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PHARM NURS 615 EXAM 2 PRACTICE
QUESTIONS WITH
RATIONALES| NURS 615 EXAM 2 PHARM
QUESTIONS WITH CORRECT ANSWERS
Which person should be treated with prophylactic antitubercular medication? a.
A child who attends the same school with a child who has tuberculosis
b. A nurse who is working in a hospital
c. An individual who is HIV-positive with a negative TB skin test
d. A patient who has close contact with someone who has tuberculosis -
Answer: D
Personal contact with a person having a diagnosis of tuberculosis is required to
indicate prophylactic treatment with antitubercular therapy. Attending the same
school does not necessarily mean close contact occurs. Health care
professionals do not need prophylactic treatment. HIV-positive individuals with
negative TB skin tests do not need prophylaxis.
A patient who has chronic liver disease reports contact with a person who has
tuberculosis (TB). The nurse will counsel this patient to contact the provider to
discuss
a. a chest x-ray.
b. a TB skin test.
c. liver function tests (LFTs).
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d. prophylactic antitubercular drugs. - ANS: B
Patients who have exposure to TB should have a TB skin test. A chest x-ray is
performed if the skin test is positive. LFTs do not need to be done simply
because of TB exposure. This patient is not a candidate for antitubercular drug
prophylaxis
A patient who has tuberculosis asks the nurse why three drugs are used to treat
this disease. The nurse will explain that multi-drug therapy is used to reduce the
likelihood of
a. disease relapse.
b. drug hypersensitivity reactions.
c. drug resistance.
d. drug adverse effects - ANS: C
Without multi-drug therapy, patients easily develop resistance to antitubercular
drugs. Using more than one antitubercular drug does not prevent relapse,
hypersensitivity reactions, or adverse effects.
The nurse caring for a patient who has tuberculosis and who is taking isoniazid,
rifampin, and streptomycin reviews the medical record and notes the patients
sputum cultures reveal resistance to streptomycin. The nurse will anticipate that
the provider will take which action?
a. Add ethambutol (Myambutol).
b. Change the streptomycin to clarithromycin.
c. Change the streptomycin to kanamycin.
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d. Order renal function tests. - ANS: C
The patients current regimen is first-phase treatment. If resistance to
streptomycin develops, the provider can change to kanamycin or to
ciprofloxacin. Ethambutol is added if there is resistance to isoniazid.
Clarithromycin is used during phase II. Renal function tests are not indicated
A patient who is taking isoniazid (INH) as part of a two-drug tuberculosis
treatment regimen reports tingling of the fingers and toes. The nurse will
recommend discussing which treatment with the provider?
a. Adding pyrazinamide
b. Changing to ethambutol
c. Increasing oral fluid intake
d. Taking pyridoxine (B6) - ANS: D
Peripheral neuropathy is an adverse reaction to INH, so pyridoxine is usually
given to prevent this. It is not necessary to change medications. Increasing
fluids will not help with this.
The nurse is teaching a patient about rifampin. Which statement by the patient
indicates understanding of the teaching?
a. I should not wear soft contact lenses while taking rifampin.
b. I will need regular eye examinations while taking this drug.
c. I will report orange urine to my provider immediately.
d. I understand that renal toxicity is a common adverse effect - ANS: A
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Patients taking rifampin should be warned that urine, feces, saliva, sputum,
sweat, and tears may turn a harmless red-orange color. Patients should not wear
soft contact lenses to avoid permanent staining. Regular eye exams are
necessary for patients who receive isoniazid and ethambutol. Orange urine is a
harmless side effect and does not need to be reported. Renal toxicity is not
common with rifampin
A patient who has completed the first phase of a three-drug regimen for
tuberculosis has a positive sputum acid-bacilli test. The nurse will tell the
patient that
a. drug resistance has probably occurred.
b. it may be another month before this test is negative.
c. the provider will change the pyrazinamide to ethambutol.
d. there may be a need to remain in the first phase of therapy for several
weeks -
ANS: B
The goal is for the patients sputum test to be negative 2 to 3 months after the
therapy. The positive test does not indicate drug resistance. The provider will
not change the drugs or keep the patient in the first phase longer than planned
A patient is being treated with isoniazid (INH), rifampin, and pyrazinamide in
phase I of treatment for tuberculosis. The organism develops resistance to
isoniazid. Which drug will the nurse anticipate the provider will order to replace
the isoniazid?
a. Ciprofloxacin (Cipro)
PHARM NURS 615 EXAM 2 PRACTICE
QUESTIONS WITH
RATIONALES| NURS 615 EXAM 2 PHARM
QUESTIONS WITH CORRECT ANSWERS
Which person should be treated with prophylactic antitubercular medication? a.
A child who attends the same school with a child who has tuberculosis
b. A nurse who is working in a hospital
c. An individual who is HIV-positive with a negative TB skin test
d. A patient who has close contact with someone who has tuberculosis -
Answer: D
Personal contact with a person having a diagnosis of tuberculosis is required to
indicate prophylactic treatment with antitubercular therapy. Attending the same
school does not necessarily mean close contact occurs. Health care
professionals do not need prophylactic treatment. HIV-positive individuals with
negative TB skin tests do not need prophylaxis.
A patient who has chronic liver disease reports contact with a person who has
tuberculosis (TB). The nurse will counsel this patient to contact the provider to
discuss
a. a chest x-ray.
b. a TB skin test.
c. liver function tests (LFTs).
, Page 2 of 44
d. prophylactic antitubercular drugs. - ANS: B
Patients who have exposure to TB should have a TB skin test. A chest x-ray is
performed if the skin test is positive. LFTs do not need to be done simply
because of TB exposure. This patient is not a candidate for antitubercular drug
prophylaxis
A patient who has tuberculosis asks the nurse why three drugs are used to treat
this disease. The nurse will explain that multi-drug therapy is used to reduce the
likelihood of
a. disease relapse.
b. drug hypersensitivity reactions.
c. drug resistance.
d. drug adverse effects - ANS: C
Without multi-drug therapy, patients easily develop resistance to antitubercular
drugs. Using more than one antitubercular drug does not prevent relapse,
hypersensitivity reactions, or adverse effects.
The nurse caring for a patient who has tuberculosis and who is taking isoniazid,
rifampin, and streptomycin reviews the medical record and notes the patients
sputum cultures reveal resistance to streptomycin. The nurse will anticipate that
the provider will take which action?
a. Add ethambutol (Myambutol).
b. Change the streptomycin to clarithromycin.
c. Change the streptomycin to kanamycin.
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d. Order renal function tests. - ANS: C
The patients current regimen is first-phase treatment. If resistance to
streptomycin develops, the provider can change to kanamycin or to
ciprofloxacin. Ethambutol is added if there is resistance to isoniazid.
Clarithromycin is used during phase II. Renal function tests are not indicated
A patient who is taking isoniazid (INH) as part of a two-drug tuberculosis
treatment regimen reports tingling of the fingers and toes. The nurse will
recommend discussing which treatment with the provider?
a. Adding pyrazinamide
b. Changing to ethambutol
c. Increasing oral fluid intake
d. Taking pyridoxine (B6) - ANS: D
Peripheral neuropathy is an adverse reaction to INH, so pyridoxine is usually
given to prevent this. It is not necessary to change medications. Increasing
fluids will not help with this.
The nurse is teaching a patient about rifampin. Which statement by the patient
indicates understanding of the teaching?
a. I should not wear soft contact lenses while taking rifampin.
b. I will need regular eye examinations while taking this drug.
c. I will report orange urine to my provider immediately.
d. I understand that renal toxicity is a common adverse effect - ANS: A
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Patients taking rifampin should be warned that urine, feces, saliva, sputum,
sweat, and tears may turn a harmless red-orange color. Patients should not wear
soft contact lenses to avoid permanent staining. Regular eye exams are
necessary for patients who receive isoniazid and ethambutol. Orange urine is a
harmless side effect and does not need to be reported. Renal toxicity is not
common with rifampin
A patient who has completed the first phase of a three-drug regimen for
tuberculosis has a positive sputum acid-bacilli test. The nurse will tell the
patient that
a. drug resistance has probably occurred.
b. it may be another month before this test is negative.
c. the provider will change the pyrazinamide to ethambutol.
d. there may be a need to remain in the first phase of therapy for several
weeks -
ANS: B
The goal is for the patients sputum test to be negative 2 to 3 months after the
therapy. The positive test does not indicate drug resistance. The provider will
not change the drugs or keep the patient in the first phase longer than planned
A patient is being treated with isoniazid (INH), rifampin, and pyrazinamide in
phase I of treatment for tuberculosis. The organism develops resistance to
isoniazid. Which drug will the nurse anticipate the provider will order to replace
the isoniazid?
a. Ciprofloxacin (Cipro)
