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How does drug therapy of tuberculosis differ from that of most other infections?
- A. Patients with tuberculosis have no symptoms.
- B. Antituberculosis drugs are used extensively for treating active disease, not prevention.
- C. Patients usually require therapy for a shorter period.
- D. Mycobacteria have a cell wall that is resistant to penetration by anti-infective drugs.
- G. D
Correct Answer: TB patients can have symptoms. Drugs treat both active disease and prevention (latent TB). TB therapy is longer (6-9 months+). Mycobacteria's resistant cell wall necessitates prolonged, combined drug therapy.
Rationale: The correct answer is G. The rationale is as follows:
1. TB patients can have symptoms: TB can present with symptoms such as cough, fever, weight loss, and night sweats.
2. Drugs treat both active disease and prevention: Antituberculosis drugs are used for both treating active TB disease and preventing latent TB from developing into active disease.
3. TB therapy is longer: TB therapy typically lasts 6-9 months or longer due to the slow-growing nature of Mycobacterium tuberculosis and the need to prevent drug resistance.
4. Mycobacteria's resistant cell wall: Mycobacteria have a unique cell wall that is resistant to penetration by many antibiotics, necessitating prolonged and combined drug therapy for effective treatment.
In summary, the other choices are incorrect because patients with TB can have symptoms, antituberculosis drugs are used for both treatment and prevention, therapy duration is usually longer, and the unique cell wall of Mycobacteria requires specific drug regimens.
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A nurse is caring for a client who has deep vein thrombosis. The client has been receiving IV heparin for the past 5 days and now has a new prescription for oral warfarin in addition to the heparin. The client asks the nurse if both medications are necessary. Which of the following is an appropriate response by the nurse?
- A. “Both heparin and warfarin work together to dissolve the clots.â€
- B. “I will ask the charge nurse to call your provider and get an explanation.â€
- C. “Heparin enhances the effects of the warfarin.â€
- D. “Heparin will be continued until the warfarin reaches a therapeutic level.â€
- G. D
Correct Answer: Heparin and warfarin prevent clot growth, not dissolution. No enhancement occurs. Heparin bridges until warfarin's therapeutic level is reached, typically 3 days.
Rationale: Correct Answer: D. "Heparin will be continued until the warfarin reaches a therapeutic level."
Rationale:
1. Heparin and warfarin work differently: Heparin prevents new clots, while warfarin stabilizes existing clots.
2. Transition period: Heparin is continued initially to prevent clotting while warfarin reaches its full anticoagulant effect.
3. Therapeutic level: Warfarin takes time to reach its target level for optimal clot prevention.
4. No clot dissolution: Neither heparin nor warfarin directly dissolve clots; they prevent further clot formation.
Summary of other choices:
A: Incorrect. Misleading information about clot dissolution.
B: Incorrect. Unnecessary escalation without clarifying the situation.
C: Incorrect. Misconception about the relationship between heparin and warfarin.
A teenage client is taking duloxetine (Cymbalta) for a generalized anxiety disorder. The dose has been changed by the physician. What adverse effects will the nurse advise the client and family to watch?
- A. Warning signs of suicide.
- B. Fatigue.
- C. Irritability.
- D. Weight gain.
- G. A,B,C
Correct Answer: Suicidal thoughts are a risk, especially in teens with dose changes. Fatigue and irritability are common. Weight gain is possible but less urgent to monitor than A, B, C.
Rationale: The correct answer is G: A, B, C. When a teenage client is taking duloxetine for generalized anxiety disorder and the dose has been changed, the nurse should advise the client and family to watch for warning signs of suicide (A) because duloxetine can increase the risk of suicidal thoughts, especially in teens with dose changes. Fatigue (B) and irritability (C) are common side effects of duloxetine and should also be monitored closely. While weight gain (D) is a possible side effect of duloxetine, it is less urgent to monitor compared to the risk of suicidal thoughts, fatigue, and irritability. Therefore, choices A, B, and C are the most important adverse effects to watch for in this scenario.
A client taking an MAOI should be instructed to avoid which item?
- A. Large amounts of water
- B. A diet that is high in salt
- C. A diet that is high in fat
- D. Foods that contain tyramine and caffeine .
- G. D
Correct Answer: Water, salt, and fat don't interact with MAOIs. Tyramine and caffeine can cause hypertensive crises with MAOIs.
Rationale: The correct answer is D: Foods that contain tyramine and caffeine. MAOIs inhibit the breakdown of tyramine and caffeine, leading to an accumulation in the body. Tyramine can cause a dangerous increase in blood pressure known as a hypertensive crisis. Caffeine can also contribute to this effect. Large amounts of water (A), a high-salt diet (B), and a high-fat diet (C) do not interact with MAOIs in a way that poses a significant risk. Therefore, instructing the client to avoid foods containing tyramine and caffeine is crucial to prevent potential adverse reactions.
Which class of drugs is successful in treating an ulcer caused by H. pylori?
- A. Antacids
- B. H2-receptor blockers
- C. Antibiotics
- D. Proton-pump inhibitors
- G. C
Correct Answer: Antacids relieve symptoms. H2 blockers and PPIs reduce acid but don't kill H. pylori. Antibiotics eradicate the bacteria, treating the ulcer's cause.
Rationale: The correct answer is C: Antibiotics. Antacids (choice A) only provide symptomatic relief by neutralizing stomach acid. H2-receptor blockers (choice B) and proton-pump inhibitors (choice D) are used to reduce stomach acid secretion but do not directly target H. pylori bacteria. Choice C, antibiotics, are successful in treating ulcers caused by H. pylori because they specifically target and eradicate the bacteria, addressing the root cause of the ulcer. Therefore, antibiotics are the most effective class of drugs for treating H. pylori-induced ulcers.
Complete the following statement: “Drugs used for the treatment of depression and a range of anxiety disorders including panic, social phobia, and post-traumatic stress disorder are known as…â€
- A. Barbiturates
- B. Rebound insomnia
- C. Antidepressants
- D. Anxiolytics
- G. C
Correct Answer: Barbiturates are sedatives. Rebound insomnia isn't a drug. Antidepressants treat depression and anxiety disorders. Anxiolytics focus on anxiety.
Rationale: The correct answer is C: Antidepressants. Antidepressants are drugs specifically designed to treat depression and various anxiety disorders, including panic, social phobia, and post-traumatic stress disorder. They work by balancing neurotransmitters in the brain to improve mood and reduce symptoms of anxiety. Barbiturates (A) are sedatives, not typically used for treating anxiety or depression. Rebound insomnia (B) is a phenomenon where insomnia worsens after discontinuing sleep medications, not a class of drugs. Anxiolytics (D) are drugs that specifically target anxiety symptoms, but they do not usually address depression. Therefore, the correct choice is C as it accurately describes the drugs used for treating depression and a range of anxiety disorders.