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?

The client reports orange-tinged urine.

There is a decrease in symptoms of tuberculosis along with improved chest radiographs and sputum cultures.

There is increased tolerance to the medication therapy, and there are fewer reports of adverse effects.

There are two consecutive negative purified protein derivative (PPD) results over 2 months.

Answer and Explanation

The Correct Answer is B

Choice A reason: Orange-tinged urine is an expected effect of rifampin, not a therapeutic response. It results from the drug’s red-orange metabolite excreted in urine, not an indicator of tuberculosis resolution. Clinical improvement, like reduced symptoms and negative cultures, better reflects the effectiveness of antitubercular therapy.

Choice B reason: A therapeutic response to antitubercular therapy is indicated by decreased symptoms (e.g., cough, fever), improved chest radiographs (reduced infiltrates), and negative sputum cultures, showing reduced Mycobacterium tuberculosis burden. These objective measures confirm the drugs, like isoniazid and rifampin, are effectively killing the bacteria and resolving the infection.

Choice C reason: Increased tolerance to antitubercular therapy or fewer adverse effects does not indicate a therapeutic response. Tolerance reflects patient adaptation to side effects, not bacterial clearance. Objective measures like symptom reduction and negative cultures are needed to confirm the therapy’s effectiveness against tuberculosis.

Choice D reason: Negative PPD results are not used to monitor active tuberculosis treatment. PPD tests detect latent tuberculosis or prior exposure, not active disease. Therapeutic response is assessed through symptom improvement, chest imaging, and sputum cultures, which directly indicate the reduction of active Mycobacterium tuberculosis infection.

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Correct Answer is C

Explanation

Choice A reason: Fluticasone propionate, an inhaled corticosteroid, reduces airway inflammation over days, not suitable for acute asthma or COPD exacerbations. Its slow onset targets chronic control, not immediate bronchodilation, making it ineffective for rapid relief of acute bronchospasm or worsening respiratory symptoms.

Choice B reason: Salmeterol, a long-acting beta-2 agonist, provides sustained bronchodilation (12 hours) for maintenance therapy. Its slow onset (20-30 minutes) makes it unsuitable for acute asthma or COPD exacerbations, where rapid-acting agents like albuterol are needed for immediate airway relaxation.

Choice C reason: Albuterol, a short-acting beta-2 agonist, has a rapid onset (within minutes) by stimulating beta-2 receptors, increasing cyclic AMP, and relaxing airway smooth muscle. This makes it the first-line choice for acute asthma attacks or COPD exacerbations, providing quick relief of bronchospasm and dyspnea.

Choice D reason: Zafirlukast, a leukotriene receptor antagonist, prevents inflammation and bronchoconstriction for asthma maintenance. Its oral administration and slow onset (hours) make it ineffective for acute asthma or COPD exacerbations, which require rapid bronchodilation from inhalers like albuterol, not leukotriene modifiers.

A. Delayed growth development B. Permanent discoloration of the teeth C. Drug-induced neurotoxicity D. Gastrointestinal and rectal bleeding

Correct Answer is B

Explanation

Choice A reason: Delayed growth development is not a primary adverse effect of tetracycline in children. Tetracyclines inhibit protein synthesis and may affect bone growth minimally, but this is not well-documented. Their primary concern in children under 8 is tooth discoloration, making this incorrect.

Choice B reason: Tetracycline use in children under 8 causes permanent tooth discoloration by binding to calcium in developing teeth, forming a yellow-gray stain. This occurs during tooth enamel formation, making it a significant adverse effect, as the discoloration is irreversible, requiring cosmetic dental intervention.

Choice C reason: Drug-induced neurotoxicity is not a common effect of tetracycline. While tetracyclines can cause rare side effects like intracranial hypertension, neurotoxicity is more associated with drugs like aminoglycosides. Tooth discoloration is the primary concern in children, making this an incorrect choice.

Choice D reason: Gastrointestinal and rectal bleeding are not typical tetracycline side effects. Tetracyclines may cause gastrointestinal upset, like nausea, but bleeding is more associated with anticoagulants or NSAIDs. In children, tooth discoloration is the most significant adverse effect, making this choice incorrect.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which drug has a quick onset of action and is recommended for use during an acute asthma attack or chronic obstructive pulmonary disease (COPD) exacerbation?

Correct Answer is C

Explanation

Which adverse effect can result if tetracycline is administered to children younger than 8 years of age?

Correct Answer is B

Explanation

The nurse is administering an amphotericin B infusion. Which actions by the nurse are appropriate? (Select all that apply)

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During an intravenous (IV) infusion of amphotericin B, a patient develops tingling and numbness in his toes and fingers. What will the nurse do first?

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