A nurse has educated a client on isoniazid.
What statement by the client indicates that teaching has been effective?
I need to take extra vitamin C while on isoniazid.
I should take this medicine with milk or juice.
I will take this medication on an empty stomach.
My contact lenses will be permanently stained.
The Correct Answer is C
Choice A rationale
There is no specific scientific rationale requiring extra vitamin C supplementation while on isoniazid. Isoniazid can cause pyridoxine (vitamin B6) deficiency, which leads to peripheral neuropathy, due to its chemical structure interfering with pyridoxal phosphate metabolism. Therefore, vitamin B6 supplementation is routinely prescribed to prevent this adverse effect, rather than vitamin C, which is not directly involved in this metabolic pathway.
Choice B rationale
Taking isoniazid with milk or juice is generally discouraged as it can interfere with drug absorption. Isoniazid absorption is optimized in an acidic environment and can be reduced by food, particularly dairy products, which can chelate the drug or alter gastric pH. Therefore, consuming it with milk or juice might decrease its bioavailability, leading to sub-therapeutic drug levels and potentially compromising treatment efficacy against Mycobacterium tuberculosis.
Choice C rationale
Isoniazid absorption is best on an empty stomach because food, especially high-fat meals, can significantly decrease its bioavailability. The presence of food in the stomach can delay gastric emptying and interfere with the dissolution and absorption of the drug from the gastrointestinal tract. Optimal absorption ensures that therapeutic drug concentrations are achieved in the bloodstream, which is crucial for effectively inhibiting bacterial cell wall synthesis in Mycobacterium tuberculosis.
Choice D rationale
Isoniazid is not known to cause permanent staining of contact lenses. This side effect is associated with rifampin, another antituberculosis drug, which can cause reddish-orange discoloration of body fluids, including tears, urine, and sweat, due to its chromophore properties and excretion pathways. Isoniazid's mechanism of action and metabolic breakdown do not produce colored metabolites that would result in such staining.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
While support groups can be beneficial, this response is premature and dismisses the client's immediate emotional expression. It focuses on a generalized solution rather than exploring the client's individual feelings and the specific reasons for their social withdrawal. Understanding the underlying psychological impact of chronic illness is crucial for providing person-centered care.
Choice B rationale
Prescribing medication is outside the nurse's scope of practice. Furthermore, immediately suggesting an antianxiety agent without a comprehensive assessment of the client's mental and emotional state can mask the true source of their distress and prevent exploration of coping mechanisms or other interventions.
Choice C rationale
This therapeutic communication technique prioritizes active listening and allows the client to elaborate on their feelings and experiences. It demonstrates empathy and respect, fostering a trusting relationship. Understanding the client's perspective is fundamental to developing an individualized and effective care plan for managing the psychosocial challenges of COPD.
Choice D rationale
While friends can offer support, this statement generalizes and might not be relevant to the client's specific situation. It also shifts the focus away from the client's internal experience and onto external factors, potentially minimizing their current distress and the impact of their condition on social engagement.
Correct Answer is D
Explanation
Choice A rationale
Offering plenty of fluids is important for hydration and thinning secretions in asthma, but carbonated beverages can cause gastric distension and worsen respiratory distress by pressing on the diaphragm, making them unsuitable. Furthermore, this intervention does not directly address the acute bronchoconstriction that defines an asthma attack.
Choice B rationale
While humidified oxygen might be indicated for hypoxemia, a cool mist tent is not the primary intervention for acute asthma. The core problem is bronchoconstriction, which requires bronchodilators to open the airways. A cool mist tent offers general comfort but does not provide specific therapeutic relief for the underlying pathophysiology.
Choice C rationale
Administering sedatives to a child experiencing an acute asthma attack is generally contraindicated. Sedation can depress respiratory drive, worsen hypoventilation, and mask signs of worsening respiratory distress, potentially leading to respiratory arrest, especially when the child's respiratory effort is already compromised.
Choice D rationale
Positioning the child with arms resting on the overbed table, often referred to as the "tripod position," allows for the use of accessory respiratory muscles (e.g., sternocleidomastoid, scalenes) to facilitate breathing. This position optimizes lung expansion and reduces the work of breathing by providing a stable base for shoulder girdle muscles to pull up the chest cage.
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