A patient with active pulmonary tuberculosis is admitted. What precautions should be followed?

• A. Airborne precautions; negative-pressure room; N95 respirator for staff.
• B. Standard precautions only.
• C. Droplet precautions with surgical mask.
• D. Contact precautions.

Answer: (B)

Airborne transmission is the key concept here. Mycobacterium tuberculosis spreads via tiny droplet nuclei that can remain suspended in the air and be inhaled by others, so preventing spread requires measures that protect both the patient and healthcare staff from inhaling those aerosols.

Airborne precautions are necessary: place the patient in a private room with negative pressure relative to surrounding areas, keep the door closed, and ensure adequate air changes per hour. Healthcare workers should wear a properly fitted N95 respirator (or higher-level respirator) whenever entering the room, and the patient should wear a mask if they need to be transported outside the room. Standard precautions alone do not stop the inhalation of airborne bacilli, and droplet or contact precautions are not sufficient for active pulmonary tuberculosis.