Questions: An occupational health nurse is interpreting the results of a tuberculin skin test for a group of clients who received the test 48 hr ago. Which of the following clients should the nurse identify as having a positive test result? A client whose injection site has an elevated area measuring 15 mm ( 0.6 in ) A client whose injection site is ecchymotic A client whose injection site is firm and measures 3 mm ( 0.1 in ) A client whose injection site is scabbed

The answer is the first one: A client whose injection site has an elevated area measuring 15 mm (0.6 in).

Explanation for each option:

1. A client whose injection site has an elevated area measuring 15 mm (0.6 in): This is considered a positive result for a tuberculin skin test, especially in individuals who are at higher risk for tuberculosis, such as those with recent contact with TB cases, those with HIV, or those with certain medical conditions. A 15 mm induration is generally considered positive for individuals with no known risk factors.

2. A client whose injection site is ecchymotic: Ecchymosis refers to bruising and is not an indicator of a positive tuberculin skin test. It is a reaction to the injection itself and does not measure induration.

3. A client whose injection site is firm and measures 3 mm (0.1 in): An induration of 3 mm is generally considered negative for all groups, as it is below the threshold for a positive result.

4. A client whose injection site is scabbed: A scab is not an indicator of a positive tuberculin skin test. The test is interpreted based on the size of the induration, not the presence of a scab.

In summary, the client with a 15 mm induration should be identified as having a positive test result.