Prep U Test 2

the need to increase fluid intake, even if the client feels nauseated

A female client has been diagnosed with tuberculosis and has been prescribed rifampin 600 mg PO daily. What health education should the nurse prioritize?

skin rash or itching

A nurse is speaking to a 62-year-old female client who has been started on sulfisoxazole, a sulfonamide antibiotic. The nurse should teach this client to contact the health care provider if the client experiences what adverse effect associated with the drug?

The continuation phase includes the drugs rifampin and isoniazid.

A nurse is teaching a client about the standard treatment for tuberculosis, which is divided into two phases. Which statement best explains the difference in the two phases?

"I will apply it in a very thin layer over the area."

A nurse is teaching a client how to apply a topical sulfonamide to a burn. Which statement by the client would indicate that the teaching was effective?

cause optic neuritis.

A nurse teaching the client with tuberculosis (TB) should state that ethambutol can:

An HIV-positive client

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

hepatotoxicity

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?

"TB can be cured by antitubercular drugs."

A student nurse needs further explanation about tuberculosis (TB) when making the following statement:

primary and secondary

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?

"It would not be a good idea to be outside while taking this medication because of possible photosensitivity occurring."

A professional female cyclist has been prescribed SMZ-TMP for chronic urethritis. She has informed the nurse that she has a cross-country race in 2 days. Which would be an appropriate response by the nurse?

It usually lasts 6 to 9 months.

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

Fear of incontinence.

The nurse is giving instructions to a client age 77 years who has been prescribed a sulfonamide for treatment of a urinary tract infection. The nurse has instructed the client to increase fluids while taking this medication. What does the nurse anticipate will be the client's greatest fear related to this instruction?

Hypoglycemia

The nurse is preparing to administer a sulfonamide to a client who is a Type 2 diabetic taking an oral hypoglycemic agent. The nurse will monitor the client for what reaction?

Decreased absorption of isoniazid

The nurse is teaching a client taking isoniazid. The client also suffers from occasional acid reflux. What should the nurse teach this client about?

Inflammation is decreased because of interaction with intestinal bacteria.

The nurse knows that sulfonamides are chosen to treat ulcerative colitis because of what action?

Mycobacterium tuberculosis

The nurse knows that tuberculosis (TB) is an infectious disease seen around the world and in many cases due to overcrowding. The nurse would be aware of this condition if the lab reports showed which bacteria?

Stevens-Johnson syndrome (SJS)

A client is given sulfasalazine to treat ulcerative colitis. The client begins to report flu-like symptoms including fever, cough, headache, and muscle aches and pains. The nurse notices red wheals on the client's face and neck. The nurse suspects which adverse effect?

2 to 3 weeks

A client is prescribed isoniazid and rifampin for the treatment of active tuberculosis (TB). The client's medication education should stress that initial symptom improvement is likely to take how long?

Renal damage

A client is started on sulfamethoxazole-trimethoprim for a urinary infection. What adverse effect should the nurse assess with this client?

Latent tuberculosis

A client who was frequently homeless over the past several years has begun a drug regimen consisting solely of isoniazid (INH). What is this client's most likely diagnosis?

route.

A client with a diagnosis of rhinosinusitis has been prescribed ciprofloxacin 250 mg SC b.i.d. When contacting the prescriber, the nurse should question the:

BUN and creatinine

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?

Orally, on an empty stomach

A client, diagnosed with tuberculosis, will soon begin first-line drug treatment. How will rifampin most likely be administered to this client?

Obtain urine for culture and sensitivity.

The nurse is assisting in the admission of a client with a suspected urinary tract infection and an oral temperature of 100.9°F. The health care provider has written the following orders: acetaminophen 500 mg PO for elevated temperature; urinalysis for culture and sensitivity; sulfasalazine (Azulfidine) 500 mg PO four times daily; and force fluids to 3 L/day. Which order will the nurse complete first?

Ulcerative Colitis

The nurse is caring for a client who has been prescribed a sulfonamide but does not have an infection. The nurse is aware that the medication has been prescribed to treat what condition?

A 35-year-old woman with a urinary tract infection and a history of ulcerative colitis

The nurse is caring for four clients on a medical floor. For which client would the nurse suspect the health care provider might order a sulfonamide?

Burning sensation or pain

The nurse understands that the most frequent adverse reaction seen with the topical application of a sulfonamide is which of the following?

Taking medications as prescribed

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

-Leukopenia -Thrombocytopenia -Aplastic anemia

The nursing instructor is teaching the nursing students about serious hematologic adverse reactions that can occur with prolonged sulfonamide therapy. Which of the following should be included?

When sulfonamides interact with intestinal bacteria, they help to inhibit the inflammatory process.

The nursing student is caring for a client with ulcerative colitis. The student asks the instructor why the client is taking a sulfonamide. What should the instructor tell the student?

Inhibit the activity of folic acid in bacterial cell metabolism

The nursing student is studying about sulfonamides and learns that their which is their mode of action?

leprosy.

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 which?

Sulfonamides

The nursing student studying pharmacology identifies correctly which classes of drugs to be the first to effectively treat infections?

"I will make sure to use extra sunscreen when I go to the tanning booth."

Which statement by a client taking a sulfonamide requires further instruction?

The continuation phase

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

numbness and tingling in his feet

A 35-year-old man being treated with isoniazid (INH) for exposure to TB has this 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 health care provider right away?

fluids

A client diagnosed with malaria has been prescribed treatment with sulfadiazine. The nurse should encourage the client to increase consumption of what dietary component?

Rifabutin (Mycobutin)

A client has been infected with Mycobacterium avium complex from an indoor pool. Which medication is the recommended antitubercular used to treat MAC?

3

A client 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.

8

A client has been prescribed 4 gm of sulfamethoxazole-trimethoprim tablets per day. The available drug is in the form of 500 mg. To meet the recommended dose, the nurse will administer _______ tablets each day.

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

A client has just been diagnosed with TB. The client is extremely upset and is asking questions concerning the medications. What is an appropriate response by the nurse?

INH, rifampin, pyrazinamide, ethambutol

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

Assessing for renal insufficiency

A client is being treated for a urinary tract infection with trimethoprim-sulfamethoxazole. What assessment should the nurse make prior to the administration of the medication?

an alcoholic who has hepatitis C (HCV)

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?

-inadequate initial drug treatment -noncompliance with the therapeutic regimen

A male client newly diagnosed with tuberculosis (TB) asks the nurse if medications will make him better. The nurse informs the client that sometimes treatment fails and why this happens. What are some reasons for treatment failure?

-Skin test -Chest radiograph -Interferon gamma release assay (IGRA)

A new client presents with persistent cough, weight loss, anorexia, and night sweats. What would the nurse expect the health care provider to order?

isoniazid

A nurse is administering an antitubercular drug that exhibits bactericidal activity. Which drug will the nurse administer?

The client does not have renal impairment.

A nurse is assigned to care for a client with tuberculosis who has been prescribed rifampin. What should the nurse confirm to be sure that rifampin is not contraindicated in the client?

Adverse effect of rifampin

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?

at the high end of the recommended range.

A nurse is caring for a 61-year-old client whose health care provider has ordered 2200 mg of ethambutol daily. The recommended dose for ethambutol is 15-25 mg/kg/day. The client weighs 90 kg. Based on dosage calculation, the prescribed dose is:

2

A nurse is explaining standard treatment for tuberculosis to a client. The nurse would describe the treatment as occurring in how many phases?

bacteriostatic

After teaching a group of nursing students about the different classes of drugs, the instructor determines that the teaching was successful when the students identify drugs that slow or retard the multiplication of bacteria as which type of medication?

dapsone

After teaching a group of students about antitubercular therapy, the instructor determines that additional teaching is needed when the students identify which drug as an antitubercular agent?

bactericidal

Drugs that destroy bacteria are known as which type of drug?

he should wear glasses during the therapy.

Gary is a construction worker who is diagnosed with leprosy and is prescribed rifampin. Gary is married, an alcoholic, and wears contact lenses. At the time of initiating the therapy, the nurse should inform the client:

Cleanse the wound of debris prior to applying the silver sulfadiazine

Mr. Laird is a 49-year-old electrician who experienced severe burns on his trunk, arms, and hands in a workplace accident 2 weeks ago. Part of his current wound care regimen involves the daily application of silver sulfadiazine to his wounds. The nurses who are providing care for Mr. Laird in the burns and plastics unit of the hospital should perform what action when administering this medication?

-Urinary tract infections -Ulcerative colitis -Acute otitis media -Second- and third-degree burns

Nursing students are learning that sulfonamides work on both gram-negative and gram-positive bacteria. Some infections that this class of drugs treats include which?

Thrombocytopenia

The client who has been on long-term sulfonamide therapy begins to demonstrate symptoms associated with side affects of the therapy. The nurse knows that these symptoms are related to which complication associated with sulfonamide therapy?

Direct observed therapy

The client with a diagnosis of TB has a nursing diagnosis of ineffective self-health management. The nurse understands that the most effective method to ensure compliance to TB medications is which of the following?

Crystalluria

The nurse instructs a client on sulfonamide therapy to drink a full glass of water when taking the medication and to also drink at least 8 large glasses of water each day until therapy is finished. The nurse is trying to prevent which complication associated with sulfonamide therapy?

"I'm sorry that it hurts, but many clients report a burning sensation when this medication is applied."

The nurse is applying silver sulfadiazine (Silvadene) to a client's burn when the client states, "Every time you put that on me it burns." What is the nurse's best response?

jaundice

The nurse is assessing a client who has been prescribed treatment with isoniazid. What assessment finding would most likely necessitate contacting the health care provider to recommend discontinuing treatment?

alcohol

The nurse is providing health education to a client prescribed isoniazid. What should the nurse instruct the client to avoid?

inhibits cell wall formation

What is isoniazid's mechanism of action?

pyrazinamide

When a client fails to improve appreciably after 4 weeks of treatment with first-line drugs, what adjuvant first-line antitubercular drug will be considered for inclusion in the existing medication regimen?

Sulfonamides

Which category of antimicrobial agents is used chiefly because of low cost and effectiveness in treating common bacterial infections?

culture and sensitivity (C&S)

A client is diagnosed with an infection. What would the nurse anticipate being used to determine the best drug to treat the infection?

burning sensation during application

The primary health care provider has prescribed mafenide for a client with second-degree burns. The nurse would be alert for which effect as the most frequent adverse reaction associated with the topical application of mafenide on the affected area?