Chapter 41: Antitubercular Drugs

The nurse is caring for a patient with tuberculosis. How does the nurse determine that the patient's tuberculosis strain is drug sensitive? A) By observing a reduction in infection B) By observing a reduction in coughing C) By reviewing chest radiograph results D) By observing a reduction in weight loss E) By reviewing drug susceptibility test results

A) By observing a reduction in infection B) By observing a reduction in coughing D) By observing a reduction in weight loss

A patient is given isoniazid to treat tuberculosis. Which adverse effects may occur in this patient? A) Changes in vision B) Yellowing of skin C) Changes in hearing D) Tingling of extremities E) Passing red-brown urine

A) Changes in vision B) Yellowing of skin D) Tingling of extremities

A patient who is on antitubercular therapy complains of numbness and a tingling sensation in the feet. Which antitubercular drug can cause the patient's symptoms? A) Isoniazid B) Ethambutol C) Streptomycin D) Pyrazinamide

A) Isoniazid

Which antitubercular drug works by disrupting cell wall synthesis and essential cellular functions? A) Isoniazid B) Rifapentine C) Ethambutol D) Pyrazinamide

A) Isoniazid

Which is the first-line antitubercular drug? A) Isoniazid B) Amikacin C) Cycloserine D) Capreomycin

A) Isoniazid

Which medications are safe to administer to a pregnant patient with tuberculosis? A) Isoniazid B) Rifampin C) Cycloserine D) Capreomycin E) Pyrazinamide

A) Isoniazid B) Rifampin E) Pyrazinamide

From which bacterial strain is Bacille Calmette-Guérin derived? A) Mycobacterium bovis B) Mycobacterium leprae C) Mycobacterium tuberculosis D) Mycobacterium avium-intracellulare complex

A) Mycobacterium bovis

The nurse is caring for a patient with advanced human immunodeficiency virus (HIV) infection. The primary health care provider prescribed an antitubercular drug to prevent the tuberculosis caused by Mycobacterium avium-intracellulare bacteremia. Which medication will the nurse expect to administer to this patient? A) Rifabutin B) Rifapentine C) Ethambutol D) Ethionamide

A) Rifabutin

Which antitubercular drug causes red-orange-brown discoloration of urine? A) Rifampin B) Amikacin C) Ethambutol D) Cycloserine

A) Rifampin

What are the clinical uses of rifampin as an antitubercular drug? A) Used as a first-line drug for treatment of tuberculosis B) Used as a substitute when the patient is allergic to rifabutin C) Used with at least one other antiinfective drug in the treatment of leprosy D) Used for preventive therapy in patients exposed to isoniazid-resistant M. tuberculosis E) Used to prevent or delay development of Mycobacterium avium- intracellulare bacteremia

A) Used as a first-line drug for treatment of tuberculosis C) Used with at least one other antiinfective drug in the treatment of leprosy D) Used for preventive therapy in patients exposed to isoniazid-resistant M. tuberculosis

The nurse is caring for a pregnant patient with tuberculosis. The patient has been prescribed ethambutol. The patient says to the nurse, "I heard that most antitubercular drugs are not safe to administer during pregnancy." What appropriate response does the nurse provide the patient? A) "Antitubercular drugs in category D are safe to administer during pregnancy." B) "Ethambutol is a first-line drug and belongs to category B, so it is safe to administer." C) "Someone gave you wrong information; antitubercular drugs are safe during pregnancy." D) "Ethambutol can be administered even to a 5-year-old child, so you need not worry about safety."

B) "Ethambutol is a first-line drug and belongs to category B, so it is safe to administer."

A patient is prescribed isoniazid to treat tuberculosis. The patient has elevated liver enzymes. The nurse will contact the provider to discuss which next step? A) Administer capreomycin. B) Adjust the dose of isoniazid. C) Prevent administration of isoniazid. D) Replace isoniazid with another drug.

B) Adjust the dose of isoniazid.

The nurse is caring for a patient with tuberculosis who was prescribed rifampin 10 mg/kg PO. Before administering the medication, the nurse checks the patient's weight and finds that it is 60 kg. What does the nurse implement for safe administration of the medication to the patient? A) Administers 60 mg of medication to the patient by the oral route B) Administers 600 mg of medication to the patient by the oral route C) Administers 0.6 g of medication to the patient by the parenteral route D) Administers 10 mg of medication to the patient by the parenteral route

B) Administers 600 mg of medication to the patient by the oral route

Which are the second-line antitubercular drugs? A) Rifabutin B) Amikacin C) Ethambutol D) Ethionamide E) Streptomycin F) Para-aminosalicylic acid

B) Amikacin D) Ethionamide F) Para-aminosalicylic acid

Which nursing intervention is appropriate before initiating streptomycin therapy in a patient with tuberculosis? A) Performing a gross eye examination B) Assessing the patient's hearing status C) Monitoring the patient's complete blood count D) Reviewing analysis report of sputum specimens

B) Assessing the patient's hearing status

A patient has a positive Mantoux test. Which test will the provider order next? A) Sputum culture B) Chest radiography C) Tuberculin skin test D) Stomach secretion culture

B) Chest radiography

The nurse finds that a patient who is receiving treatment with first-line antitubercular drugs for tuberculosis of the bone is not responding to the current therapy. Which other antitubercular drug does the nurse expect will be beneficial to this patient for long-term use? A) Amikacin B) Cycloserine C) Ethionamide D) Capreomycin

B) Cycloserine

What is the mechanism of action of streptomycin, which is used for the treatment of tuberculosis? A) Inhibition of lipid synthesis B) Inhibition of protein synthesis C) Inhibition of cell wall synthesis D) Inhibition of mycolic acid synthesis

B) Inhibition of protein synthesis

For which condition can rifampin be prescribed to a patient? A) Cancer B) Leprosy C) Epilepsy D) Hepatitis

B) Leprosy

The nurse is caring for a patient with pulmonary tuberculosis who has been prescribed para-aminosalicylic acid and isoniazid. The nurse finds that the patient has rhinitis caused by an allergy. What will the nurse do in this situation? A) Request an order to discontinue the para-aminosalicylic acid B) Request an order to administer diphenhydramine to the patient C) Inform the patient that rhinitis is caused by an isoniazid allergy D) Ask the primary health care provider to change the patient's prescription

B) Request an order to administer diphenhydramine to the patient

A primary health care provider orders a Mantoux test for a patient with symptoms of tuberculosis. Which action does the nurse take while conducting the Mantoux test? A) The nurse administers an inactivated strain of Mycobacterium bovis. B) The nurse intradermally injects 5 tuberculin units of purified protein derivative (PPD). C) The nurse gives 0.1 mL of Bacille Calmette-Guérin to the patient by the subcutaneous route. D) The nurse reports the test to be positive because of erythema at the site of administration.

B) The nurse intradermally injects 5 tuberculin units of purified protein derivative (PPD).

The nurse is caring for a patient who has tuberculosis. The patient has been treated with isoniazid and then with rifampin and isoniazid combination therapy with no improvement in symptoms. What will the nurse suspect? A) The patient has a severe tuberculosis infection. B) The patient has multidrug-resistant tuberculosis. C) The patient has a Mycobacterium bovis infection. D) The patient has extensively drug-resistant tuberculosis.

B) The patient has multidrug-resistant tuberculosis.

What information will the nurse provide to a patient receiving rifampin? A) Oral contraception is the preferred method of birth control when using rifampin. B) The patient will need to take this medication only for the prescribed 14-day period. C) A nonharmful side effect of the drug is red-orange discoloration of urine, sweat, and tears. D) Peripheral neuropathy is an expected side effect, and the patient should report any numbness or tingling of the extremities.

C) A nonharmful side effect of the drug is red-orange discoloration of urine, sweat, and tears.

The nurse is caring for a patient who is taking rifampin. The patient has a heart rate of 90 beats/min, blood pressure of 100/89 mm Hg, and red-orange urine. What is the nurse's best action? A) Collect a urine culture. B) Call the health care provider. C) Document the findings and teach the patient. D) Discard the first void and start a 24-hour urine collection.

C) Document the findings and teach the patient.

A patient is administered isoniazid for the treatment of tuberculosis. What alteration may the nurse find in the patient's laboratory report? A) Increase in the neutrophil level B) Decrease in the blood glucose level C) Increase in the alanine aminotransferase serum levels D) Decrease in the aspartate aminotransferase serum levels

C) Increase in the alanine aminotransferase serum levels

A patient is treated with rifabutin for tuberculosis. Which adverse effect does the nurse expect in the patient? A) Hyperuricemia B) Psychotic behavior C) Reddish-brown feces D) Hematologic disorder

C) Reddish-brown feces

Which antituberculosis medication inhibits the deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) synthesis in the mycobacterium? A) Isoniazid B) Cycloserine C) Streptomycin D) Pyrazinamide

C) Streptomycin

A patient has been diagnosed with pulmonary tuberculosis (TB). What test will be necessary to determine whether the TB has spread to other parts of the body? A) Muscle biopsy B) Liver function test C) Kidney function test D) Brain computed tomography (CT)

D) Brain computed tomography (CT)

The nurse is caring for a patient with tuberculosis and acquired immunodeficiency syndrome (AIDS). The patient's laboratory findings indicate the presence of Mycobacterium flavescens in the culture of the patient's sputum and stomach secretions. Which medication should be included in the treatment regimen for treating tuberculosis in this patient? A) Cephalexin B) Penicillin G C) Doxycycline D) Clarithromycin

D) Clarithromycin

The nurse is teaching a patient with tuberculosis who has been prescribed isoniazid, pyrazinamide, and rifampin. Knowing that antitubercular drugs cause ulcers, teratogenic effects, and peripheral neuropathy, what instruction does the nurse give to the patient? A) Discuss with the provider taking antacids to prevent stomach ulcers. B) Discuss with the provider taking oral contraceptives to prevent pregnancy. C) Discuss with the provider taking streptomycin to prevent teratogenic effects. D) Discuss with the provider taking pyridoxine to prevent peripheral neuropathy.

D) Discuss with the provider taking pyridoxine to prevent peripheral neuropathy.

The nurse is caring for a patient with tuberculosis. The patient's drug susceptibility test reports are not known. What will the nurse expect the provider to order for this patient? A) Cycloserine B) Capreomycin C) No drug therapy D) Four-drug regimen therapy

D) Four-drug regimen therapy

The nurse anticipates an order for vitamin supplementation for a patient who is receiving isoniazid therapy. What vitamin supplement is usually used with isoniazid? A) Folate B) Calcium C) Vitamin E D) Vitamin B6

D) Vitamin B6