Question

An occupational health nurse in a factory is performing a routine TB screening and identifies an employee who has a positive Mantoux tuberculin test. Which of the following actions should the nurse plan to take?

a. Refer the employee to a primary care physician for further evaluation
b. Isolate the employee from coworkers immediately
c. Administer a second Mantoux test for confirmation
d. Notify the local health department and follow their guidelines

Answer 1

An occupational health nurse should refer an employee with a positive Mantoux tuberculin test to a primary care physician for further evaluation to confirm active tuberculosis. Immediate isolation or a second Mantoux test is not necessary at this initial stage.

Step-by-step explanation:

If an employee has a positive Mantoux tuberculin test, an occupational health nurse should plan to refer the employee to a primary care physician for further evaluation. This step is crucial because a positive test indicates exposure to Mycobacterium tuberculosis and possibly an active infection. However, a positive result does not necessarily confirm active tuberculosis (TB), as it could also result from prior exposure or vaccination with the BCG vaccine. The primary care physician may conduct further tests, like a chest radiograph, to confirm if the employee has active TB. It’s not necessary to isolate the employee immediately or administer a second Mantoux test for confirmation at this stage. Notifying the local health department and following their guidelines may be required depending on the results of the further evaluation and local regulations.