# An occupational-health nurse is reviewing tuberculosis screening for U.S. health care personnel. For each action, select the best classification. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=396192&lang=en > language: en > subject: Health Screening > category: HPM ## Question An occupational-health nurse is reviewing tuberculosis screening for U.S. health care personnel. For each action, select the best classification. | | Baseline screening at hire | Ongoing or postexposure action | Not routinely indicated | | --- | --- | --- | --- | | Complete an individual TB risk assessment and symptom evaluation | | | | | Use an IGRA or TST when there is no documented prior TB disease or latent TB infection | | | | | Provide annual education about TB risk factors, signs, symptoms, and reporting procedures | | | | | After a recognized exposure, evaluate symptoms and test as indicated; repeat a negative initial test 8 to 10 weeks after the last exposure | | | | | Evaluate a newly positive test for TB disease, then offer or encourage latent TB infection treatment when disease is excluded | | | | | Perform annual serial TB testing for every low-risk worker despite no exposure or evidence of ongoing transmission | | | | ## Explanation At hire, U.S. health care personnel receive an individual TB risk assessment, symptom evaluation, and a TB test when there is no documented prior TB disease or latent TB infection. In the absence of known exposure or ongoing transmission, routine annual serial TB testing is not recommended, although facilities provide annual TB education. After a recognized exposure, personnel receive symptom evaluation and testing as indicated; if the initial test is negative, repeat testing 8 to 10 weeks after the last exposure is recommended. A newly positive result requires evaluation for TB disease before latent TB infection treatment is offered or encouraged. ## In-depth explanation Correct Answer Use risk assessment, symptom evaluation, and indicated testing at baseline. Provide annual TB education and conduct exposure-based evaluation and follow-up. Do not schedule universal annual serial testing for low-risk personnel without exposure or ongoing transmission. Why It Fits Current U.S. recommendations moved away from routine annual testing in low-risk settings while preserving baseline assessment, education, and rapid postexposure follow-up. Clinical Picture A negative test obtained too soon after exposure may precede immune conversion, so an indicated repeat test is timed 8 to 10 weeks after the last exposure. A positive result triggers assessment for active disease before latent-infection management. Memory Link Baseline once, education yearly, test again for exposure or transmission. NCLEX Rule Separate annual education from annual testing. Choose the pathway based on baseline status, exposure, symptoms, local transmission, and the timing of the last exposure. Why the Alternatives Fail Automatic annual testing without exposure conflicts with current CDC guidance for low-risk personnel. Skipping a postexposure repeat after an early negative test can miss later conversion. Treating a positive test without first evaluating for TB disease bypasses a critical safety step. Source 1CDC TB Screening and Testing of Health Care Personnel 2CDC and NTCA Recommendations for U.S. Health Care Personnel 32026 NCLEX-RN Test Plan ## Clinical scenario The facility follows current CDC recommendations. The personnel member has no documented prior TB disease or latent TB infection at hire and works in a setting without known ongoing transmission. Later findings are handled according to exposure and test status. ## Key concepts - **Baseline TB Screening** — The preplacement evaluation for health care personnel that includes an individual risk assessment, symptom evaluation, and indicated TB testing based on prior documentation and current guidance. - **IGRA or TST** — An interferon-gamma release assay or tuberculin skin test used to identify TB infection. The result is interpreted with risk, symptoms, exposure history, and evaluation for TB disease. - **Postexposure Follow-Up** — Symptom evaluation and indicated testing after a recognized TB exposure, including repeat testing 8 to 10 weeks after the last exposure when an initial test is negative. ## Related questions - [A 76-year-old client visits the primary care clinic for an annual wellness exam. The clien…](https://mymerci.kr/pages/nclex_q.php?qn_id=363451&lang=en) - [A 50-year-old male presents for a routine physical exam. 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Always follow current clinical guidelines and your institution’s protocols._