A client arrives with a 3-week cough, night sweats, weight loss, and an upper-lobe cavitary lesion. Complete the priority infection-control response.
Drop-down Cloze
Choose your responses, then check the answer.
Explanation
Suspected infectious pulmonary tuberculosis requires immediate airborne precautions in an AIIR. Staff enter wearing a fit-tested N95 or higher-level respirator. Limit transport; when transport is necessary, place a surgical mask on the client and coordinate testing and infection-control notification.
Quick answer Place the client in an airborne-infection isolation room, use a fit-tested N95 or higher-level respirator for staff, and mask the client with a surgical mask when transport is necessary.
Why this is correct A prolonged cough, constitutional symptoms, and an upper-lobe cavity are concerning for infectious pulmonary tuberculosis. Precautions begin when disease is suspected, not only after laboratory confirmation.
Easy analogy or mental picture Control the air at both ends: contain the client's respiratory particles and protect staff who enter the room.
Memory hook Suspected TB: AIIR, respirator, and patient mask for transport.
NCLEX decision rule Use airborne precautions and an AIIR for suspected infectious pulmonary TB. Respirator use must be part of a respiratory-protection program with fit testing. Limit movement and perform aerosol-generating or sputum-induction procedures in appropriate isolation or ventilated settings.
Why the other choices are wrong Droplet precautions alone and a standard surgical mask on staff do not provide the recommended respiratory protection. Waiting for culture confirmation leaves others exposed during the diagnostic interval.
Source
1CDC Tuberculosis Infection Control in Health Care Settings
2CDC Transmission-Based Precautions
32026 NCLEX-RN Test Plan
Pulmonary tuberculosis is suspected before microbiologic confirmation. The nurse initiates airborne precautions, applies source control during transport, and coordinates diagnostic specimen collection in an airborne-infection isolation or otherwise appropriately ventilated setting.
Airborne infection isolation room — A negative-pressure single-patient room designed to prevent airborne contaminants from escaping to adjacent areas.
Fit-tested N95 respirator — A filtering facepiece respirator verified to seal appropriately to the individual wearer.
Source control — Placing a mask on a potentially infectious person to reduce dispersal of respiratory particles.