Chapter 10: Anti-tubercular Drugs Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. An HIV-positive client in a continuing phase of TB has shown no positive sputum results for 6 months. The nurse is aware that the second phase can last 4 months or more under which circumstances? a. Positive sputum culture after the completion of initial treatment b. Inclusion of pyrazinamide in the initial treatment c. Following the same eating habits in the continuing phase d. Nausea or vomiting after completing the initial treatment Answer: A Rationale: Positive sputum culture after the completion of initial treatment leads to treatment in the second phase lasting for 4 to 7 months. Following the same eating habits (diet) will not cause treatment in the second phase to last for 4 months or more, nor will nausea or vomiting occurring after completing the initial treatment. Noninclusion of pyrazinamide in the initial treatment leads to the second phase lasting for 4 to 7 months or more. Question Format: Multiple Choice Chapter: 10 Learning Objective: 1, 2 Cognitive Level: Understand Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 117, Standard Treatment Protocol 2. The nurse administers ethambutol to a client in the initial phase of tuberculosis. The nurse will monitor the client for which potential adverse reaction? a. Hypersensitivity b. Skin eruptions c. Joint pain d. Myalgia Answer: C Rationale: Joint pain is an adverse reaction of ethambutol. Hypersensitivity and skin eruptions are adverse reactions of isoniazid. Myalgia is an adverse reaction of pyrazinamide. Question Format: Multiple Choice Chapter: 10 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 119, Ethambutol 3. The nurse is preparing to teach a client about the proper way to take the various antitubercular drugs. Which action should the nurse point out as the best way to minimize GI complications? a. Double the dose if earlier dose is missed. b. Take prescribed pyrazinamide without regard to food. c. Take prescribed ethambutol with food. d. Avoid the consumption of alcohol. Answer: D Rationale: The nurse should instruct the client to avoid the consumption of alcohol since alcoholism compounds the client's difficulties and complicates the general condition of the client's gastrointestinal tract. The nurse should instruct the client to take the prescribed dose of ethambutol without regard to food and to take the prescribed pyrazinamide along with food. The nurse should instruct the client to avoid doubling the dose in case the earlier dose was missed. Question Format: Multiple Choice Chapter: 10 Learning Objective: 6 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Teaching/Learning Reference: p. 122, Malnutrition: Less Than Body Requirements 4. The nurse is completing a preadministration assessment on a client with tuberculosis who is to start pyrazinamide. The nurse should question giving this drug after discovering which factor in the client's medical record? a. Acute gout b. Age younger than 13 years c. Diabetic retinopathy d. Cataracts Answer: A Rationale: The nurse should know that pyrazinamide is contraindicated among clients with acute gout. Pyrazinamide is also contraindicated in clients with acute hepatic or renal impairment and in clients with diabetes mellitus. Ethambutol is contraindicated in clients with diabetic retinopathy, clients with cataracts, and clients who are younger than 13 years. Question Format: Multiple Choice Chapter: 10 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 120, Hepatotoxicity 5. A nurse is caring for a client undergoing the second phase of standard TB treatment. The nurse expects to administer which combinations of drugs to the client? a. Pyrazinamide and dapsone b. Rifampin and pyrazinamide c. Rifampin and isoniazid d. Dapsone and isoniazid Answer: C Rationale: The nurse knows that a combination of rifampin and isoniazid drugs should be used during the second phase of standard treatment. Isoniazid, rifampin, and pyrazinamide are not used together as combination drugs in the second phase of standard treatment. Dapsone is used for leprosy and cannot be used in combination with isoniazid or any other drug for TB. Question Format: Multiple Choice Chapter: 10 Learning Objective: 1 Cognitive Level: Understand Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 117, Standard Treatment Protocol 6. The nurse administers rifampin to a 45-year-old client with tuberculosis. The nurse would monitor the client for which potential adverse reaction? a. Diarrhea b. Fever c. Dermatitis d. Vertigo