A nurse is providing discharge teaching to a client who has tuberculosis and is taking rifampin.
Which of the following statements by the client indicates an understanding of the teaching?
Jaundice is a harmless adverse effect of this medication.
I shouldn't wear my soft contact lenses because they will become discolored.
The best time to take this medication is when my stomach is full.
It is okay to drink alcohol while I am on this medication as long as it is in moderation.
The Correct Answer is B
Choice A rationale
Jaundice is a serious indicator of hepatotoxicity, a known and potentially severe adverse effect of rifampin. It signifies liver dysfunction and requires immediate medical attention. Therefore, stating that jaundice is harmless demonstrates a critical misunderstanding of the medication's potential risks and the need for prompt reporting to the healthcare provider.
Choice B rationale
Rifampin is known to cause discoloration of body fluids, including urine, sweat, tears, and saliva, due to its reddish-orange pigment. This discoloration can permanently stain soft contact lenses. Therefore, a client's statement about not wearing soft contact lenses indicates an understanding of this specific and important adverse effect.
Choice C rationale
Rifampin absorption is reduced when taken with food. To maximize its bioavailability and effectiveness, rifampin should be taken on an empty stomach, typically one hour before or two hours after a meal. Taking it when the stomach is full would decrease its therapeutic efficacy, indicating a misunderstanding of the teaching.
Choice D rationale
Rifampin is metabolized by the liver, and alcohol consumption also places a significant metabolic burden on the liver. Concurrent use of rifampin and alcohol significantly increases the risk of hepatotoxicity, which can lead to severe liver damage. Therefore, drinking alcohol while on rifampin is strongly contraindicated and shows a lack of understanding. .
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Aspartate aminotransferase (AST) is an enzyme primarily found in the liver, heart, and muscle. Elevated levels can indicate hepatocellular damage or cardiac muscle injury. While some medications can affect liver function, AST is not a primary monitoring parameter for methylprednisolone, which is a corticosteroid, unless specific hepatotoxicity is suspected or pre-existing liver conditions exist. Normal AST levels are typically 10-40 U/L.
Choice B rationale
Fibrin split products (FSPs) are indicators of fibrinolysis, the breakdown of fibrin clots. Elevated FSPs suggest active clotting and subsequent clot degradation, often seen in disseminated intravascular coagulation (DIC). Methylprednisolone, a corticosteroid, does not directly impact fibrinolysis or coagulation to warrant routine monitoring of FSPs as a primary concern. This test is not routinely indicated.
Choice C rationale
Blood urea nitrogen (BUN) measures the amount of nitrogen in the blood that comes from the waste product urea. Elevated BUN can indicate kidney dysfunction or dehydration. While corticosteroids can influence fluid balance, BUN is not a specific or primary laboratory value monitored for the direct effects of methylprednisolone therapy unless a pre-existing renal impairment is present. Normal BUN levels are typically 7-20 mg/dL.
Choice D rationale
Methylprednisolone, a glucocorticoid, significantly impacts carbohydrate metabolism by promoting gluconeogenesis and glycogenolysis, leading to increased blood glucose levels. This can induce hyperglycemia and even steroid-induced diabetes, particularly in predisposed individuals. Therefore, close monitoring of blood glucose is crucial to prevent and manage this common adverse effect. Normal fasting glucose is typically 70-99 mg/dL.
Correct Answer is ["200"]
Explanation
Step 1 is to determine the total volume to be infused, which is 100 mL.
Step 2 is to determine the infusion time in hours. The infusion time is 30 min, which is 0.5 hours.
Step 3 is to calculate the infusion rate in mL/hr by dividing the total volume by the infusion time in hours: 100 mL ÷ 0.5 hr = 200 mL/hr. The nurse should set the IV infusion pump to deliver 200 mL/hr.
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