Chapter 41: Antitubercular Drugs Lilley: Pharmacology and the Nursing
Process, 10th Edition
1. A patient who has been taking isoniazid has a new prescription for pyridoxine.
She is wondering why she needs this medication. The nurse explains that
pyridoxine is often given concurrently with the isoniazid to prevent which
condition?
A. Hair loss
B. Renal failure
C. Peripheral neuropathy
D. Heart failure
Answer: C
Explanation: Isoniazid can cause vitamin B6 (pyridoxine) deficiency, leading to peripheral
neuropathy. Pyridoxine supplementation is given prophylactically to prevent this neurological
complication.
2. When monitoring patients on antitubercular drug therapy, the nurse knows that
which drug may cause a decrease in visual acuity?
A. Rifampin
B. Isoniazid
C. Ethambutol
D. Streptomycin
Answer: C
Explanation: Ethambutol can cause optic neuritis, leading to blurred vision, decreased visual
acuity, and color blindness. Patients must have baseline and periodic visual acuity tests.
3. A patient who has started drug therapy for tuberculosis wants to know how long
he will be on the medications. Which response by the nurse is correct?
A. –Drug therapy will last until the symptoms have stopped.‖
B. –Drug therapy will continue until the tuberculosis develops resistance.‖
C. –You should expect to take these drugs for as long as 12 months.‖
D. –You will be on this drug therapy for the rest of your life.‖
Answer: C
Explanation: Standard treatment for drug-susceptible tuberculosis typically lasts 6 to 12
months. Completion of the full course is essential to prevent relapse and drug resistance.
, 4. The nurse is discussing adverse effects of antitubercular drugs with a patient
who has active tuberculosis. Which potential adverse effect of antitubercular
drug therapy should the patient report to the prescriber?
A. Gastrointestinal upset
B. Headache and nervousness
C. Reddish-orange urine and stool
D. Numbness and tingling of extremities
Answer: D
Explanation: Numbness and tingling in the extremities may indicate peripheral neuropathy, a
known adverse effect of isoniazid. This requires prompt medical attention. Reddish-orange
discoloration of body fluids is an expected, harmless effect of rifampin.
5. The nurse will assess the patient for which potential contraindication to
antitubercular therapy?
A. Glaucoma
B. Anemia
C. Heart failure
D. Hepatic impairment
Answer: D
Explanation: First-line antitubercular drugs like isoniazid, rifampin, and pyrazinamide are
hepatotoxic. Pre-existing severe liver disease is a contraindication due to the increased risk of
liver failure.
6. A patient has been taking antitubercular therapy for 3 months. The nurse will
assess for what findings that indicate a therapeutic response to the drug therapy?
A. The chronic cough is gone.
B. There are two consecutive negative purified protein derivative (PPD) results over 2
months.
C. There is increased tolerance to the medication therapy, and there are fewer reports
of adverse effects.
D. There is a decrease in symptoms of tuberculosis along with improved chest
radiographs and sputum cultures.
Answer: D
Explanation: A therapeutic response is confirmed by both clinical improvement (reduced
symptoms) and microbiological/radiological evidence (negative sputum cultures and
improved chest X-rays). Symptom resolution alone is not sufficient.
, 7. The nurse is reviewing the medication administration record of a patient who is
taking isoniazid. Which drug or drug class has a significant drug interaction
with isoniazid?
A. Pyridoxine
B. Penicillins
C. Phenytoin
D. Benzodiazepines
Answer: C
Explanation: Isoniazid inhibits the metabolism of phenytoin, leading to increased phenytoin
levels and potential toxicity. Close monitoring of phenytoin levels is necessary.
8. A patient newly diagnosed with tuberculosis (TB) has been taking antitubercular
drugs for 1 week calls the clinic and is very upset. He says, –My urine is dark
orange! What’s wrong with me?! Which response by the nurse is correct?
A. –You will need to stop the medication, and it will go away.‖
B. –It’s possible that the TB is worse. Please come in to the clinic to be checked.‖
C. –This is not what we usually see with these drugs. Please come in to the clinic to
be checked.‖
D. –This is an expected side effect of the medicine. Let’s review what to expect.‖
Answer: D
Explanation: Rifampin causes a harmless reddish-orange discoloration of urine, sweat, tears,
and other body fluids. Patients should be informed of this expected effect to prevent
unnecessary anxiety.
9. The nurse is counseling a woman who will be starting rifampin as part of
antitubercular therapy. The patient is currently taking oral contraceptives.
Which statement is true regarding rifampin therapy for this patient?
A. Women have a high risk for thrombophlebitis while on this drug.
B. A higher dose of rifampin will be necessary because of the contraceptive.
C. Oral contraceptives are less effective while the patient is taking rifampin.
D. The incidence of adverse effects is greater if the two drugs are taken together.
Answer: C
Explanation: Rifampin is a potent inducer of liver enzymes, which increases the metabolism
of oral contraceptives, reducing their effectiveness and increasing the risk of pregnancy. An
alternative form of contraception is recommended.
Process, 10th Edition
1. A patient who has been taking isoniazid has a new prescription for pyridoxine.
She is wondering why she needs this medication. The nurse explains that
pyridoxine is often given concurrently with the isoniazid to prevent which
condition?
A. Hair loss
B. Renal failure
C. Peripheral neuropathy
D. Heart failure
Answer: C
Explanation: Isoniazid can cause vitamin B6 (pyridoxine) deficiency, leading to peripheral
neuropathy. Pyridoxine supplementation is given prophylactically to prevent this neurological
complication.
2. When monitoring patients on antitubercular drug therapy, the nurse knows that
which drug may cause a decrease in visual acuity?
A. Rifampin
B. Isoniazid
C. Ethambutol
D. Streptomycin
Answer: C
Explanation: Ethambutol can cause optic neuritis, leading to blurred vision, decreased visual
acuity, and color blindness. Patients must have baseline and periodic visual acuity tests.
3. A patient who has started drug therapy for tuberculosis wants to know how long
he will be on the medications. Which response by the nurse is correct?
A. –Drug therapy will last until the symptoms have stopped.‖
B. –Drug therapy will continue until the tuberculosis develops resistance.‖
C. –You should expect to take these drugs for as long as 12 months.‖
D. –You will be on this drug therapy for the rest of your life.‖
Answer: C
Explanation: Standard treatment for drug-susceptible tuberculosis typically lasts 6 to 12
months. Completion of the full course is essential to prevent relapse and drug resistance.
, 4. The nurse is discussing adverse effects of antitubercular drugs with a patient
who has active tuberculosis. Which potential adverse effect of antitubercular
drug therapy should the patient report to the prescriber?
A. Gastrointestinal upset
B. Headache and nervousness
C. Reddish-orange urine and stool
D. Numbness and tingling of extremities
Answer: D
Explanation: Numbness and tingling in the extremities may indicate peripheral neuropathy, a
known adverse effect of isoniazid. This requires prompt medical attention. Reddish-orange
discoloration of body fluids is an expected, harmless effect of rifampin.
5. The nurse will assess the patient for which potential contraindication to
antitubercular therapy?
A. Glaucoma
B. Anemia
C. Heart failure
D. Hepatic impairment
Answer: D
Explanation: First-line antitubercular drugs like isoniazid, rifampin, and pyrazinamide are
hepatotoxic. Pre-existing severe liver disease is a contraindication due to the increased risk of
liver failure.
6. A patient has been taking antitubercular therapy for 3 months. The nurse will
assess for what findings that indicate a therapeutic response to the drug therapy?
A. The chronic cough is gone.
B. There are two consecutive negative purified protein derivative (PPD) results over 2
months.
C. There is increased tolerance to the medication therapy, and there are fewer reports
of adverse effects.
D. There is a decrease in symptoms of tuberculosis along with improved chest
radiographs and sputum cultures.
Answer: D
Explanation: A therapeutic response is confirmed by both clinical improvement (reduced
symptoms) and microbiological/radiological evidence (negative sputum cultures and
improved chest X-rays). Symptom resolution alone is not sufficient.
, 7. The nurse is reviewing the medication administration record of a patient who is
taking isoniazid. Which drug or drug class has a significant drug interaction
with isoniazid?
A. Pyridoxine
B. Penicillins
C. Phenytoin
D. Benzodiazepines
Answer: C
Explanation: Isoniazid inhibits the metabolism of phenytoin, leading to increased phenytoin
levels and potential toxicity. Close monitoring of phenytoin levels is necessary.
8. A patient newly diagnosed with tuberculosis (TB) has been taking antitubercular
drugs for 1 week calls the clinic and is very upset. He says, –My urine is dark
orange! What’s wrong with me?! Which response by the nurse is correct?
A. –You will need to stop the medication, and it will go away.‖
B. –It’s possible that the TB is worse. Please come in to the clinic to be checked.‖
C. –This is not what we usually see with these drugs. Please come in to the clinic to
be checked.‖
D. –This is an expected side effect of the medicine. Let’s review what to expect.‖
Answer: D
Explanation: Rifampin causes a harmless reddish-orange discoloration of urine, sweat, tears,
and other body fluids. Patients should be informed of this expected effect to prevent
unnecessary anxiety.
9. The nurse is counseling a woman who will be starting rifampin as part of
antitubercular therapy. The patient is currently taking oral contraceptives.
Which statement is true regarding rifampin therapy for this patient?
A. Women have a high risk for thrombophlebitis while on this drug.
B. A higher dose of rifampin will be necessary because of the contraceptive.
C. Oral contraceptives are less effective while the patient is taking rifampin.
D. The incidence of adverse effects is greater if the two drugs are taken together.
Answer: C
Explanation: Rifampin is a potent inducer of liver enzymes, which increases the metabolism
of oral contraceptives, reducing their effectiveness and increasing the risk of pregnancy. An
alternative form of contraception is recommended.
