An elderly client has a 17-mm induration after a tuberculin skin test (TST). Based on this result, which statement is most accurate?

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11ecbb05_c9ea_2a4d_b433_ade6f3f53eb0_MD0009_00 In a heathy client, an induration >15 mm indicates a positive TST; this means that the client was exposed to TB, developed antibodies to the disease, and has a TB infection. Additional tests are needed to determine if the client has latent TB infection (LTBI) or active TB disease. Clients with LTBI are asymptomatic and cannot transmit the microorganism to others. Clients with active TB disease usually are symptomatic and can transmit the microorganisms through the air. (Option A) The elderly have decreased immunity and may be unable to develop antibodies to react to the tuberculin; this can result in a false-negative TST reaction. (Option C) A positive reaction to TST means that the client is infected with TB bacteria. The infectious bacteria are concealed by the body's defense and do not lead to active TB disease in most individuals. When the client has a decreased immunity (eg, immunosuppression), bacteria cause an active TB disease. Additional diagnostic tests (eg, chest x-rays, bacteriologic sputum smear for acid-fast bacilli and culture) are needed to determine if this client has active TB disease. (Option D) A positive reaction indicates a TB infection only. Further evaluation and bacteriologic testing is necessary. If active TB is suspected before testing is completed, airborne transmission precautions will then be initiated. Educational objective: A positive reaction to TST means that a client was exposed to TB, developed antibodies, and now has a TB infection. Additional testing is needed to determine if a client has LTBI or active TB disease.

An Elderly Client Has a 17-Mm Induration After a Tuberculin