PN119 PrepU Chapter 10

A nurse is providing education to a patient who is taking INH. The nurse will advise the patient to avoid which of the following foods?

Cheese, dairy products, and bananas

Which of the following is considered a secondary drug to treat tuberculosis? (Choose one)

Ciprofloxacin

The nurse understands that when a client is taking isoniazid and antacids together which of the following may occur?

Decreased absorption of isoniazid

The nurse is reviewing the medical record of a client taking rifampin. The nurse notes that the client also takes Lanoxin (digoxin) daily. The nurse understands that these medications may interact in what way?

Decreased serum levels of digoxin

A client with TB is prescribed pyrazinamide. The nurse should assess and monitor for which of the following adverse reactions of pyrazinamide in the client?

Diarrhea

The nursing student is studying how tuberculosis (TB) is contracted. The nurse correclty identifies the mode of transmission to be which of the following?

Droplets

A patient is hospitalized with active tuberculosis. The patient is receiving antitubercular drug therapy and is not responding to the medications. What do you suspect the patient is suffering from?

Drug-resistant tuberculosis

A client in the initial phase of tuberculosis treatment develops a decrease in visual acuity and changes in color perception, which drug may be causing this reaction? (Choose one)

Ethambutol

The nursing instructor is teaching students about drug regimens for tuberculosis (TB). He instructs them on the different prophylactic uses of isoniazid (INH), which include? (Select all that apply.)

Household members of those recently diagnosed with TB Those whose tuberculin skin test result has become positive in the last 2 years Those at risk for TB (such as those with Hodgkin's disease, leukemia, and other serious illnesses) All patients younger than 35 years with a positive skin test

When a person is diagnosed with tuberculosis, family members may be treated prophylactically with which antitubercular drug? (Choose one)

Isoniazid (Nydrazid)

A nurse teaching the patient with tuberculosis (TB) should include the following information about ethambutol:

It can cause optic neuritis.

The nurse is educating a patient who has just been diagnosed with tuberculosis *(TB). She informs the patient that the drug regimen is extensive. What should the nurse tell this patient about the drug therapy related to duration?

It usually lasts 6 to 9 months.

A client taking isoniazid is worried about the side effects/adverse reactions. The nurse tells the client that a common adverse reaction of isoniazid is which of the following?

Jaundice

A nurse is caring for a 73-year-old TB patient. The patient has been prescribed ethambutol. Which of the following adverse reactions of ethambutol should the nurse assess for in the patient?

Optic neuritis

A nurse is assigned to care for a patient with TB who has been prescribed rifampin. Which of the following should the nurse ensure to confirm that rifampin is not contraindicated in the patient?

Patient does not have renal impairment

The nurse is aware that tuberculosis (TB) is on the rise worldwide. Which of the following populations is at risk for TB? (Select all that apply.)

People living in crowded conditions People who are immunocompromised People with debilitative conditions People with HIV

While discussing tuberculosis, the nursing instructor explains that treatment is typically divided into two phases. What is the second phase called?

The continuation phase

A nurse is caring for a patient with HIV who is suspected to also have tuberculosis (TB). Which of the following is true about patients with HIV and TB?

The skin test may not show a reaction even though the disease is present.

A patient is administered rifampin (Rifadin). Which of the following factors should the patient be taught?

The urine, tears, sweat, and other body fluids will be a discolored red-orange.

A client has been prescribed INH therapy for the treatment of latent tuberculosis. The client has a history of hypertension. The nurse informs the client not to eat cheese, dairy products, or bananas, or consume any foods or drinks containing caffeine. What is the best explanation the nurse can give the client about the effects of eating these foods while on INH?

These foods can cause an unsafe increase in blood pressure.

The nurse explains to the client that prophylactic antitubercular therapy is suggested for which of the following people?

Those who have been in close contact with a person with tuberculosis (TB)

As a nurse, you understand the main primary drugs used to treat latent, active, and drug-resistant TB infection include isoniazid, rifampin, and pyrazinamide. Isoniazid's mechanism of action is:

To inhibit cell wall formation.

A client asks the purpose for using three medications in combination to treat his tuberculosis. The nurse informs the client that multiple medications are given for which of the following reasons?

To prevent resistance

Medical treatment for tuberculosis (TB) consists of a combination of drugs to get the best results. This statement is:

True

Prior to the administration of antitubercular medications, the nurse anticipates which of the following studies? (Select all that apply.)

X-ray Culture and sensitivity Complete blood count Positive sputum culture

Active tuberculosis (TB) may be difficult to diagnose in patients infected with HIV because of their immune system deficiency. Which of the following can be used to determine if an HIV patient with a negative skin test has active TB? (Select all that apply)

X-ray studies Sputum analyses Physical examinations

After several rounds of treatment for TB over past several years, a patient continues to test positive for active TB, a fact that the care team attributes to the patient's nonadherence to treatment. The patient's most recent diagnostic workup reveals that he now has multidrug resistant TB. The nurse should anticipate that the patient may require treatment with:

a fluoroquinolone.

A homeless client presented at a street clinic with reports of hemoptysis and subsequently tested positive for TB. Which characteristics of the client's present circumstances would preclude treatment with INH?

an alcoholic who has hepatitis C (HCV)

A patient is taking rifampin (Rifadin) for active TB. When discussing this drug with the patient, the nurse should stress that

body fluids such as urine, saliva, tears, and sputum may become discolored.

With prolonged treatment for tuberculosis (TB), many patients become noncompliant with their drug regimen. Therefore, the nurse may arrange for "DOT" for the patient, which stands for which of the following?

directly observed therapy

When administering a secondary drug to a patient with tuberculosis (TB), the nurse is treating which type of TB?

extrapulmonary TB

The nurse understands that tuberculosis (TB) can affect the lungs as well as other organs of the body. The term used for TB outside the lungs is:

extrapulmonary.

A nursing instructor is teaching about the tuberculosis (TB) drug pyrazinamide and informs students that the most severe adverse reaction to this drug is which of the following?

hepatotoxicity

A nursing student is learning about the tuberculosis (TB) drug isoniazid. The student has learned to instruct patients taking this drug to refrain from drinking alcohol while taking isoniazid, for which of the following reasons?

higher incidence of drug-related hepatitis

A patient newly diagnosed with tuberculosis (TB) asks the nurse if medications will make him better. The nurse informs the patient that sometimes treatment fails and why this happens. Which of the following are reasons for treatment failure? (Select all that apply.)

inadequate initial drug treatment noncompliance with the therapeutic regimen

The nursing student read about a disease called Hansen's disease, which is caused by the bacterium Mycobacterium leprae and is treated with many of the same drugs as are used for TB. The student learned that another name for Hansen's disease is:

leprosy.

A 35-year-old man is being treated with isoniazid (INH) for exposure to TB. He has the following medical history: diabetes mellitus type 2, hypertension, hyperlipidemia, and coronary artery disease. He drinks one to two glasses of wine on the weekend and smokes two packs of cigarettes per day. Which adverse reaction should the nurse alert the client to report to his physician right away?

numbness and tingling in his feet

A client has been prescribed INH for the treatment of tuberculosis. The nurse teaches the client about dietary restrictions while taking this medication. What is the most important instruction to give the client about dietary restrictions?

"Do not drink beer or red wine while taking this medication because a serious adverse reaction can occur."

A patient is to receive rifampin. Which of the following would be most important for the nurse to include in the teaching plan for this patient?

"Your urine or sweat may become orange in color."

A nurse is caring for a 39-year-old client who is taking INH, rifampin, and pyrazinamide. The client reports that her urine is red. What is the most likely cause of this discoloration?

Adverse effect of rifampin

Patients whose tuberculosis does not respond to the primary anti-TB drugs (e.g., INH) may undergo therapy with second-line drugs. Which of the following is a second-line drug?

Cycloserine

Tuberculosis (TB) affects only the lungs. True or false?

False

A patient has just been diagnosed with tuberculosis (TB). The nurse can expect to start the patient on which of the following drugs for the initial phase of treatment?

INH, rifampin, pyrazinamide, ethambutol

The nurse knows that tuberculosis (TB) is an infectious disease caused by which of the following bacteria?

Mycobacterium tuberculosis

A patient is hospitalized due to noncompliance with an antitubercular drug treatment. Which of the following is most important for the nurse to do?

Observe the patient taking the medications

A patient has been infected with Mycobacterium avium complex from an indoor pool. Which of the following medications is the recommended antitubercular used to treat MAC?

Rifabutin (Mycobutin)

The nurse monitors the older client for liver dysfunction when which of the following antitubercular medications are administered? (Select all that apply.)

Rifampin Pyrazinamide Isoniazid

The nurse understands that which of the following is the highest priority when teaching about antitubercular medications?

Taking medications as prescribed

Which of the following are true of antitubercular drugs? (Select all that apply)

Treat active cases of tuberculosis Prophylaxis to prevent the spread of tuberculosis Render the patient noninfectious to others

A 28-year-old client taking INH, rifampin, and ethambutol arrives at the clinic reporting numbness in the feet. What adjustment to the client's drug regimen is most likely to remedy the issue?

instructing the client to take the medications with vitamin B6

A nursing student studying pharmacology is focusing on drugs used to treat tuberculosis (TB). This student correctly identifies the classifications of antitubercular drugs as which of the following?

primary and secondary

A middle-aged woman with a complex social and medical history has begun multidrug treatment for TB. Which of the nurse's following assessment questions is most therapeutic?

"What kinds of routines would work best for you to make sure that you don't miss any doses of your rifampin?"

A client has just been diagnosed with TB. The client is extremely upset and is asking questions concerning the medications the client will have to take and how long to take them. What is an appropriate response by the nurse?

"You will have multidrug therapy for 6 to 24 months."

A client has been prescribed a daily dosage of Rifampin 600 mg. The available drug is in the form of a 300 mg capsules. To meet the recommended daily dose, the client will need _________ capsules.

2

A patient has been prescribed 2 tablets of 150 mg isoniazid every day. The available drug is in the form of a 100 mg tablet. To meet the recommended dose, the nurse will administer _______ tablets each time.

3

A nurse works in a community setting and follows patients who have TB. Which of the following patients would likely require the most follow-up from rifampin therapy?

An HIV-positive patient

A 20-year-old female is being treated with rifampin and INH. What method of birth control would the nurse recommend for this patient?

Any of the above

The client is taking isoniazid (INH). It is important that the client understand INH can affect which vitamin?

B6

A client with a positive sputum culture for TB has been started on streptomycin antitubercular therapy. Upon review of the laboratory results, the nurse notes that the client may be experiencing toxicity if which of the following results is abnormal?

BUN and creatinine