Monteux tuberculin test should be administered through which of the following routes?

RIMS Nursing Officer - 2022

Nursing Foundation

Easy

Appeared in: RIMS Nursing Officer - 2022

Explanation

The Mantoux test requires an intradermal (ID) injection, which means the substance is injected into the dermis layer of the skin.
This route is chosen because it has the longest absorption time, which is necessary to observe the delayed-type hypersensitivity reaction that indicates exposure to tuberculosis.
A correct ID injection creates a visible, pale elevation of the skin called a wheal or bleb, confirming the fluid is in the correct tissue layer.
The test is typically administered on the inner surface of the forearm for easy visibility and reading.

Option A: Intramuscular (IM) injections deliver medication deep into muscle tissue for systemic absorption. This route is incorrect for a skin test as the reaction would not be visible or localized on the skin surface.
Option C: Intravenous (IV) injection delivers substances directly into the bloodstream, providing immediate systemic effect. This is completely inappropriate and dangerous for a tuberculin test.
Option D: Subcutaneous (SC) injections are given into the fat layer under the skin. While absorption is slow, this layer is deeper than the dermis, and a tuberculin test here would not produce a reliable, measurable skin reaction.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Route of administration for the Mantoux tuberculin test as background academic context rather than a clinical decision trigger.
Accurate administration of the Mantoux test is a critical nursing skill for tuberculosis (TB) screening programs. An incorrect technique can lead to false-negative results, potentially delaying diagnosis and treatment.
Nurses are responsible for not only administering the test but also educating the patient on the importance of returning within 48-72 hours for the reading, and instructing them not to scratch or cover the site.
A key patient safety aspect is assessing for a history of severe reactions to previous tuberculin tests. A positive history is a contraindication.

How to Approach the Question

First, identify the core of the question: it asks for the specific administration route for the 'Monteux tuberculin test'.
Recognize that the Mantoux test is a diagnostic skin test, designed to create a localized, visible reaction.
Recall the different parenteral routes and their primary uses. Intradermal (ID) is for skin tests, Subcutaneous (SC) is for slow absorption into fat, Intramuscular (IM) is for absorption into muscle, and Intravenous (IV) is for direct entry into the bloodstream.
Evaluate the options in the context of a skin test. The goal is to place the substance just under the top layer of skin (epidermis) into the dermis to create a bleb for observation.
Eliminate IV, IM, and SC as they are too deep for a surface-level skin reaction test.
Conclude that the intradermal route is the only one that meets the requirements for a tuberculin skin test.

Concept Tested & Keywords

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