Which diagnostic test for TB infection is more specific than the tuberculin skin test (TST) and does not cross-react with other mycobacteria or the BCG vaccine?

Choice A rationale:

Directly observed therapy (DOT) is a treatment strategy used for clients with active tuberculosis (TB) disease. The purpose of DOT is to ensure that the client takes their TB medications as prescribed, under direct observation by a healthcare provider or trained healthcare worker. By directly observing the medication administration, DOT helps to ensure medication adherence, which is crucial in preventing the development of drug-resistant TB strains. It also reduces the risk of treatment failure, relapse of the disease, and transmission of TB to others. By closely monitoring the client's adherence to the treatment regimen, healthcare providers can intervene promptly if any issues arise during the course of treatment.

Choice B rationale:

Facilitating early diagnosis and treatment is an essential aspect of TB control; however, this is not the primary purpose of directly observed therapy (DOT) Early diagnosis helps to identify and initiate appropriate treatment promptly, but DOT is specifically implemented to monitor and enhance adherence during the course of treatment, particularly for those at risk of non-compliance.

Choice C rationale:

Evaluating the impact and effectiveness of TB control programs is an important public health measure, but it is not the direct purpose of DOT. DOT mainly focuses on individual client treatment adherence rather than assessing overall program effectiveness.

Choice D rationale:

Identifying and testing persons who have been in close contact with active TB cases is part of contact tracing and TB screening efforts, which are separate from the purpose of directly observed therapy (DOT) DOT is centered on the supervision of treatment for clients already diagnosed with active TB disease.

Choice A rationale:

Monitor vital signs, fluid intake and output, weight, and skin integrity. This statement is correct. When caring for a patient with chickenpox, monitoring vital signs can help detect any signs of complications like fever. Fluid intake and output, weight, and skin integrity are important to assess the patient's hydration status and the progression of the rash.

Choice B rationale:

Administer medications as prescribed and monitor for adverse effects. This statement is correct. The nurse should give antiviral medications if prescribed to help shorten the duration of the illness and reduce its severity. Monitoring for any adverse effects from the medications is essential for patient safety.

Choice C rationale:

Encourage contact with pregnant women and immunocompromised individuals to build immunity. This statement is incorrect. Encouraging contact with pregnant women and immunocompromised individuals is not appropriate because chickenpox is highly contagious and can pose serious risks to these vulnerable populations. The nurse should advise the patient to avoid contact with them until they are no longer infectious.

Choice D rationale:

Advise the patient to avoid contact with those who have had chickenpox or been vaccinated. This statement is partially correct. The patient should avoid contact with individuals who have not had chickenpox or have not been vaccinated against it to prevent the spread of the disease. However, vaccinated individuals are less likely to transmit the virus than those with active chickenpox.

Choice E rationale:

Isolate the patient until all lesions are crusted over to prevent transmission to others. This statement is correct. Isolating the patient until all the lesions are crusted over is an important infection control measure to prevent the spread of the varicella-zoster virus to others. Once the lesions are crusted, the patient is no longer contagious.