— 降低風險 · MEDIUM · MCQ —
一位病人的結核菌素測試(Mantoux test)呈陽性,護理師的下一步為何?
A nurse is caring for a client with a positive Mantoux test. What is the nurse's next step?
- AAdminister prophylactic antibiotics給予預防性抗生素
- BObtain a chest X-ray✓ 正解進行胸部X光檢查
- CNotify the local health department通知當地衛生部門
- DInitiate airborne precautions immediately立即實施空氣隔離措施
— Explanation · 中文詳解 —
Mantoux 測試陽性僅代表病人曾接觸過結核菌(潛伏感染),不代表患有活動性肺結核。下一步應透過胸部 X 光來排除是否有活動性病灶。若 X 光正常,則不需立刻執行空氣隔離(D);若發現活動性病灶,才進行後續治療與上報衛生部門。
A positive Mantoux test indicates only prior TB exposure (latent infection), not active TB disease. The next step is a chest X-ray to rule out active disease. If the X-ray is normal, airborne precautions (D) are not immediately required; if there is an active lesion, treatment and public-health reporting follow.
✦ 台美臨床差異
台美皆遵循此篩檢邏輯,但美國對 BCG 疫苗接種史的影響判定更為謹慎,因 BCG 會造成偽陽性。