Tuberculosis — NCLEX Cheat Sheet
Airborne, acid-fast bacilliAlso known as: TB · consumption · active TB · latent TB
Use this quick-reference guide to spot, treat, and prevent Tuberculosis on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
🩺 Signs
- Chronic cough > 3 wk, hemoptysis
- Night sweats, weight loss, fever
- Fatigue, anorexia
✅ Do
- Airborne isolation, neg pressure
- N95 mask for staff
- 3 neg sputum = not infectious
🧪 Meds
- RIPE: Rifampin INH Pyraz Etham
- 6-12 months, monitor liver
- Rifampin → orange secretions
🎓 Teach
- Finish full course, no skipping
📚 Tuberculosis — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- Classic active TB signs are a chronic productive cough lasting more than three weeks, hemoptysis, night sweats, low-grade afternoon fever, and unintentional weight loss.
- A positive Mantoux (PPD) skin test shows induration, not redness, read at 48 to 72 hours; size threshold depends on risk group.
- A positive skin test or IGRA indicates exposure, but active disease is confirmed by sputum acid-fast bacilli smears and culture and chest x-ray.
- Three consecutive negative sputum AFB smears are required before airborne precautions can be discontinued.
- Latent TB is not contagious and shows a positive skin test with a normal chest x-ray and no symptoms.
- Rifampin turns body fluids (urine, sweat, tears) red-orange and is a harmless expected effect.
Nursing priorities
What to do, in order- Place the patient in a negative-pressure airborne isolation room and use an N95 respirator.
- Obtain serial early-morning sputum specimens for acid-fast bacilli.
- Administer the multi-drug regimen (rifampin, isoniazid, pyrazinamide, ethambutol) and stress adherence.
- Use directly observed therapy to ensure the full 6 to 12 month course is completed.
- Teach the patient to cover the mouth when coughing and wear a mask when leaving the isolation room.
Red flags — report now
Escalate immediately- Massive hemoptysis is a medical emergency requiring immediate intervention.
- Yellowing of the skin or eyes, dark urine, or right upper quadrant pain may indicate isoniazid or rifampin hepatotoxicity, hold the drug and notify the provider.
- Visual changes or color vision loss with ethambutol indicate optic neuritis and require stopping the drug.
- Stopping medications early breeds multidrug-resistant TB, a serious public health threat.
Labs & values
Numbers to know- Positive sputum AFB smear and culture confirms active disease
- PPD induration measured at 48-72h (>=15mm low risk, >=10mm moderate, >=5mm high risk/HIV)
- Baseline and periodic liver enzymes (AST/ALT) due to hepatotoxic drugs
Patient teaching
What patients must know- Take all TB medications exactly as prescribed for the full course, even after symptoms resolve, to prevent drug resistance.
- Take isoniazid with vitamin B6 (pyridoxine) to prevent peripheral neuropathy and avoid alcohol due to liver risk.
- Rifampin discolors body fluids orange and reduces the effectiveness of oral contraceptives, so use a backup method.
❓ Tuberculosis: NCLEX FAQs
What are the priority nursing interventions for Tuberculosis?
Place the patient in a negative-pressure airborne isolation room and use an N95 respirator. Obtain serial early-morning sputum specimens for acid-fast bacilli. Administer the multi-drug regimen (rifampin, isoniazid, pyrazinamide, ethambutol) and stress adherence. Use directly observed therapy to ensure the full 6 to 12 month course is completed.
What are the warning signs of Tuberculosis a nurse must report?
Massive hemoptysis is a medical emergency requiring immediate intervention. Yellowing of the skin or eyes, dark urine, or right upper quadrant pain may indicate isoniazid or rifampin hepatotoxicity, hold the drug and notify the provider. Visual changes or color vision loss with ethambutol indicate optic neuritis and require stopping the drug. Stopping medications early breeds multidrug-resistant TB, a serious public health threat.
What do I need to know about Tuberculosis for the NCLEX?
Classic active TB signs are a chronic productive cough lasting more than three weeks, hemoptysis, night sweats, low-grade afternoon fever, and unintentional weight loss. A positive Mantoux (PPD) skin test shows induration, not redness, read at 48 to 72 hours; size threshold depends on risk group. A positive skin test or IGRA indicates exposure, but active disease is confirmed by sputum acid-fast bacilli smears and culture and chest x-ray. Three consecutive negative sputum AFB smears are required before airborne precautions can be discontinued.
What patient teaching is important for Tuberculosis?
Take all TB medications exactly as prescribed for the full course, even after symptoms resolve, to prevent drug resistance. Take isoniazid with vitamin B6 (pyridoxine) to prevent peripheral neuropathy and avoid alcohol due to liver risk. Rifampin discolors body fluids orange and reduces the effectiveness of oral contraceptives, so use a backup method.
Quick Tip
Classic active TB signs are a chronic productive cough lasting more than three weeks, hemoptysis, night sweats, low-grade afternoon fever, and unintentional weight loss.
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