Deck 51: Pharmacotherapy of Mycobacterial Infections

Question 1

The nurse is teaching a community course at a local senior citizen center regarding tuberculosis.The nurse would be correct in informing the class that clients acquire Mycobacterium tuberculosis by which route?

A)Sexual transmission
B)Fecal/oral
C)Respiratory droplets
D)Hand-to-hand contact

Answer 1

Respiratory droplets

Question 2

The nurse is preparing a plan of care for a client with leprosy.Which medication is considered the mainstay of pharmacological intervention for clients with leprosy and is included in all regimens?

A)Pyrazinamide (PZA)
B)Ethambutol (Myambutol)
C)Trimethoprim
D)Dapsone

Answer 2

Dapsone

Question 3

The nurse is teaching a community course regarding leprosy at a local senior citizen center.The nurse would be correct in informing the class that clients acquire Mycobacterium leprae by which route?

A)Sexual transmission
B)Hand-to-hand contact
C)Fecal/oral
D)Respiratory droplets

Answer 3

Respiratory droplets

Question 4

The nurse is caring for a client who is suspected of having tuberculosis.Which symptoms would the client exhibit with a tuberculosis infection? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Fatigue
B)Nonproductive cough
C)Night sweats
D)High fever
E)Weight loss

Question 5

The substance present in Mycobacterium that protects it from disinfectants,including chlorinated water,is:

A)polysaccharides.
B)mycolic acid.
C)yeast.
D)acetylation.

Question 6

The nurse is caring for a client hospitalized with lepromatous leprosy.The nurse anticipates the duration of pharmacological management to be:

A)1 month.
B)14 days.
C)2-5 years.
D)6-12 months.

Question 7

The nurse is caring for a client who is hospitalized for the reactivation of tuberculosis.The nurse knows that once tuberculosis is reactivated,it is spread throughout the body by the: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)respiratory tract.
B)blood.
C)lymphatic system.
D)liver.
E)kidneys.

Question 8

The nurse knows that which medication is considered the mainstay of pharmacological intervention in the client with tuberculosis?

A)Isoniazid
B)Pyrazinamide (PZA)
C)Rifampin (Rifadin,Rimactane)
D)Ethambutol (Myambutol)

Question 9

The nurse knows that which regimens are included in the initial phase of treatment for clients with tuberculosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Isoniazid daily for 2 months
B)Ethambutol (Myambutol)two to three times a week for 9 months
C)Ethambutol (Myambutol)daily for 4 months
D)Rifampin (Rifadin)daily for 2 months
E)Pyrazinamide (PZA)two to three times a week for 4 months

Question 10

The nurse caring for several clients with mycobacterium infections on a medical unit monitors which clients for atypical mycobacterial infections (AMIs)? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)A client with tuberculosis
B)A client with HIV
C)A client with leprosy
D)A client who is post-transplant
E)A client with leukemia

Question 11

The nurse is educating a client with tuberculosis.The client asks the nurse to estimate the duration of treatment.Which responses would be correct in identifying the expected duration for pharmacological management of tuberculosis?

A)1 month
B)7 days
C)14 days
D)6-12 months

Question 12

The client recently diagnosed with tuberculosis asks the nurse why so many different pills are required to treat the infection.The nurse bases the response on the knowledge that:

A)Treatment is a trial-and-error process,and it will take 14 days for the appropriate drug to be identified.
B)Mycobacteria grow slowly and often develop resistance during the course of treatment.
C)It is difficult for a single drug to break down the cysts that are formed by the tubercle.
D)The client might have a genetic difference that requires multiple dosing.

Question 13

In a postprimary or reactivation stage infection of tuberculosis,the most common nonrespiratory infection sites are the:

A)lymph nodes and genitourinary system.
B)skin and muscles.
C)bowel and liver.
D)heart and blood vessels.

Question 14

The nurse caring for a client with tuberculosis anticipates that the first 2 months of drug therapy for this client should include which medications? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Isoniazid
B)Albuterol
C)Ethambutol (Myambutol)
D)Rifampin (Rifadin,Rimactane)
E)Pyrazinamide (PZA)

Question 15

The nurse caring for a client with tuberculosis knows that the primary reason for lack of success in the treatment of tuberculosis is:

A)the development of resistance.
B)underdosing by the provider.
C)client nonadherence.
D)medication errors by the nurse.

Question 16

The nurse caring for a client being treated for tuberculosis anticipates that the client will also receive which medications to help prevent peripheral neuropathy?

A)Niacin
B)Pyridoxine (vitamin B₆)
C)Cyanocobalamin (vitamin B₁₂)
D)Neurontin

Question 17

The nurse is reading the client's medical history and learns that the client has a history of infections with Mycobacterium leprae.Based on this finding,the nurse would expect the client to have which infection?

A)Leprosy
B)AIDS
C)Tuberculosis
D)Hepatitis

Question 18

The nurse caring for a client with tuberculosis knows that the infection can be spread through which activities? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Sneezing
B)Shaking hands
C)Coughing
D)Talking
E)Hugging

Question 19

The client recently diagnosed with tuberculosis asks the nurse why family members also will be treated.On what facts does the nurse base the response?

A)The medication for the family is preventative.
B)Smaller doses now will prevent side effects should they need the medication in larger doses later.
C)The medication will increase the family members' immune response.
D)The family members will get the disease,and treatment must begin early.

Question 20

The nurse is reading the client's medical history and learns that the client has a history of infections with Mycobacterium scrofulaceum.Based on this finding,the nurse would expect the client to be from which age group?

A)60-75 years
B)40-50 years
C)12-18 years
D)1-3 years

Question 21

The nurse is caring for a male client who has been diagnosed with tuberculosis.The client asks when he will be considered noninfectious.The nurse knows that a client will be considered noninfectious when the:

A)PPD is negative.
B)white blood cell count is normal.
C)sputum culture and smear are negative.
D)chest x-ray is clear.

Question 22

In addition to close family members of tuberculosis clients,which other group should the nurse expect to receive prophylactic treatment with antimycobacterial agents?

A)Burn clients
B)Trauma clients
C)HIV/AIDS clients
D)Pregnant clients

Question 23

The nurse is administering dapsone to a client hospitalized on a medical-surgical unit.The nurse knows that the most frequent adverse effects of dapsone are related to which system?

A)Hematologic
B)Urinary
C)Respiratory
D)Gastrointestinal

Question 24

The nurse is caring for a client being treated with ethambutol in the treatment of tuberculosis.What assessment findings would indicate that the client is experiencing a side effect of this therapy?

A)Alteration in colored vision
B)White patches in the mucous membranes
C)Ringing in the ears
D)Alteration in smelling

Question 25

A nurse in an outpatient clinic is teaching a client about the criteria for being considered noninfectious.The nurse knows the client has understood the teaching when the client states:

A)"I am considered noninfectious when my white blood cell count is normal."
B)"I am considered noninfectious when my sputum culture and smear are negative."
C)"I am considered noninfectious when my PPD is negative."
D)"I am considered noninfectious when my chest x-ray is clear."

Question 26

The nurse is caring for a client with latent TB.Which circumstances would place this nurse in the high-risk category for the transmission of TB? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Caring for a client in a pediatric clinic
B)Caring for a client who is HIV-positive
C)Caring for a client who is currently serving a prison sentence
D)Caring for a pregnant client
E)Caring for a client who is living with someone with active TB

Question 27

The nurse is caring for a pregnant client who is taking isoniazid for the treatment of tuberculosis.The nurse knows that pregnant clients taking isoniazid therapy should also receive:

A)ethambutol (Myambutol).
B)pyrazinamide (PZA).
C)pyridoxine.
D)rifampin (Rifadin,Rimactane).

Question 28

The nurse is implementing direct observance therapy (DOT)for a client being treated for tuberculosis in the community.The nursing student asks what this means.The nurse correctly responds by saying:

A)"The client must swear all medications have been taken."
B)"The nurse must physically observe the client taking the medication."
C)"A family member must swear that the client is taking the medication."
D)"The nurse must watch the client document that the medication has been taken."

Question 29

The nurse reviewing the medication history of the client taking dapsone would have concern if which drug were listed?

A)Potassium
B)Aspirin
C)Viagra
D)St.John's wort

Question 30

The nurse is preparing to administer dapsone to a client and knows it is important to monitor which body system for adverse effects when administering this medication?

A)Urinary
B)Hematologic
C)Gastrointestinal
D)Respiratory

Question 31

The nurse caring for a client who has been diagnosed with a respiratory infection caused by Mycobacterium avium complex (MAC)anticipates that this infection will be treated by what class of antibiotics?

A)Fluoroquinolones
B)Macrolides
C)Cephalosporins
D)Penicillins

Question 32

The nurse is caring for a client who has been prescribed isoniazid prophylactically for tuberculosis.When used for prophylaxis,isoniazid will be used for what time period?

A)6-12 months
B)2-5 years
C)1 year
D)1 month

Question 33

For the client receiving treatment for tuberculosis,the priority assessment at monthly exams should include the monitoring of:

A)proteinuria.
B)liver function.
C)white blood cell counts.
D)electrolytes.

Question 34

The nurse is caring for a client who is being discharged on dapsone (DDS)for the treatment of leprosy.The nurse educates the client that it is essential to notify a health care provider when which adverse effects occur? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Nausea
B)Weight gain
C)Nose bleeds
D)Brittle fingernails
E)Yellowing of the skin

Question 35

The nurse caring for a client who has been diagnosed with Mycobacterium avium complex anticipates that the client could be treated with which medications? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Clarithromycin (Biaxin)
B)Azithromycin (Zithromax)
C)Ethambutol (Myambutol)
D)Isoniazid (INH)
E)Rifabutin (Mycobutin).

Question 36

The nurse is reviewing the medical record of a newly admitted client and notes that the client has been diagnosed with a Mycobacterium avium complex (MAC)infection.The nurse knows that this type of infection is believed to be spread via what route?

A)Blood contact
B)Contaminated meat
C)Respiratory droplets
D)Contaminated soil

Question 37

The nurse is preparing to administer INH to a client with tuberculosis and knows that this medication can be administered through which routes? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)By mouth
B)Intramuscular
C)Intravenous
D)Subcutaneous
E)Intradermal

Question 38

The nurse is caring for a client who has been diagnosed with an infection caused by Mycobacterium avium complex (MAC).The nurse knows that this organism primarily attacks which body systems?

A)Lymph nodes and genitourinary system
B)Bowel and liver
C)Heart and blood vessels
D)Lungs

Question 39

The nurse is caring for a client who has been diagnosed with a form of tuberculosis that is resistant to isoniazid therapy.What drug does the nurse anticipate the client will be prescribed for first-line therapy?

A)Ethambutol (Myambutol)
B)Pyrazinamide (PZA)
C)Rifampin (Rifadin,Rimactane)
D)Pyridoxine