Chapter 41: Antitubercular Drugs
Lilley: Pharmacology and the Nursing Process, 9th Edition
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MULTIPLE CHOICE
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1. 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
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b. Headache and nervousness
c. Reddish-orange urine and stool
d. Numbness and tingling of extremities
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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,
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and other body secretions reddish-orange, but this is not an effect that needs to be reported.
Patients need to be informed of this expected effect. The other options are incorrect.
DIF: Cognitive Level: Applying (Application)
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TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
abirb.com/test for pyridoxine. She is
2. A patient who has been taking isoniazid (INH) has a new prescription
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
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b. Renal failure
c. Peripheral neuropathy
d. Heart failure
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ANS: C
Pyridoxine (vitamin B6) may be beneficial for isoniazid-induced peripheral neuropathy. The
other options are incorrect.
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DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
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3. The nurse will assess the patient for which potential contraindication to antitubercular
therapy?
a. Glaucoma
b. Anemia
c. Heart failure
d. Hepatic impairment
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ANS: D
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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
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contraindication to these drugs. In addition, the patient’s history
of alcohol use needs to be
assessed.
DIF: Cognitive Level: Understanding (Comprehension)
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TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
4. When monitoring patients on antitubercular drug therapy, abirb.com/test
the nurse knows that which drug
may cause a decrease in visual acuity?
a. Rifampin (Rifadin)
b. Isoniazid (INH)
c. Ethambutol (Myambutol)
d. Streptomycin
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ANS: C
Ethambutol may cause a decrease in visual acuity or even abirb.com/test
blindness resulting from retrobulbar
neuritis. The other options are incorrect.
DIF: Cognitive Level: Understanding (Comprehension)
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TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. A patient has been taking antitubercular therapy for 3 months.
The nurse will assess for what
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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
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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 alongabirb.com/test
with improved chest
radiographs and sputum cultures.
ANS: D
A therapeutic response to antitubercular therapy is manifested
by a decrease in the symptoms
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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 will be used to confirm the
clinical findings of resolution of the infection.
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DIF: Cognitive Level: Analyzing (Analysis)
TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
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6. The nurse is counseling a woman who will be starting rifampin (Rifadin) 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 onabirb.com/test
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.
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ANS: C
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Women taking oral contraceptives and rifampin need to be counseled about other forms of
birth control because of the impaired effectiveness of the oral contraceptives during
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concurrent use of rifampin.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
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MSC: NCLEX: Physiological Integrity: Physiological Adaptation
7. The nurse is reviewing the medication administration record of a patient who is taking
isoniazid (INH). Which drug or drug class has a significantabirb.com/test
drug interaction with isoniazid?
a. Pyridoxine (vitamin B6)
b. Penicillins
c. Phenytoin (Dilantin)
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d. Benzodiazepines
ANS: C
Taking INH with phenytoin will cause decreased metabolism of the phenytoin, leading to
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increased drug effects. Pyridoxine is often given with isoniazid
to prevent peripheral
neuropathy. The other options are incorrect.
DIF: Cognitive Level: Understanding (Comprehension)
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TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
8. A patient who has started drug therapy for tuberculosis wants
to know how long he will be on
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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.”
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c. “You should expect to take these drugs for as long as 24
months.”
d. “You will be on this drug therapy for the rest of your life.”
ANS: C
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Drug therapy commonly lasts for 24 months if consistent drug
therapy has been maintained.
The other options are incorrect.
DIF: Cognitive Level: Analyzing (Analysis)
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TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
9. The nurse is preparing to administer morning medicationsabirb.com/test
to a patient who has been newly
diagnosed with tuberculosis. The patient asks, “Why do I have to take so many different
drugs?” Which response by the nurse is correct?
a. “Your prescriber hopes that at least one of these drugs will work to fight the
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tuberculosis.”
b. “Taking multiple drugs is recommended because of the increasing presence of
resistance to TB drug therapy.
c. “Using more than one drug can help to reduce side effects.”
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d. “Using multiple drugs enhances the effect of each drug.”
ANS: B
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The 2016 American Thoracic Society/CDC treatment guidelines recommend the use of
multiple medications because of the increasing presence of resistance. The other options are
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incorrect.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
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MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral
Therapies
10. 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 urineabirb.com/test
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.”
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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.”
ANS: D
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Rifampin, one of the first-line drugs for TB, causes a red-orange-brown discoloration of urine,
tears, sweat, and sputum. Patients need to be warned about this side effect. The other options
are incorrect.
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DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral
Therapies
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MULTIPLE RESPONSE
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1. The nurse is providing patient teaching for a patient who is starting antitubercular drug
therapy. Which of these statements should be included? (Select all that apply.)
a. “Take the medications until the symptoms disappear.”
b. “Take the medications at the same time every day.” abirb.com/test
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.”
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e. “Avoid alcoholic beverages 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 fingersabirb.com/test
or toes, report it to your
prescriber immediately.”
h. “Oral contraceptives may not work while you are taking these drugs, so you will
have to use another form of birth control.”
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ANS: B, E, G, H
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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,
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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 must not be stopped. Because
of potential liver toxicity, patients on this drug therapy must not drink alcohol. Discoloration
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of the urine is an expected adverse effect, and patients need to be warned about it beforehand.
Burning or tingling in the fingers or toes may indicate that peripheral neuropathy is
developing, and the prescriber needs to be notified immediately. A second form of birth
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control must be used because antitubercular drug therapy makes
oral contraceptives
ineffective.
DIF: Cognitive Level: Applying (Application)
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TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
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