A 32-Year-Old Nurse Is Evaluated 3 Days After Being Exposed

A 32-year-old nurse is evaluated 3 days after being exposed to a patient with active pulmonary tuberculosis.  The source patient presented with cough, and a chest radiograph revealed a cavitary lung lesion.  His sputum testing returned positive for acid-fast bacilli.  The nurse cared for the patient for several hours without using respiratory precautions before airborne isolation precautions were implemented.  She has had no symptoms and has no prior medical problems.  Her only medication is an oral contraceptive.  Vital signs are within normal limits, and physical examination shows no abnormalities.
Tuberculin skin test (TST) is administered and reveals a 2-mm induration at 48 hours.
Which of the following is the most appropriate next step in management of the nurse?

A) Clinical follow-up only
B) Interferon gamma release assay now
C) Repeat TST in 6 months
D) Repeat TST in 8 to 12 weeks
E) Treatment with isoniazid for 9 months

Correct Answer:

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