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 D

Explanation

Choice A reason: Stopping antitubercular medication due to dark orange urine is incorrect, as this is an expected effect of rifampin. Discontinuing therapy prematurely risks treatment failure and resistance development. Patient education about harmless discoloration is needed, not cessation, unless serious adverse effects like hepatotoxicity occur.

Choice B reason: Dark orange urine does not indicate worsening tuberculosis. It is a benign effect of rifampin’s red-orange metabolite excreted in urine. Worsening tuberculosis would present with increased symptoms like cough or fever, not urine discoloration, making this response inaccurate and alarming to the patient.

Choice C reason: Dark orange urine is a common, expected effect of rifampin, not an unusual finding requiring clinic evaluation. Rifampin’s metabolites cause harmless discoloration of bodily fluids. Only symptoms like jaundice or abdominal pain would warrant further investigation, not this benign side effect.

Choice D reason: Dark orange urine is an expected side effect of rifampin, a first-line antitubercular drug. Its red-orange metabolite discolors urine, sweat, and tears, which is harmless. Educating the patient about this effect reassures them, ensures adherence, and prevents unnecessary concern, focusing on other potential serious side effects.

A. It depends on the dose of heparin. B. You will need several doses before it will affect you. C. Heparin will start working in about 20 minutes. D. Heparin will start working immediately. E. Patients stop taking an antibiotic when they feel better.

Correct Answer is D

Explanation

Choice A reason: The onset of IV heparin is not dose-dependent; it is immediate due to its direct interaction with antithrombin, inhibiting clotting factors. While therapeutic aPTT varies with dose, anticoagulation begins instantly upon IV administration, making this response incorrect for onset timing.

Choice B reason: IV heparin does not require multiple doses to start working. Its immediate onset enhances antithrombin activity, providing instant anticoagulation. Multiple doses may be needed for sustained therapeutic aPTT, but the initial effect is immediate, making this an incorrect response.

Choice C reason: A 20-minute onset is incorrect for IV heparin, which acts immediately by binding antithrombin, inhibiting thrombin and factor Xa. Subcutaneous heparin has a delayed onset (20-60 minutes), but IV administration ensures rapid anticoagulation, critical for acute conditions like thrombosis.

Choice D reason: IV heparin starts working immediately by enhancing antithrombin’s inhibition of thrombin and factor Xa, preventing clot formation. This rapid onset, measurable by aPTT within minutes, makes it ideal for acute anticoagulation needs, like pulmonary embolism, aligning with its pharmacokinetic profile.

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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

A patient newly diagnosed with tuberculosis (TB) has been taking antitubercular drugs for 1 week and calls the clinic, saying, "My urine is dark orange! What’s wrong with me?" Which response by the nurse is correct?

Correct Answer is D

Explanation

The nurse is preparing to administer heparin intravenously (IV). Which response by the nurse would be appropriate when the patient asks when the medication will start working?

Correct Answer is D

Explanation

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