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A patient who is taking isoniazid (INH) as part of a two-drug tuberculosis treatment regimen reports tingling of the fingers and toes. The nurse will recommend discussing which treatment with the provider?
- A. Adding pyrazinamide
- B. Changing to ethambutol
- C. Increasing oral fluid intake
- D. Taking pyridoxine (B6)
Correct Answer: D
Rationale: Pyridoxine prevents INH-induced neuropathy (tingling); changing drugs or fluids doesn't address this. Peripheral neuropathy is an adverse reaction to INH, so pyridoxine is usually given to prevent this.
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An example of a first-dose reaction that may occur includes:
- A. Orthostatic hypotension that does not occur with repeated doses
- B. Purple glove syndrome with phenytoin use
- C. Hemolytic anemia from ceftriaxone use
- D. Contact dermatitis from neomycin use
Correct Answer: C
Rationale: Hemolytic anemia from ceftriaxone can occur after the first dose as a Type II reaction, unlike orthostatic hypotension (A, adaptive) or others (B, D, later onset).
A 32-year-old female is admitted to your unit with a diagnosis of hypovolemia. You are writing a care plan for this patient. You know that an appropriate nursing diagnosis to help prevent medication errors is what?
- A. Dysfunctional gastrointestinal motility
- B. Ineffective self health maintenance
- C. Risk for injury
- D. Deficient fluid volume
Correct Answer: D
Rationale: Hypovolemia aligns with 'Deficient fluid volume,' guiding drug therapy to correct volume status and prevent errors.
A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states she took penicillin 3 years ago and developed a rash. Which of the following actions should the nurse take?
- A. Administer the prescribed dose.
- B. Withhold the medication.
- C. Ask the provider to change the prescription to an oral form.
- D. Administer an oral antihistamine at the same time
Correct Answer: B
Rationale: A history of rash suggests a possible allergy; withholding the medication and consulting the provider is safest.
When determining drug treatment, the NP prescriber should:
- A. Always use evidence-based guidelines
- B. Individualize the drug choice for the specific patient
- C. Rely on his or her experience when prescribing for complex patients
- D. Use the newest drug on the market for the condition being treated
Correct Answer: B
Rationale: Individualizing treatment tailors therapy to the patient, balancing evidence and experience , while avoiding untested new drugs .
Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action?
- A. Notifying the registered nurse
- B. Discontinuing the medication
- C. Informing the client that this is normal
- D. Applying a thinner film than prescribed to the burn site
Correct Answer: C
Rationale: Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to treat burns to reduce bacteria present in avascular tissues. The client should be informed that the medication will cause local discomfort and burning and that this is a normal reaction; therefore options 1, 2, and 4 are incorrect.