Chapter 41: Antitubercular Drugs
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
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
b. Headache and nervousness
c. Reddish-orange urine and stool
d. Numbness and tingling of extremities
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,
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)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. A patient who has been taking isoniazid has a new prescription for pyridoxine. She is
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
b. Renal failure
c. Peripheral neuropathy
d. Heart failure
ANS: C
Pyridoxine (vitamin B6) may be beneficial for isoniazid-induced peripheral neuropathy. The
other options are incorrect.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
3. The nurse will assess the patient for which potential contraindication to antitubercular
therapy?
a. Glaucoma
b. Anemia
c. Heart failure
d. Hepatic impairment
ANS: D
, 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
contraindication to these drugs. In addition, the patient’s history of alcohol use needs to be
assessed.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
4. When monitoring patients on antitubercular drug therapy, the nurse knows that which drug
may cause a decrease in visual acuity?
a. Rifampin
b. Isoniazid
c. Ethambutol
d. Streptomycin
ANS: C
Ethambutol may cause a decrease in visual acuity or even blindness resulting from retrobulbar
neuritis. The other options are incorrect.
DIF: Cognitive Level: Understanding (Comprehension)
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
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
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 along with improved chest
radiographs and sputum cultures.
ANS: D
A therapeutic response to antitubercular therapy is manifested by a decrease in the symptoms
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.
DIF: Cognitive Level: Analyzing (Analysis) TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is counseling a woman who will be starting rifampin 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 on 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.
ANS: C
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
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
b. Headache and nervousness
c. Reddish-orange urine and stool
d. Numbness and tingling of extremities
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,
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)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. A patient who has been taking isoniazid has a new prescription for pyridoxine. She is
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
b. Renal failure
c. Peripheral neuropathy
d. Heart failure
ANS: C
Pyridoxine (vitamin B6) may be beneficial for isoniazid-induced peripheral neuropathy. The
other options are incorrect.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
3. The nurse will assess the patient for which potential contraindication to antitubercular
therapy?
a. Glaucoma
b. Anemia
c. Heart failure
d. Hepatic impairment
ANS: D
, 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
contraindication to these drugs. In addition, the patient’s history of alcohol use needs to be
assessed.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
4. When monitoring patients on antitubercular drug therapy, the nurse knows that which drug
may cause a decrease in visual acuity?
a. Rifampin
b. Isoniazid
c. Ethambutol
d. Streptomycin
ANS: C
Ethambutol may cause a decrease in visual acuity or even blindness resulting from retrobulbar
neuritis. The other options are incorrect.
DIF: Cognitive Level: Understanding (Comprehension)
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
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
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 along with improved chest
radiographs and sputum cultures.
ANS: D
A therapeutic response to antitubercular therapy is manifested by a decrease in the symptoms
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.
DIF: Cognitive Level: Analyzing (Analysis) TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is counseling a woman who will be starting rifampin 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 on 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.
ANS: C
