antitubercular (before midterm)

Question 1

Patients taking isoniazid (Isotamine®) should watch for and report which potential adverse effect(s)?
a. Rash
b. Headache and nervousness
c. Insomnia
d. Numbness and tingling of extremities

Answer 1

ANS: D
Patients on isoniazid therapy should report numbness and tingling of extremities. Rash, headache, nervousness, and insomnia are not adverse effects of isoniazid. Headache and insomnia are adverse effects of levofloxacin and some of the other antibiotics used to treat tuberculosis.

Question 2

A patient who has been taking isoniazid (Isotamine) has a new prescription for pyridoxine (vitamin B6) and asks the nurse why this medication is needed. The nurse explains that pyridoxine is given concurrently with the isoniazid to prevent which condition?
a. Hair loss
b. Renal failure
c. Neurological adverse effects
d. Heart failure

Answer 2

ANS: C
The neurological adverse effects of isoniazid—such as isoniazid-precipitated peripheral neuropathies and numbness, tingling, or burning of extremities—may be prevented with the administration of pyridoxine.

Question 3

When assessing patients who are to receive antitubercular therapy, the nurse should monitor for which sign?
a. Glaucoma
b. Weight gain
c. Heart failure
d. Hepatic impairment

Answer 3

ANS: D
Isoniazid (INH) and rifampin (Rifadin®) may cause hepatic impairment. Therefore, liver function and alcohol use should be assessed.

Question 4

Which antitubercular drug may cause retrobulbar neuritis?
a. rifampin (Rifadin)
b. isoniazid (Isotamine)
c. ethambutol (Etibi®)
d. streptomycin

Answer 4

ANS: C
Ethambutol may cause retrobulbar neuritis and blindness.

Question 5

What indicates a patient’s therapeutic response to antitubercular drugs?
a. Cessation of the chronic cough
b. Two consecutive negative purified protein derivative tuberculin skin test results
over 2 months
c. An increased tolerance to the medication therapy and fewer reports of adverse
effects
d. A decrease in symptoms of tuberculosis (TB) and improved chest X-rays and
sputum cultures

Answer 5

ANS: D
A therapeutic response to the therapy is indicated by a decrease in symptoms of TB, supported by improved chest X-rays, sputum cultures and sensitivities.

Question 6

What information is the nurse to provide to a woman who is beginning rifampin therapy and is currently taking an oral contraceptive?
a. There is an increased risk of thrombophlebitis.
b. A higher dose of rifampin will be necessary.
c. Oral contraceptives are ineffective while the patient is taking rifampin.
d. The incidence of adverse effects is greater when the two drugs are taken together.

Answer 6

ANS: C
Women taking oral contraceptives and rifampin should be counselled on other forms of birth control because of the impaired effectiveness of the oral contraceptives during concurrent use of rifampin.

Question 7

Which has a significant drug interaction with isoniazid (Isotamine)? a. Alcohol
b. Nicotine c. Antacids d. Laxatives

Answer 7

ANS: C
Antacids reduce the absorption of isoniazid and thus reduce serum levels.

Question 8

patient who has started drug therapy for TB asks the nurse how long the medications will have to be taken. Which statement is the nurse’s best response to the patient’s question?
a. Drug therapy will last until the symptoms have stopped.
b. Drug therapy will continue until the TB develops resistance.
c. The patient should expect to take these drugs for up to 24 months.
d. The tuberculosis drug therapy will continue for the rest of the patient’s life.

Answer 8

ANS: C
Drug therapy often lasts for up to 24 months if patient adherence has been maintained.

Question 9

Which is the reason for using multidrug therapy in the treatment of TB?
a. Multiple drugs are required to eradicate TB.
b. The use of multiple medications reduces the chance of TB becoming drug
resistant.
c. Multidrug therapy will have a faster effect than will single-drug therapy.
d. Using multidrug therapy enhances the effect of each drug.

Answer 9

ANS: B
The use of multiple medications reduces the possibility of the organism becoming drug resistant.

Question 10

Family members exposed to a patient with active TB may require prophylactic drug therapy. How long do they need to take this therapy?
a. 6 months
b. 9 months
c. 18 months
d. 24 months

Answer 10

ANS: B
Some family members exposed to an individual with active TB may require prophylactic drug therapy for up to 9 months.