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

Question 1

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

Answer 1

Isoniazid, pyrazinamide, ethambutol + rifabutin

Question 2

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.

Answer 2

clinic staff can observe adherence to drug regimens.

Question 3

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

Answer 3

monitoring phenytoin levels.

Question 4

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

Question 5

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 6

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 7

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 8

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.

Question 9

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 10

A nursing student asks a nurse why tuberculosis resistance is so high. Which reasons are correct?

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 11

A patient who is taking drugs to treat HIV has tuberculosis and has been on a four-drug regimen for 3 months without improvement in symptoms. Which drug will the nurse anticipate that the provider will add to this patient's regimen?

A) bedaquiline [Sirturo]
B) capreomycin [Capastat Sulfate]
C) ethionamide [Trecator]
D) pyridoxine

Question 12

A patient who has drug-sensitive tuberculosis has completed 2 months of the standard four-drug therapy and asks the nurse how long he will have to take medication. Which response by the nurse is correct?

A) "As long as you remain symptomatic, you will not have to take more medication."
B) "The four-drug regimen will continue for 3 more months."
C) "You will have to take maintenance drugs indefinitely."
D) "You will need to take only two drugs for the next 4 months."

Question 13

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

Question 14

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

Question 15

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 16

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 17

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 drugs would the nurse expect to be added to the treatment plan of a patient with HIV/AIDS?

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

Question 18

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 19

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 20

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 21

Which patients should be tested for latent TB?

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