a crucial step, but it should follow an assessment of the current immunization rates. Without data, it is difficult to know the exact need or how to effectively tailor the education to the community’s specific situation.
C) Join a political action group that focuses attention on the issue in the local news media:
While raising awareness through media and political action can be effective, it is more important to first understand the specific problem through data. The approach to media and political action can be informed and refined based on the findings from the epidemiological data review.
D) Partner with a local children's hospital in setting up free "shot" clinics in the neighborhood:
Setting up free clinics can be a valuable intervention, but before implementing such a program, it is essential to understand the scope of the problem through data review. This ensures that resources are allocated effectively and that the clinics are set up in the areas with the greatest need.
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