Nokea
A nurse is assigned to care for a patient with TB in a health care facility. The patient has been prescribed pyrazinamide. Which of the following would the nurse identify as a contraindication to the prescribed therapy?
- A. Acute gout
- B. Age younger than 13 years
- C. Diabetic retinopathy
- D. Cataracts
Correct Answer: A
Rationale: The nurse should know that pyrazinamide is contraindicated among patients with acute gout. Pyrazinamide is also contraindicated in patients with acute hepatic or renal impairment and in patients with diabetes mellitus. Ethambutol is contraindicated in patients with diabetic retinopathy, patients with cataracts, and patients who are younger than 13 years of age.
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A client should be educated to limit consumption of which of the following foods to prevent an exaggerated sympathetic-type response when taking isoniazid (INH) for the treatment of tuberculosis? Select all that apply.
- A. Alcohol
- B. Grapes
- C. Bananas
- D. Meats
- E. Broccoli
Correct Answer: A,C,D
Rationale: When isoniazid is taken with foods containing tyramine, such as aged cheese and meats, bananas, yeast products, and alcohol, an exaggerated sympathetic-type response can occur.
A patient with TB is undergoing initial therapy in the treatment. The nurse has to administer three or more drugs in combination to the patient. The patient wishes to know the reason for administering a combination of drugs. Which of the following explanations does the nurse offer related to the combination of medications?
- A. Prevents the incidence of liver dysfunction
- B. Slows down bacterial resistance
- C. Slows body's resistance to medication
- D. Prevents further spreading of TB
Correct Answer: B
Rationale: The nurse should inform the patient that administering two to three drugs in combination slows down the development of bacterial resistance in the body. Administering a combination of drugs will not specifically prevent the incidence of liver dysfunction. Using drugs in combination does not slow down the body's resistance to medication, though it does reduce the development of bacterial resistance. Prophylactic treatment helps in preventing the TB from spreading further.
A nurse would suspect tuberculosis caused by drug-resistant organisms in which of the following clients? Select all that apply.
- A. Clients who are HIV positive
- B. Clients who have no response to therapy
- C. Clients who have been treated in the past
- D. Clients who have asthma
- E. Clients who have smoke
Correct Answer: B,C
Rationale: Tuberculosis caused by drug-resistant organisms should be considered in clients who have no response to therapy and in patients who have been treated in the past.
A nurse is preparing to administer ethambutol (Myambutol) to several clients. The nurse would expect to administer the drug cautiously to which clients? Select all that apply.
- A. Clients with hepatic impairment
- B. Clients with hypertension
- C. Clients with cataracts
- D. Clients with diabetic neuropathy
- E. Clients with renal impairment
Correct Answer: A,C,E
Rationale: Ethambutol (Myambutol) should be used cautiously in clients with hepatic or renal impairment and in clients with diabetic retinopathy or cataracts.
A nurse would expect to administer pyrazinamide cautiously to which clients? Select all that apply.
- A. Clients with diabetes
- B. Clients with hepatic impairment
- C. Clients with renal impairment
- D. Clients with hypertension
- E. Clients with HIV infection
Correct Answer: A,B,C,E
Rationale: Pyrazinamide should be used cautiously in clients during pregnancy and lactation and in clients with hepatic or renal impairment, HIV infection, or diabetes.