Deck 90: Antimycobacterial Agents: Drugs for Tuberculosis, Leprosy, and Mycobacterium Avium Complex Infection

Question 1

A patient comes to a clinic for tuberculosis medications 2 weeks after beginning treatment with a four-drug induction phase. The patient's sputum culture remains positive, and no drug resistance is noted. At this point, the nurse will expect the provider to:

A) change the regimen to a two-drug continuation phase.
B) continue the four-drug regimen and recheck the sputum in 2 weeks.
C) obtain a chest radiograph and consider adding another drug to the regimen.
D) question the patient about adherence to the drug regimen.

Answer 1

continue the four-drug regimen and recheck the sputum in 2 weeks.

Question 2

A nurse is performing a physical assessment on a patient with tuberculosis who takes rifampin (Rifadin). What would be an expected finding?

A) Crystalluria
B) Myopathy
C) Peripheral neuropathy
D) Red-orange-tinged urine

Answer 2

Red-orange-tinged urine

Question 3

A patient who is being treated for HIV infection has a 5-mm area of induration after a routine TST. The patient's chest radiograph is normal, and there are no other physical findings. The nurse will expect this patient to begin treatment with which drugs?

A) Isoniazid and rifabutin
B) Isoniazid and rifampin
C) Isoniazid and rifapentine
D) Isoniazid and pyrazinamide

Answer 3

Isoniazid and rifabutin

Question 4

A patient is about to begin treatment for latent tuberculosis. The patient is an alcoholic, has difficulty complying with drug regimens, and has mild liver damage. What will the nurse tell this patient?

A) "You must stop drinking before adequate treatment can begin."
B) "You must take isoniazid with close monitoring of hepatic function."
C) "You must take rifampin daily for 4 months."
D) "You will begin a regimen of isoniazid and rifampin."

Question 5

A nurse is teaching a group of nursing students about the problems associated with the long-term therapy required to treat tuberculosis. Which statement by a student indicates a need for further teaching?

A) "Long-term therapy increases the emergence of drug-resistant organisms."
B) "Long-term therapy increases the incidence of drug toxicities."
C) "Long-term therapy increases the likelihood of reactivation of latent infection."
D) "Long-term therapy results in decreased patient adherence to drug regimens."

Question 6

A patient has been taking isoniazid (Nydrazid) for 4 months for latent tuberculosis. The patient reports bilateral tingling and numbness of the hands and feet, as well as feeling clumsy. The nurse expects the provider to:

A) discontinue the isoniazid.
B) lower the isoniazid dose and add rifampin.
C) order pyridoxine 100 mg per day.
D) recheck the tuberculin skin test to see whether it worsens.

Question 7

A nurse reads a tuberculin skin test on a patient and notes a 6 to 7 mm area of induration. The patient is a young adult who has recently immigrated from a country with a high prevalence of tuberculosis. The patient has no other risk factors. The nurse will expect the provider to:

A) begin treating this patient with a two-drug regimen of isoniazid and rifampin.
B) order a chest radiograph and a sputum culture to assess for active tuberculosis.
C) order a nucleic acid amplification test of the patient's sputum.
D) reassure the patient that this is not considered a positive test result.

Question 8

A patient is about to begin therapy with ethambutol. The nurse knows that, before initiating treatment with this drug, it is important to obtain which test(s)?

A) Color vision and visual acuity
B) Complete blood cell (CBC) count
C) Hearing testing and a tympanogram
D) Hepatic function tests

Question 9

A patient with high-risk factors for tuberculosis will begin therapy for latent TB with isoniazid and rifampin. The nurse learns that this patient takes oral contraceptives. The nurse will counsel this patient to discuss _____ with her provider.

A) another birth control method
B) reducing the rifampin dose
C) reducing the isoniazid dose
D) increasing the oral contraceptive dose

Question 10

A patient is about to begin treatment for latent tuberculosis with a short course of daily rifampin. The patient asks why rifapentine (Priftin) cannot be used, because it can be given twice weekly. What will the nurse tell this patient about rifapentine?

A) It is more toxic than rifampin.
B) It is not approved for treatment of latent TB.
C) It is not well absorbed and thus not as effective.
D) It will stain contact lenses orange.

Question 11

A patient is about to begin treatment with isoniazid. The nurse learns that the patient also takes phenytoin (Dilantin) for seizures. The nurse will contact the provider to discuss:

A) reducing the isoniazid dose.
B) reducing the phenytoin dose.
C) monitoring isoniazid levels.
D) monitoring phenytoin levels.

Question 12

Which patient should begin treatment for tuberculosis?

A) A patient with HIV and a tuberculin skin test result of a 4-mm region of induration
B) A recent immigrant from a country with a high prevalence of TB with a 10-mm region of induration
C) A patient with no known risk factors who has a job-related tuberculin skin test result of a 12-mm area of induration
D) An intravenous drug abuser with a tuberculin skin test result of a 5-mm region of induration

Question 13

A nurse is caring for a patient with HIV/acquired immunodeficiency syndrome (AIDS) who has taken protease inhibitors for 18 months. The patient has been diagnosed with active tuberculosis. Which drug(s) would the nurse expect to be added to the treatment plan of a patient with HIV/AIDS? (Select all that apply.)

A) Isoniazid
B) Rifampin (Rifadin)
C) Pyrazinamide (PZA)
D) Ethambutol (Myambutol)
E) Rifabutin (Mycobutin)

Question 14

A patient with HIV who takes protease inhibitors develops tuberculosis and will begin treatment. Which drug regimen will be used for this patient?

A) Isoniazid, pyrazinamide, ethambutol + rifabutin
B) Isoniazid, pyrazinamide, ethambutol
C) Isoniazid, rifampin, pyrazinamide, ethambutol
D) Isoniazid + rifabutin

Question 15

A hospitalized patient is being treated for tuberculosis with a drug regimen that includes pyrazinamide. The patient complains of pain in the knee and shoulder joints. The nurse will contact the provider to request an order for:

A) ibuprofen.
B) renal function tests.
C) discontinuation of the pyrazinamide.
D) measurement of uric acid levels.

Question 16

A patient newly diagnosed with tuberculosis asks the nurse why oral medications must be given in the clinic. The nurse will tell the patient that medications are given in the clinic so that:

A) clinic staff can observe adherence to drug regimens.
B) nurses can monitor for drug toxicities.
C) providers can adjust doses as needed.
D) the staff can ensure that the U.S. Food and Drug Administration (FDA) regulations are met.

Question 17

A nursing student asks a nurse why tuberculosis resistance is so high. Which reasons are correct? (Select all that apply.)

A) Adherence to drug regimens is erratic.
B) Drug doses are often too low.
C) Many hosts are immunocompromised.
D) Many regimens contain too few drugs.
E) Some TB drugs are bacteriostatic.

Question 18

Which patient(s) should be tested for latent TB? (Select all that apply.)

A) A day care employee
B) A worker in a mycobacteriology laboratory
C) A patient with cardiovascular disease
D) A patient with diabetes mellitus
E) An immigrant from a country where TB is prevalent

Question 19

A healthcare worker who is asymptomatic has a screening TST result of 10 mm of induration during a pre-employment physical. What will the nurse reading this test tell the patient?

A) "This is a negative test, so you are cleared for employment."
B) "You have latent TB and will need to take isoniazid for 6 to 9 months."
C) "You need to have a chest radiograph and a sputum culture."
D) "You will begin taking a four-drug regimen to treat tuberculosis."

Question 20

A patient is beginning treatment for active tuberculosis (TB) in a region with little drug-resistant TB. Which treatment regimen will be used initially?

A) Isoniazid and pyrazinamide
B) Isoniazid, pyrazinamide, and ethambutol
C) Rifampin, pyrazinamide, and ethambutol
D) Isoniazid, rifampin, pyrazinamide, and ethambutol