TB Test Communication and Documentation 2 — Questions and Answers
Question 1: A patient's TST result shows 12mm induration. The patient is an immigrant from a high-prevalence country. How should this be documented?
- Record as negative since 12mm is below the 15mm threshold
- Document as positive with the measurement and note the patient's high-risk status (Correct answer)
- Record only the measurement without interpretation
- Mark as inconclusive pending repeat testing
Correct answer: Document as positive with the measurement and note the patient's high-risk status
For immigrants from high-prevalence countries, 10mm or more is considered a positive result and should be documented with the measurement and risk factor noted.
Question 2: Which of the following is the correct way to document a TB contact investigation in a school setting?
- List only students who tested positive
- Record all contacts identified, testing offered, results, and follow-up actions (Correct answer)
- Document only the index case information
- File a single report covering all contacts without individual records
Correct answer: Record all contacts identified, testing offered, results, and follow-up actions
Contact investigation documentation must include all identified contacts, testing offered and results, and follow-up actions taken for each individual.
Question 3: When a healthcare worker refuses TB testing, how should this be documented?
- No documentation is required since testing is voluntary
- Document the refusal, the date, the reason given if provided, and any counseling offered (Correct answer)
- Only note the refusal in the worker's personal file
- Report immediately to law enforcement
Correct answer: Document the refusal, the date, the reason given if provided, and any counseling offered
Refusals must be documented with the date, reason if given, and any education or counseling provided to protect the institution and ensure follow-up.
Question 4: A patient on LTBI treatment misses two consecutive monthly appointments. What is the appropriate communication action?
- Discontinue treatment and close the case
- Attempt to contact the patient by phone and document all outreach attempts (Correct answer)
- Wait for the patient to reschedule on their own
- Notify law enforcement of the non-compliance
Correct answer: Attempt to contact the patient by phone and document all outreach attempts
Active outreach attempts should be made and documented, as lost-to-follow-up patients represent a public health concern and program accountability issue.
Question 5: Which information is LEAST critical to include when documenting an IGRA result?
- The specific IGRA test brand used
- The patient's favorite physician (Correct answer)
- Date the blood was collected and tested
- Quantitative result values (IFN-γ levels)
Correct answer: The patient's favorite physician
The patient's preferred physician is administrative information not essential to the clinical interpretation and documentation of an IGRA result.
Question 6: A public health nurse must report a newly confirmed TB case. Within what timeframe must most states require this report?
- Within 30 days
- Within 7 days or less, often within 24 hours (Correct answer)
- Within 90 days
- No mandatory timeframe exists
Correct answer: Within 7 days or less, often within 24 hours
Most states require TB case reports within 24 hours to 7 days, enabling rapid contact investigation and treatment initiation.
Question 7: When documenting a patient's TB history obtained from a foreign medical record written in another language, the nurse should:
- Omit the information since it cannot be verified
- Note the source, use a certified interpreter or translator, and document what was understood (Correct answer)
- Accept a family member's verbal translation as official
- Assume all foreign records are inaccurate
Correct answer: Note the source, use a certified interpreter or translator, and document what was understood
Foreign records should be documented with source noted and professional translation used to ensure accuracy and legal defensibility.
TB Test Communication and Documentation 2
A patient's TST result shows 12mm induration.
The patient is an immigrant from a high-prevalence country.
How should this be documented?