Pneumonia Q 6 - Gyan Darpan : Learning Portal
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Thursday, 21 April 2022

Pneumonia Q 6

A client who is HIV+ has had a PPD skin test. The nurse notes a 7-mm area of induration at the site of the skin test. The nurse interprets the results as:
     A. Positive
     B. Negative
     C. Inconclusive
     D. The need for repeat testing.

Correct Answer: A. Positive

The client with HIV+ status is considered to have positive results on PPD skin test with an area greater than 5-mm of induration. The client with HIV is immunosuppressed, making a smaller area of induration positive for this type of client. If the PPD is reddened and raised 10mm or more, it’s considered positive according to the CDC. If the infection risk is very high, the PPD test need not be repeated. The positive PPD test is usually followed by TB symptom assessment, physical exam, and chest radiograph.

Option B: If the patient is at a high risk of developing an active infection, a repeat test is recommended after an initial negative test to rule out the possibility of missing a case. However, a decision is made based on the risk factors.
Option C: Inconclusive isn’t a term used to describe results of a PPD test. It is a time-sensitive test. Tests that are read late are not accurate as they tend to under-estimate the size of the skin reaction. Therefore, the reliability of the test is compromised, and the results are doubtful.
Option D: To avoid this, repeat testing is recommended if the reaction is not read on time. The second test can be administered as soon as possible. However, if repeated, the test should preferably be performed within 7 days of the initial test to avoid boosting effect.

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