Chapter 90: Antimycobacterial Agents: Drugs for Tuberculosis, Leprosy, and Mycobacterium avium Complex Infection

Chapter 90: Antimycobacterial Agents: Drugs for Tuberculosis, Leprosy, and Mycobacterium avium Complex Infection

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse is performing a physical assessment on a patient with tuberculosis who takes rifampin [Rifadin]. What would be an expected finding?

a.	Crystalluria
b.	Myopathy
c.	Peripheral neuropathy
d.	Red-orange–tinged urine

 

 

ANS:  D

Urine tinged red-orange is a normal finding associated with rifampin’s adverse effects. Peripheral neuropathy, myopathy, and crystalluria are not manifestations of adverse effects of rifampin.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 1078-1079

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

2. A patient who has drug-sensitive tuberculosis has completed 2 months of the standard four-drug therapy and asks the nurse how long he will have to take medication. Which response by the nurse is correct?

a.	“As long as you remain symptomatic, you will not have to take more medication.”
b.	“The four-drug regimen will continue for 3 more months.”
c.	“You will have to take maintenance drugs indefinitely.”
d.	“You will need to take only two drugs for the next 4 months.”

 

 

ANS:  D

Patients with drug-sensitive tuberculosis take four drugs for 2 months during the induction phase, followed by two drugs for 4 months in the continuation phase. Drug therapy does not stop after the induction phase, even for asymptomatic patients. Although drug therapy is prolonged, it is not indefinite.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 1073-1074

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

3. A nurse reads a tuberculin skin test on a patient and notes a 6- to 7-mm area of induration. The patient is a young adult who has recently immigrated from a country with a high prevalence of tuberculosis. The patient has no other risk factors. The nurse will expect the provider to:

a.	begin treating this patient with a two-drug regimen of isoniazid and rifampin.
b.	order a chest radiograph and a sputum culture to assess for active tuberculosis.
c.	order a nucleic acid amplification test of the patient’s sputum.
d.	reassure the patient that this is not considered a positive test result.

 

 

ANS:  D

This patient has a moderate risk of tuberculosis; the area of induration would have to be 10 mm or greater to be considered a positive skin test result. Without other clinical signs, there is no indication to treat this patient or to perform diagnostic testing, so a chest x-ray or sputum cultures are not recommended.

 

PTS:   1                    DIF:    Cognitive Level: Application

REF:   pp. 1072-1074 | pp. 1074-1076         TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

4. A patient is beginning treatment for active tuberculosis (TB) in a region with little drug-resistant TB. Which treatment regimen will be used initially?

a.	Isoniazid and pyrazinamide
b.	Isoniazid, pyrazinamide, and ethambutol
c.	Rifampin, pyrazinamide, and ethambutol
d.	Isoniazid, rifampin, pyrazinamide, and ethambutol

 

 

ANS:  D

The induction phase of treatment for patients in a region without drug resistance is the same as for patients who are human immunodeficiency virus (HIV) negative or HIV positive and includes isoniazid, rifampin, pyrazinamide, and ethambutol. It is not correct to begin with two drugs. The three-drug regimen is used for inductions in areas with resistance to either isoniazid or rifampin.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 1073-1074

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential