Exposure with a positive TB skin test usually requires six months of prophylactic treatment unless contraindicated. The TB skin test should not be repeated; the results will always be positive. A CXR is usually not required annually in the event that the skin test was positive. TB is a type of pneumonia caused by the acid-fast bacillus, mycobacterium tuberculosis, and is contracted by airborne droplets that enter the lungs and multiply in the pulmonary alveoli. Nursing Assessment: (1) Assessment includes symptom analysis of type and progression of symptoms; color, consistency, and amount of sputum; knowledge of the disease; weight pattern; vital signs; description of any pain; palpable lymph nodes; breath sounds; and activity tolerance. (2) Diagnostic tests:a) CXR (shows dense lesions in the upper lobes, enlarged lymph nodes, and formation of large cavities); b) CBC (presence of leukocytosis); c) Fiberoptic bronchoscopy and bronchial washing (for obtaining culture specimens); d) Tuberculin skin test (positive at 5 to 9 mm for clients with abnormal CXR or HIV; positive at 10 to 15 mm for clients with high-risk factors such as intravenous [IV] drug use; residence in a long-term facility, high-incidence country; positive at 15 mm for all other people); e) Three early-morning sputum collections for acid-fast staining, culture and sensitivity positive for M. tuberculosis. Results can take up to 10 days.Physiological Adaptation