HIV and TB Case Review
Meet the Client: Jeff Smith
Thirty-two-year-old Jeff Smith is admitted from his healthcare provider's office to the acute care
facility. Jeff was diagnosed HIV positive 2 years ago. His history includes fatigue, a productive
cough, and weight loss. A tuberculosis (TB) skin test was administered in the healthcare
provider's office. Admission prescriptions include "isolation precautions for suspected pulmonary
tuberculosis." - ANS
The nurse welcomes Jeff to a private room at the end of the hall. According to hospital protocol
the nurse puts on a mask before starting the admission process. Jeff tells the nurse that his
partner is downstairs and he would like his partner to stay in the room with him. The nurse
response:
A. Your healthcare provider wants you to get some rest.
B. Your partner may stay but only after we have the results of his tuberculin test
C. Your partner may stay, but he needs to wear a mask.
D. You don't want to risk infecting your partner with TB too do you? - ANSC. Your partner may
stay, but he needs to wear a mask.
Jeff's partner wants to know why a mask is necessary for people entering his room. What
teaching should the nurse implement?
a. Explain the use of a private room and mobile high-efficiency particle fibers placed in the room
b. Explain that the TB organism is most often spread through the air. When an infected person
coughs or sneezes, they produce infectious droplets that can be breathed in by another person
c. Tell Jeff that TB will not be spread to others, and everything will be okay if the mask is worn
d. Tell Jeff that masks are required for those people who do not agree to be vaccinated with
BCG vaccine - ANSExplain that the TB organism is most often spread through the air. When an
infected person coughs or sneezes, they produce infectious droplets that can be breathed in by
another person
The UAP asks why Jeff can't be in an empty semiprivate room closer to the nurse's station.
What info should the nurse provide on infection control practices?
a. The client needs to be at the end of the hall because he requires privacy
b. The implementation of airborne precautions for possible TB requires a private, negative
pressure room assignment
c. A private room is required to implement contact precautions for possible TB
d. The client needs to be at the end of the hall for confidentiality - ANSThe implementation of
airborne precautions for possible TB requires a private, negative pressure room assignment
The nurse notices the UAP about to enter Jeff's room to deliver a meal tray without wearing any
PPE. What info should the nurse provide to the UAP?
, a. A mask is required for healthcare workers entering the room of someone suspected of having
active TB
b. Wearing a mask, gown, and gloves is required for healthcare workers entering Jeff's room for
any reason
c. The UAP will only be in the room for a brief moment to deliver the tray, so no intervention is
needed by the nurse
d. Non-sterile gloves are necessary to deliver the meal and prevent the spread of TB - ANSA
mask is required for healthcare workers entering the room of someone suspected of having
active TB
Which tasks may the nurse delegate to the UAP? (SAA)
a. Tell Jeff that the specimen must be collected in the early morning
b. Provide Jeff with 3 Sterile specimen cups at his bedside
c. Teach the client how to cough to obtain sputum from deep in the bronchi
d. Document the time and date that each sputum specimen was collected
e. Assess Jeff's ability to expectorate a sputum specimen - ANSTell Jeff that the speciment must
be collected in the early morning
Provide Jeff with 3 Sterile specimen cups at his bedside
Document the time and date that each sputum specimen was collected
What activity should Jeff perform first upon awakening?
a. Eat a nutritionally dense, early morning snack sent from the food services department
b. Obtain the first of 3 sputum specimens for lab testing
c. Take a shower and get ready to go to radiology for a chest x-ray
d. Weigh to determine if weight loss from the disease is continuing - ANSObtain the first of 3
sputum specimens for lab testing
A female staff nurse tells the supervisor that she doesn't want to care for an HIV pt. The nursing
supervisor should base her response on what information about the right of a nurse to refuse to
care for clients with HIV?
a. The RN has the right and responsibility to protect the health of self and family and may
therefore refuse to care for clients with contagious diseases
b. The RN may refuse to care for the pt in circumstances where risk to the nurse outweighs the
nurse's responsibility to care for a client or if the assignment conflicts with the nurse's ethical
standards
c. Refusal to treat or care for a pt based on race, gender, or age is discrimination, which the
federal government prohibits
d. The required staffing ratio of licensed personnel to client population does not allow for
professional nurses to refuse to care for a client - ANSThe RN may refuse to care for the pt in
circumstances where risk to the nurse outweighs the nurse's responsibility to care for a client or
if the assignment conflicts with the nurse's ethical standards
How should the nursing supervisor respond to the staff nurse who does not want to care for
Jeff?
Meet the Client: Jeff Smith
Thirty-two-year-old Jeff Smith is admitted from his healthcare provider's office to the acute care
facility. Jeff was diagnosed HIV positive 2 years ago. His history includes fatigue, a productive
cough, and weight loss. A tuberculosis (TB) skin test was administered in the healthcare
provider's office. Admission prescriptions include "isolation precautions for suspected pulmonary
tuberculosis." - ANS
The nurse welcomes Jeff to a private room at the end of the hall. According to hospital protocol
the nurse puts on a mask before starting the admission process. Jeff tells the nurse that his
partner is downstairs and he would like his partner to stay in the room with him. The nurse
response:
A. Your healthcare provider wants you to get some rest.
B. Your partner may stay but only after we have the results of his tuberculin test
C. Your partner may stay, but he needs to wear a mask.
D. You don't want to risk infecting your partner with TB too do you? - ANSC. Your partner may
stay, but he needs to wear a mask.
Jeff's partner wants to know why a mask is necessary for people entering his room. What
teaching should the nurse implement?
a. Explain the use of a private room and mobile high-efficiency particle fibers placed in the room
b. Explain that the TB organism is most often spread through the air. When an infected person
coughs or sneezes, they produce infectious droplets that can be breathed in by another person
c. Tell Jeff that TB will not be spread to others, and everything will be okay if the mask is worn
d. Tell Jeff that masks are required for those people who do not agree to be vaccinated with
BCG vaccine - ANSExplain that the TB organism is most often spread through the air. When an
infected person coughs or sneezes, they produce infectious droplets that can be breathed in by
another person
The UAP asks why Jeff can't be in an empty semiprivate room closer to the nurse's station.
What info should the nurse provide on infection control practices?
a. The client needs to be at the end of the hall because he requires privacy
b. The implementation of airborne precautions for possible TB requires a private, negative
pressure room assignment
c. A private room is required to implement contact precautions for possible TB
d. The client needs to be at the end of the hall for confidentiality - ANSThe implementation of
airborne precautions for possible TB requires a private, negative pressure room assignment
The nurse notices the UAP about to enter Jeff's room to deliver a meal tray without wearing any
PPE. What info should the nurse provide to the UAP?
, a. A mask is required for healthcare workers entering the room of someone suspected of having
active TB
b. Wearing a mask, gown, and gloves is required for healthcare workers entering Jeff's room for
any reason
c. The UAP will only be in the room for a brief moment to deliver the tray, so no intervention is
needed by the nurse
d. Non-sterile gloves are necessary to deliver the meal and prevent the spread of TB - ANSA
mask is required for healthcare workers entering the room of someone suspected of having
active TB
Which tasks may the nurse delegate to the UAP? (SAA)
a. Tell Jeff that the specimen must be collected in the early morning
b. Provide Jeff with 3 Sterile specimen cups at his bedside
c. Teach the client how to cough to obtain sputum from deep in the bronchi
d. Document the time and date that each sputum specimen was collected
e. Assess Jeff's ability to expectorate a sputum specimen - ANSTell Jeff that the speciment must
be collected in the early morning
Provide Jeff with 3 Sterile specimen cups at his bedside
Document the time and date that each sputum specimen was collected
What activity should Jeff perform first upon awakening?
a. Eat a nutritionally dense, early morning snack sent from the food services department
b. Obtain the first of 3 sputum specimens for lab testing
c. Take a shower and get ready to go to radiology for a chest x-ray
d. Weigh to determine if weight loss from the disease is continuing - ANSObtain the first of 3
sputum specimens for lab testing
A female staff nurse tells the supervisor that she doesn't want to care for an HIV pt. The nursing
supervisor should base her response on what information about the right of a nurse to refuse to
care for clients with HIV?
a. The RN has the right and responsibility to protect the health of self and family and may
therefore refuse to care for clients with contagious diseases
b. The RN may refuse to care for the pt in circumstances where risk to the nurse outweighs the
nurse's responsibility to care for a client or if the assignment conflicts with the nurse's ethical
standards
c. Refusal to treat or care for a pt based on race, gender, or age is discrimination, which the
federal government prohibits
d. The required staffing ratio of licensed personnel to client population does not allow for
professional nurses to refuse to care for a client - ANSThe RN may refuse to care for the pt in
circumstances where risk to the nurse outweighs the nurse's responsibility to care for a client or
if the assignment conflicts with the nurse's ethical standards
How should the nursing supervisor respond to the staff nurse who does not want to care for
Jeff?
