# Stage 5 — Take action. Place the five action clusters in the safest sequence after the nurse recognizes suspected infectious pulmonary TB. Team tasks may overlap when qualified personnel are available. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=372911&lang=en > language: en > subject: Standard/Transmission-Based Precautions/Surgical Asepsis > category: SIPC ## Question Stage 5 — Take action. Place the five action clusters in the safest sequence after the nurse recognizes suspected infectious pulmonary TB. Team tasks may overlap when qualified personnel are available. Place a mask on the client, close the current private-room door, limit entry and transport, remain outside until appropriate respiratory protection is available, and call for assistance. Collect the respiratory specimens in an appropriate controlled setting, obtain indicated HIV and baseline studies, and begin the clinician-prescribed regimen without waiting unnecessarily for culture results. Reassess the client and isolation controls, provide focused teach-back, document the timeline and handoff, and verify that exposure follow-up has an accountable owner. Notify the responsible clinician and infection prevention, coordinate required public-health reporting, reconstruct shared-air exposure, and prioritize vulnerable contacts for prompt evaluation. Transfer the client to an AIIR as soon as possible and restrict entry to essential personnel using a fit-tested N95 or higher-level respirator. ## Explanation Safest sequence: 2 → 3 → 5 → 4 → 1 First stop further unprotected exposure with client source control, a closed door, limited entry, and appropriate respiratory protection (choice 2). Next establish AIIR environmental control (choice 3). Then activate the clinical, infection-prevention, and public-health response and identify vulnerable contacts (choice 5). Obtain the diagnostic set and initiate the prescribed regimen without unnecessary delay (choice 4). Reassessment, teach-back, documentation, and closed-loop handoff complete the response (choice 1). In practice, notification, transfer preparation, and testing often overlap across the team. ## In-depth explanation 1 — Stop the exposure Mask the client, close the door, limit entry, and ensure personnel do not enter without appropriate respiratory protection. 2 — Establish engineering control AIIR placement reduces spread while respiratory protection remains required for entry. 3 and 4 — Coordinate and diagnose Notify the accountable teams, establish the exposure window, and collect the recommended respiratory specimens. Treatment generally should not be delayed while awaiting bacteriologic results when TB is presumptive. 5 — Close the loop Reassess isolation and clinical status, use teach-back, document facts and times, and hand off each pending specimen, treatment, and contact-follow-up task. ## Clinical scenario Scenario (Stage 5 — Take action) The nurse must stop continuing exposure, establish airborne controls, and connect bedside care to diagnosis and public-health follow-up. ## Key concepts - **Contain before confirmation** — Immediate source, environmental, and respiratory controls used for suspected disease while laboratory confirmation proceeds. - **Parallel team response** — Qualified personnel may prepare AIIR transfer, notify infection prevention, and organize testing concurrently after immediate exposure control. - **Closed-loop exposure handoff** — Transfer of the infectious-period estimate, exposed-person list, PPE and ventilation details, vulnerabilities, symptoms, tests, and follow-up dates to an accountable team. ## Related questions - [A nurse is caring for a client newly admitted with suspected methicillin-resistant Staphyl…](https://mymerci.kr/pages/nclex_q.php?qn_id=360517&lang=en) - [A nurse is about to enter the room of a client with Clostridioides difficile infection dur…](https://mymerci.kr/pages/nclex_q.php?qn_id=361226&lang=en) - [A 22-year-old female client presents to the emergency department with a 4-week history of …](https://mymerci.kr/pages/nclex_q.php?qn_id=361677&lang=en) - [A 65-year-old client admitted to the medical ICU with sepsis and acute delirium has just p…](https://mymerci.kr/pages/nclex_q.php?qn_id=361679&lang=en) - [A new graduate registered nurse (RN) on a medical unit just hung an intravenous antibiotic…](https://mymerci.kr/pages/nclex_q.php?qn_id=361710&lang=en) - [A nurse is caring for a client newly admitted with active Clostridioides difficile infecti…](https://mymerci.kr/pages/nclex_q.php?qn_id=363996&lang=en) - [A nurse is caring for an adult client newly admitted with suspected active pulmonary tuber…](https://mymerci.kr/pages/nclex_q.php?qn_id=366306&lang=en) - [A nurse cares for a client newly admitted with a positive surveillance culture for vancomy…](https://mymerci.kr/pages/nclex_q.php?qn_id=366709&lang=en) ## Read in another language - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=372911&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=372911&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=372911&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=372911&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=372911&lang=vi) --- More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en) _For study reference only. Always follow current clinical guidelines and your institution’s protocols._