Question 1

A patient newly diagnosed with tuberculosis (TB)has been taking antitubercular drugs for 1 week calls the clinic and is very upset.He says,"My urine is dark orange! What's wrong with me?" Which response by the nurse is correct?

A) "You will need to stop the medication,and it will go away."
B) "It's possible that the TB is worse.Please come in to the clinic to be checked."
C) "This is not what we usually see with these drugs.Please come in to the clinic to be checked."
D) "This is an expected side effect of the medicine.Let's review what to expect."

"This is an expected side effect of the medicine.Let's review what to expect."

Accepted Answer

Dark orange urine is an expected side effect of the medication, specifically of the drug rifampin. It is important to reassure the patient that this is a normal occurrence and does not indicate a worsening of their tuberculosis. The nurse should take this opportunity to review the expected side effects of the medication with the patient. Option A is incorrect, as the patient should not stop taking the medication without consulting their healthcare provider. Option B is incorrect, as dark orange urine does not indicate a worsening of the TB. Option C is incorrect, as dark orange urine is a known side effect of rifampin.

Question 2

A patient who has been taking isoniazid (INH)has a new prescription for pyridoxine.She is wondering why she needs this medication.The nurse explains that pyridoxine is often given concurrently with the isoniazid to prevent which condition?

A) Hair loss
B) Renal failure
C) Peripheral neuropathy
D) Heart failure

Peripheral neuropathy

Accepted Answer

Pyridoxine is given concurrently with isoniazid to prevent peripheral neuropathy, which is a common side effect of isoniazid therapy.

Question 3

When monitoring patients on antitubercular drug therapy,the nurse knows that which drug may cause a decrease in visual acuity?&#10;A) Rifampin (Rifadin)&#10;B) Isoniazid (INH)&#10;C) Ethambutol (Myambutol)&#10;D) Streptomycin

Accepted Answer

Ethambutol (Myambutol) is known to cause optic neuritis and can lead to a decrease in visual acuity. Patients on this medication should have regular ophthalmic exams to monitor for visual changes. Rifampin (Rifadin), Isoniazid (INH), and Streptomycin are not known to cause a decrease in visual acuity.

Question 4

A patient has been taking antitubercular therapy for 3 months.The nurse will assess for what findings that indicate a therapeutic response to the drug therapy?&#10;A) The chronic cough is gone.&#10;B) There are two consecutive negative purified protein derivative (PPD)results over 2 months.&#10;C) There is increased tolerance to the medication therapy,and there are fewer reports of adverse effects.&#10;D) There is a decrease in symptoms of tuberculosis along with improved chest x-rays and sputum cultures.

Accepted Answer

The most appropriate response to indicate a therapeutic response to antitubercular therapy is a decrease in symptoms of tuberculosis, along with improved chest x-rays and sputum cultures. While options A and C may be desirable outcomes, they do not necessarily indicate a therapeutic response to the antitubercular medication. Option B refers to the results of PPD, which is used for screening but not for monitoring treatment response.

Question 5

The nurse is discussing adverse effects of antitubercular drugs with a patient who has active tuberculosis.Which potential adverse effect of antitubercular drug therapy should the patient report to the prescriber?

A) Gastrointestinal upset
B) Headache and nervousness
C) Reddish-orange urine and stool
D) Numbness and tingling of extremities

Accepted Answer

Numbness and tingling of extremities is a potential adverse effect of isoniazid, one of the antitubercular drugs, and could indicate peripheral neuropathy which requires immediate medical attention. Gastrointestinal upset, headache and nervousness, and reddish-orange urine and stool are common side effects of antitubercular drugs and may not require immediate medical attention.

Question 6

The nurse is reviewing the medication administration record of a patient who is taking isoniazid (INH).Which drug or drug class has a significant drug interaction with isoniazid? A) Pyridoxine (vitamin B₆) B) Penicillins C) Phenytoin (Dilantin) D) Benzodiazepines

Accepted Answer

Isoniazid can increase the levels of phenytoin in the blood, leading to potential toxicity.

Question 7

A patient who has started drug therapy for tuberculosis wants to know how long he will be on the medications.Which response by the nurse is correct?&#10;A) &#34;Drug therapy will last until the symptoms have stopped.&#34;&#10;B) &#34;Drug therapy will continue until the tuberculosis develops resistance.&#34;&#10;C) &#34;You should expect to take these drugs for as long as 24 months.&#34;&#10;D) &#34;You will be on this drug therapy for the rest of your life.&#34;

Accepted Answer

The current standard treatment for tuberculosis involves taking multiple medications for at least 6 months, and in some cases up to 24 months. It is important for the patient to complete the full course of treatment to help prevent the development of drug-resistant tuberculosis. The duration of drug therapy is not determined by the absence of symptoms, as medication must continue after symptoms have resolved to ensure that all the bacteria have been killed. Nor is drug therapy lifelong, although some patients may require long-term medication to prevent reinfection or reactivation of the disease.

Question 8

The nurse will assess the patient for which potential contraindication to antitubercular therapy?&#10;A) Glaucoma&#10;B) Anemia&#10;C) Heart failure&#10;D) Hepatic impairment

Accepted Answer

Hepatic impairment is a potential contraindication to antitubercular therapy because many of these drugs are metabolized in the liver, and hepatic impairment can lead to increased levels of these drugs in the body and potential toxicities. Glaucoma, anemia, and heart failure are not known contraindications to antitubercular therapy.

Question 9

The nurse is counseling a woman who will be starting rifampin (Rifadin)as part of antitubercular therapy.The patient is currently taking oral contraceptives.Which statement is true regarding rifampin therapy for this patient?

A) Women have a high risk for thrombophlebitis while on this drug.
B) A higher dose of rifampin will be necessary because of the contraceptive.
C) Oral contraceptives are less effective while the patient is taking rifampin.
D) The incidence of adverse effects is greater if the two drugs are taken together.

Accepted Answer

Rifampin can decrease the effectiveness of hormonal contraceptives due to its ability to induce liver enzymes, which can decrease the levels of hormones in the body. Women taking hormonal contraceptives should also use alternative forms of contraception while taking rifampin.

Question 10

The nurse is preparing to administer morning medications to a patient who has been newly diagnosed with tuberculosis.The patient asks,"Why do I have to take so many different drugs?" Which response by the nurse is correct?

A) "Your prescriber hopes that at least one of these drugs will work to fight the tuberculosis."
B) "Taking multiple drugs reduces the chance that the tuberculosis will become drug resistant."
C) "Using more than one drug can help to reduce side effects."
D) "Using multiple drugs enhances the effect of each drug."

Accepted Answer

Taking multiple drugs reduces the chance that the tuberculosis will become drug resistant. When multiple drugs are used to treat tuberculosis, they work together to fight the bacteria in different ways. This makes it less likely that the bacteria will become resistant to any one drug, increasing the chance of successful treatment.

Deck 41: Antitubercular Drugs