Chapter 33 Antifungal Drugs
MULTIPLE CHOICE
1. Which person should be treated with prophylactic antitubercular medication?
a. A child who attends the same school with a child who has tuberculosis
b. A nurse who is working in a hospital
c. An individual who is HIV-positive with a negative TB skin test
d. A patient who has close contact with someone who has tuberculosis
ANS D
Personal contact with a person having a diagnosis of tuberculosis is required to indicate
prophylactic treatment with antitubercular therapy. Attending the same school does not
necessarily mean close contact occurs. Health care professionals do not need
prophylactic treatment. HIV-positive individuals with negative TB skin tests do not
need prophylaxis.
DIF COGNITIVE LEVEL Applying (Application) REF dm 437
TOP NURSING PROCESS Assessment
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
2. A patient who has chronic liver disease reports contact with a person who has
tuberculosis (TB). The nurse will counsel this patient to contact the provider to discuss a. a
chest x-ray.
b. a TB skin test.
c. liver function tests (LFTs).
d. prophylactic antitubercular drugs.
ANS B
Patients who have exposure to TB should have a TB skin test. A chest x-ray is performed if the
skin test is positive. LFTs do not need to be done simply because of TB exposure. This patient
is not a candidate for antitubercular drug prophylaxis.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 437 TOP
NURSING PROCESS Nursing Intervention
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
3. A patient who has tuberculosis asks the nurse why three drugs are used to treat this
disease. The nurse will explain that multi-drug therapy is used to reduce the likelihood of a.
disease relapse.
b. drug hypersensitivity reactions.
c. drug resistance.
d. drug adverse effects.
ANS C
, Without multi-drug therapy, patients easily develop resistance to antitubercular drugs. Using
more than one antitubercular drug does not prevent relapse, hypersensitivity reactions, or
adverse effects.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 437
TOP NURSING PROCESS Nursing Intervention Patient Teaching
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
4. A patient is being treated with isoniazid (INH), rifampin, and pyrazinamide in phase I of
treatment for tuberculosis. The organism develops resistance to isoniazid. Which drug will
the nurse anticipate the provider will order to replace the isoniazid? a. Ciprofloxacin (Cipro)
b. Ethambutol (Myambutol)
c. Kanamycin
d. Streptomycin sulfate
ANS B
If there is bacterial resistance to isoniazid, the first phase may be changed to ethambutol,
rifampin, and pyrazinamide. Ciprofloxacin, kanamycin, and streptomycin are not generally
first- line antitubercular drugs.
DIF COGNITIVE LEVEL Applying (Application) REF dm 437 TOP
NURSING PROCESS Nursing Intervention
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
5. The nurse is caring for a patient who is diagnosed with tuberculosis. The patient tells the
nurse that the provider plans to order a prophylactic antitubercular drug for family members
and asks which drug will be ordered. The nurse will expect the provider to order which drug?
a. Isoniazid (INH)
b. Pyrazinamide
c. Rifampin (Rifadin)
d. Streptomycin
ANS A
INH is the drug of choice for prophylactic treatment of patients who have had close contact
with a patient who has tuberculosis.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 437
TOP NURSING PROCESS Planning
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
6. The nurse caring for a patient who has tuberculosis and who is taking isoniazid, rifampin,
and streptomycin reviews the medical record and notes the patients sputum cultures reveal
resistance to streptomycin. The nurse will anticipate that the provider will take which action? a.
Add ethambutol (Myambutol).
b. Change the streptomycin to clarithromycin.
c. Change the streptomycin to kanamycin.
d. Order renal function tests.
MULTIPLE CHOICE
1. Which person should be treated with prophylactic antitubercular medication?
a. A child who attends the same school with a child who has tuberculosis
b. A nurse who is working in a hospital
c. An individual who is HIV-positive with a negative TB skin test
d. A patient who has close contact with someone who has tuberculosis
ANS D
Personal contact with a person having a diagnosis of tuberculosis is required to indicate
prophylactic treatment with antitubercular therapy. Attending the same school does not
necessarily mean close contact occurs. Health care professionals do not need
prophylactic treatment. HIV-positive individuals with negative TB skin tests do not
need prophylaxis.
DIF COGNITIVE LEVEL Applying (Application) REF dm 437
TOP NURSING PROCESS Assessment
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
2. A patient who has chronic liver disease reports contact with a person who has
tuberculosis (TB). The nurse will counsel this patient to contact the provider to discuss a. a
chest x-ray.
b. a TB skin test.
c. liver function tests (LFTs).
d. prophylactic antitubercular drugs.
ANS B
Patients who have exposure to TB should have a TB skin test. A chest x-ray is performed if the
skin test is positive. LFTs do not need to be done simply because of TB exposure. This patient
is not a candidate for antitubercular drug prophylaxis.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 437 TOP
NURSING PROCESS Nursing Intervention
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
3. A patient who has tuberculosis asks the nurse why three drugs are used to treat this
disease. The nurse will explain that multi-drug therapy is used to reduce the likelihood of a.
disease relapse.
b. drug hypersensitivity reactions.
c. drug resistance.
d. drug adverse effects.
ANS C
, Without multi-drug therapy, patients easily develop resistance to antitubercular drugs. Using
more than one antitubercular drug does not prevent relapse, hypersensitivity reactions, or
adverse effects.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 437
TOP NURSING PROCESS Nursing Intervention Patient Teaching
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
4. A patient is being treated with isoniazid (INH), rifampin, and pyrazinamide in phase I of
treatment for tuberculosis. The organism develops resistance to isoniazid. Which drug will
the nurse anticipate the provider will order to replace the isoniazid? a. Ciprofloxacin (Cipro)
b. Ethambutol (Myambutol)
c. Kanamycin
d. Streptomycin sulfate
ANS B
If there is bacterial resistance to isoniazid, the first phase may be changed to ethambutol,
rifampin, and pyrazinamide. Ciprofloxacin, kanamycin, and streptomycin are not generally
first- line antitubercular drugs.
DIF COGNITIVE LEVEL Applying (Application) REF dm 437 TOP
NURSING PROCESS Nursing Intervention
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
5. The nurse is caring for a patient who is diagnosed with tuberculosis. The patient tells the
nurse that the provider plans to order a prophylactic antitubercular drug for family members
and asks which drug will be ordered. The nurse will expect the provider to order which drug?
a. Isoniazid (INH)
b. Pyrazinamide
c. Rifampin (Rifadin)
d. Streptomycin
ANS A
INH is the drug of choice for prophylactic treatment of patients who have had close contact
with a patient who has tuberculosis.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 437
TOP NURSING PROCESS Planning
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
6. The nurse caring for a patient who has tuberculosis and who is taking isoniazid, rifampin,
and streptomycin reviews the medical record and notes the patients sputum cultures reveal
resistance to streptomycin. The nurse will anticipate that the provider will take which action? a.
Add ethambutol (Myambutol).
b. Change the streptomycin to clarithromycin.
c. Change the streptomycin to kanamycin.
d. Order renal function tests.
