Lilley: Pharmacology and the Nursing Process, 7th Edition

Test Bank

Chapter 41: Antitubercular Drugs

MULTIPLE CHOICE

1. The nurse is discussing adverse effects of antitubercular drugs. Which

potential adverse effect should the patient report to his or her prescriber?
A. Gastrointestinal upset
B. Headache and nervousness
C. Reddish-orange urine and stool
D. Numbness and tingling of extremities
ANS: D
Patients on antitubercular therapy should report experiencing numbness and tingling of
extremities, which may indicate peripheral neuropathy. Some drugs may color the urine,
stool, and other body secretions reddish-orange, but this is not an effect that needs to be
reported. Patients should be informed of this expected effect.

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MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

2. A patient who has been taking isoniazid (INH) has a new prescription for
pyridoxine. She is wondering why she needs this medication. The nurse explains that
pyridoxine is given concurrently with the isoniazid to prevent
A. hair loss.
B. renal failure.
C. peripheral neuropathy.
D. heart failure.
ANS: C
Pyridoxine (vitamin B6) may be beneficial for isoniazid-induced peripheral neuropathy. The
other options are not correct.

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3. When assessing patients who are to receive antitubercular therapy, the nurse
should assess for which potential contraindication?
A. Glaucoma
 B. Anemia
C. Heart failure
D. Hepatic impairment
ANS: D
Results of liver function studies (e.g., bilirubin level, liver enzyme levels) need to be
assessed because isoniazid and rifampin may cause hepatic impairment; severe liver
dysfunction is a contraindication to these drugs. In addition, the patient’s history of alcohol
use should be assessed.

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MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential

4. 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
ANS: C
Ethambutol may cause a decrease in visual acuity or even blindness resulting from retrobul-
bar neuritis.

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TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

5. A patient has been taking antitubercular therapy for 3 months. The nurse notes
a therapeutic response to these drugs with which assessment findings?
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 x-rays
and sputum cultures.
ANS: D
A therapeutic response to antitubercular therapy is manifested by a decrease in the symptoms
of tuberculosis, such as cough and fever, and by weight gain. The results of laboratory
studies (culture and sensitivity tests) and the chest radiographic findings should confirm the
clinical findings of resolution of the infection.
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TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
6. The nurse is counseling a woman who will be starting rifampin. The patient is on 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.
ANS: C
Women taking oral contraceptives and rifampin should be counseled about other forms of
birth control because of the impaired effectiveness of the oral contraceptives during concur-
rent use of rifampin.

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MSC: NCLEX: Physiological Integrity: Physiological Adaptation

7. The nurse is reviewing the medication record of a patient who is taking

isoniazid (INH). Which drug or drug class has a significant drug interaction with isoniazid?
A. Pyridoxine
B. Penicillin
C. Antacids
D. Benzodiazepines
ANS: C
Antacids reduce absorption of isoniazid and thus reduce serum levels. Pyridoxine is often
given with isoniazid to prevent peripheral neuropathy. The other options are not correct.

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8. A patient who has started drug therapy for tuberculosis wants to know how
long he will be on the medications. What is the nurse’s best response?
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 24 months.”
D. “You will be on antituberculosis drug therapy for the rest of your life.”
ANS: C
Drug therapy commonly lasts for 24 months if consistent drug therapy has been maintained.

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 9. The nurse is preparing to administer morning medications to a patient who has
been newly diagnosed with tuberculosis. The patient asks, “Why do I have to take so many
different drugs?” Which answer by the nurse is correct?
A. “It is hoped that at least one of these drugs will work to fight the tuberculosis.”
B. “Taking multiple drugs reduces the chance that the tuberculosis will become drug
resistant.”
C. “Using several drugs has a faster effect than single-drug therapy.”
D. “Using multiple drugs enhances the effect of each drug.”
ANS: B
The use of multiple medications reduces the possibility that the organism will become drug
resistant. The other options are not correct.

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MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

MULTIPLE RESPONSE

1. Important points the nurse should emphasize when teaching a patient who will
be taking antitubercular therapy include which of the following? Select all that apply.
A. “Take medications until the symptoms disappear.”
B. “Take medications at the same time every day.”
C. “You will be considered contagious during most of the illness and must take
precautions to avoid spreading the disease.”
D. “Stop taking the medications if you have severe adverse effects.”
E. “Alcoholic beverages should be avoided while on this therapy.”
F. “If you notice reddish-brown or reddish-orange urine, stop taking the drug and
contact your doctor right away.”
G. “If you experience a burning or tingling in your fingers or toes, report it to your
physician immediately.”
H. “Oral contraceptives may not work while you are taking these drugs, so you will
have to use another form of birth control.”
ANS: B, E, G, H
Medications for tuberculosis must be taken on a consistent schedule to maintain blood levels.
Medication therapy for tuberculosis may last up to 24 months, long after symptoms
disappear, and patients are infectious during the early part of the treatment. Compliance with
antitubercular drug therapy is key, so if symptoms become severe, the prescriber should be
contacted for an adjustment of the drug therapy. The medication should not be stopped.
Because of potential liver toxicity, patients on this drug therapy should not drink alcohol.
Discoloration of the urine is an expected adverse effect, and patients should be warned about
it beforehand. A second form of birth control should be used because antitubercular drug
therapy makes oral contraceptives ineffective.
DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 653
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies