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.

Answer and Explanation

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.

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Correct Answer is ["A","C"]

Explanation

Choice A rationale

Swimming is often recommended for asthmatic children because the warm, humid air around a swimming pool helps to keep airways moist, reducing the likelihood of exercise-induced bronchoconstriction. The horizontal body position also facilitates easier breathing and lessens the impact of gravity on respiratory effort.

Choice B rationale

Gymnastics involves short bursts of intense activity and often takes place in indoor environments where air quality might be variable or allergens present. The sudden, high-intensity exertion without sustained rhythmic breathing can trigger exercise-induced asthma, making it less ideal for asthmatic children due to fluctuating energy demands.

Choice C rationale

Baseball involves intermittent activity with periods of rest, allowing for recovery between bursts of exertion. This stop-and-go nature, combined with playing outdoors in potentially open air, generally makes it a suitable sport for children with asthma as it reduces the continuous strenuous effort that can trigger bronchospasm.

Choice D rationale

Cross-country skiing, especially in cold, dry air, is a significant trigger for exercise-induced bronchoconstriction in asthmatic individuals. The combination of intense, sustained exertion and breathing cold, dry air rapidly irritates and constricts the airways, making it a high-risk activity for asthmatic children.

Choice E rationale

Distance running involves prolonged, continuous, and often high-intensity aerobic activity, which can lead to significant increases in minute ventilation. This sustained exertion, especially in varying environmental conditions, is a common and potent trigger for exercise-induced asthma, making it a challenging sport for many asthmatic children.

A. "I will take my bronchodilators after meals.”. B. "I will eat five or six small meals each day.”. C. "I will rest for at least 30 minutes before eating.”. D. "I will choose foods that are not gas-forming.”.

Correct Answer is A

Explanation

Choice A rationale

Taking bronchodilators after meals can reduce their effectiveness in bronchodilation during digestion, as blood flow is shunted to the gastrointestinal tract. Optimal bronchodilation is crucial before meals to improve breathing, reduce dyspnea, and enhance food intake. This timing ensures maximum therapeutic effect of the medication when respiratory demand might increase due to the physiological process of eating.

Choice B rationale

Eating five or six small meals daily helps reduce the volume of food in the stomach at any one time, minimizing pressure on the diaphragm. This prevents diaphragmatic splinting and allows for better lung expansion, reducing the feeling of fullness and breathlessness that can occur with large meals in individuals with chronic obstructive pulmonary disease.

Choice C rationale

Resting for at least 30 minutes before eating conserves energy and reduces oxygen demand, which is vital for clients with chronic obstructive pulmonary disease. Fatigue can exacerbate dyspnea, making it difficult to consume adequate nutrition. This rest period allows the respiratory muscles to recover, making the act of eating less strenuous.

Choice D rationale

Choosing foods that are not gas-forming helps prevent abdominal distension. A distended abdomen can elevate the diaphragm, restricting lung expansion and increasing respiratory effort. Avoiding gas-producing foods reduces intra-abdominal pressure, thereby facilitating more comfortable breathing during and after meals for individuals with chronic obstructive pulmonary disease.

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A nurse has educated a client on isoniazid. What statement by the client indicates that teaching has been effective?

Nursing Test Bank

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Correct Answer is ["A","C"]

Explanation

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Correct Answer is A

Explanation

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A nurse has educated a client on isoniazid.
What statement by the client indicates that teaching has been effective?