[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-429705-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-429705-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","xavier-university-college-of-nursing-tb-questionnaire","Xavier University College of Nursing - TB Questionnaire","","This document is an annual tuberculosis (TB) screening questionnaire required by the Xavier University College of Nursing for students who have previously tested positive for tuberculosis via skin or blood tests but have maintained a clear or negative chest X-ray. The form serves as a standardized health assessment to identify active TB symptoms. It mandates a comprehensive review of nine specific clinical indicators, including persistent cough, hemoptysis, unexplained fever, night sweats, fatigue, chest pain, and significant weight loss. Students are required to acknowledge their understanding that the emergence of two or more of these symptoms necessitates an immediate professional medical evaluation, including diagnostic imaging. By formalizing this monitoring process, the institution ensures that students with latent TB remain under proper surveillance, mitigating health risks within the clinical learning environment. The content is derived from the 2019 Symptom Screen protocols established by Hamilton County TB Control to maintain compliance with institutional health safety standards.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/xavier-university-college-of-nursing-tb-questionnaire/429705/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/xavier-university-college-of-nursing-tb-questionnaire/429705.png","ImageObject",300,407,{"name":42,"@type":43},"Aria","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Who is required to complete this TB questionnaire?","Question",{"text":63,"@type":64},"This form is required annually for students who have a positive tuberculosis skin or blood test result but a negative or clear chest X-ray.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What clinical signs and symptoms must be reviewed?",{"text":68,"@type":64},"The review includes nine symptoms: loss of appetite, chest pain, fatigue, hemoptysis, unexplained fever, night sweats, productive cough for 2-3 weeks, weakness, and unexplained weight loss.",{"name":70,"@type":61,"acceptedAnswer":71},"What action must a student take if they develop two or more symptoms?",{"text":72,"@type":64},"The student must be evaluated by a physician for possible active Tuberculosis disease, which includes undergoing a chest X-ray.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},429705,1790764111,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":30,"preview_page_count":4},2336464648322,"https://ap-avatar.wpscdn.com/avatar/2200025388227c56fec?_k=1778556882303663488","College of Nursing  \n3800 Victory Parkway Cincinnati, OH 45207-7351 513 745-3814  \nTB QUESTIONNAIRE REQUIRED ANNUALLY  \nFor students with: A positive tuberculosis skin or blood test result AND negative/clear chest x-ray. DATE   \nNAME   \n_  \nSIGNS AND SYMPTOMS OF TUBERCULOSIS REVIEWED WITH PATIENT:  \n\n| SIGN / SYMPTOM OF TB | YES | NO |\n| --- | --- | --- |\n| LOSS OF APPETITE | □ | □ |\n| CHEST PAIN | □ | □ |\n| FATIGUE | □ | □ |\n| HEMOPTYSIS | □ | □ |\n| UNEXPLAINED FEVER | □ | □ |\n| NIGHT SWEATS | □ | □ |\n| PRODUCTIVE COUGH FOR 2-3 WEEKS | □ | □ |\n| WEAKNESS | □ | □ |\n| UNEXPLAINED WEIGHT LOSS | □ | □ |\n\nI understand that if I develop two or more signs and/or symptoms of Tuberculosis, I will be evaluated (including a chest X-ray) by a physician for possible active Tuberculosis disease.  \nSIGNATURE AND CREDENTIALS OF MEDICAL PROFESSIONAL REVIEWING  \nSIGNATURE OF PATIENT  \nNAME/ADDRESS/PHONE OF PROVIDER:  \nSource: Symptom Screen, Hamilton County TB Control, 2019","cbCaioQB4fekt5EG","https://ap.wps.com/l/cbCaioQB4fekt5EG","pdf",43276,"English","# TB Questionnaire Overview\n## Required Symptoms Review\n## Student Acknowledgment and Evaluation Policy","[{\"question\":\"Who is required to complete this TB questionnaire?\",\"answer\":\"This form is required annually for students who have a positive tuberculosis skin or blood test result but a negative or clear chest X-ray.\"},{\"question\":\"What clinical signs and symptoms must be reviewed?\",\"answer\":\"The review includes nine symptoms: loss of appetite, chest pain, fatigue, hemoptysis, unexplained fever, night sweats, productive cough for 2-3 weeks, weakness, and unexplained weight loss.\"},{\"question\":\"What action must a student take if they develop two or more symptoms?\",\"answer\":\"The student must be evaluated by a physician for possible active Tuberculosis disease, which includes undergoing a chest X-ray.\"}]","Xavier University College of Nursing - TB Questionnaire | PDF",1790650900]