Chapter 66: Antitubercular Agents

Chapter 66: Antitubercular Agents

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A patient receives a Mantoux tuberculin skin test as part of screening for a new job. The test is administered on a Friday, and the patient returns to the clinic the following Wednesday. The primary care nurse practitioner (NP) notes a 3-mm area of induration. The patient has no risk factors for tuberculosis (TB). The NP should:

ANS:  A

If the patient returns after more than 3 days and the results appear negative, the test should be repeated.

DIF:    Cognitive Level: Applying (Application)                           REF:   706

2. A patient comes to the clinic to have a Mantoux tuberculin skin test read after 48 hours. The primary care NP notes a 6-mm area of induration. The patient is a young adult with no known contacts and has never traveled abroad. The NP should:

ANS:  B

A chest x-ray should be obtained on all patients who have a positive purified protein derivative tuberculin test (PPD). The test was read in the appropriate time frame, so repeating the test is not necessary. This patient has a positive PPD. Referral to an infectious disease specialist should be made when the diagnosis is confirmed.

DIF:    Cognitive Level: Applying (Application)                           REF:   707

3. A primary care NP sees a 5-year-old child for a tuberculin skin test. The child lives in a high-risk community, and a grandparent who babysits has active TB. The PPD shows a 6-mm area of induration. A chest radiograph is normal. The NP will refer this patient to an infectious disease specialist and should expect the patient to be on _____ for _____ months.

ANS:  C

This child has a positive PPD with no pulmonary signs, so a 3-month course of isoniazid and rifapentine is indicated. Ethambutol is not recommended in children younger than 13 years.

DIF:    Cognitive Level: Applying (Application)                           REF:   708

4. A patient has a Mantoux tuberculin skin test with a 12-mm area of induration. The patient has a cough, and a chest radiograph is positive. The primary care NP should refer this patient to an infectious disease specialist and should plan to monitor a regimen of:

ANS:  D

Newly diagnosed patients with active disease should be started on a four-drug regimen.

DIF:    Cognitive Level: Understanding (Comprehension)             REF:   708