BTSC 3 August 2025
Medical Surgical Nursing
Easy
In the context of infection control, which type of precaution is required for a patient with Pulmonary Tuberculosis?
Appeared in: BTSC 3 August 2025
Explanation
- Pulmonary Tuberculosis (TB) is transmitted via infectious airborne particles, known as droplet nuclei, which are smaller than 5 microns in size.
- These small particles can remain suspended in the air for prolonged periods and can be inhaled by susceptible individuals.
- This mode of transmission necessitates Airborne Precautions to prevent the spread of the infection.
- Key components of Airborne Precautions include placing the patient in a negative-pressure Airborne Infection Isolation Room (AIIR) and the use of a fit-tested N95 respirator by all healthcare staff entering the room.
Why Other Options Were Wrong
- Option A: Contact precautions are incorrect because TB is not primarily transmitted through direct or indirect contact with the patient or their environment.
- Option B: Droplet precautions are insufficient because they are designed for pathogens transmitted by large droplets (larger than 5 microns), which travel short distances. TB particles are much smaller and remain airborne longer.
- Option D: While Standard Precautions are applied to all patients, they are not sufficient alone for TB. They do not include the specific respiratory protection (N95 mask) and environmental controls (negative-pressure room) needed to prevent airborne transmission.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Transmission-Based Precautions for Pulmonary Tuberculosis to guide bedside assessment, documentation, and the next nursing action.
- Correctly identifying and implementing transmission-based precautions is a fundamental nursing responsibility to prevent healthcare-associated infections (HAIs) and protect healthcare workers, other patients, and visitors.
- Failure to place a patient with active pulmonary TB on airborne precautions can lead to a nosocomial outbreak, posing a significant risk to vulnerable populations within the hospital.
- What if? If a patient with a persistent cough, fever, and night sweats is admitted to a semi-private room before TB is suspected, the nurse's priority is to place a surgical mask on the patient, move them to a private room (ideally a negative pressure room if available), and immediately notify the physician and infection control department to initiate airborne precautions pending diagnosis.
How to Approach the Question
- First, identify the specific disease mentioned in the question: Pulmonary Tuberculosis.
- Recall the mode of transmission for this disease. TB is a classic example of a disease spread through the air via tiny particles (droplet nuclei).
- Review the different types of transmission-based precautions and their purposes.
- Match the mode of transmission (airborne) with the corresponding precaution type. Airborne transmission requires Airborne Precautions.
- Eliminate the other options by confirming their indications: Contact is for touch-transmitted pathogens, Droplet is for large-particle respiratory droplets, and Standard is the universal baseline but insufficient for TB.
Concept Tested & Keywords
- Concept Tested: Transmission-Based Precautions for Pulmonary Tuberculosis
- Stem keywords: Pulmonary Tuberculosis, infection control, precaution
- Lead-in keywords: which type
- Negative lead-in flag: false
Question ID
Q7t7yV8gEoSO3CB9o14r_r
Reference Book
E6 Nursing Fundamentals Potter Perry 12e Part 2 p. 235-237
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 43-45
E6 Microbiology Applied AnjuDhir 3e Part 2 p. 143-145
Practise the full BTSC 3 August 2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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