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?
You will need to stop the medication, and it will go away.
It’s possible that the TB is worse. Please come in to the clinic to be checked.
This is not what we usually see with these drugs. Please come in to the clinic to be checked.
This is an expected side effect of the medicine. Let’s review what to expect.
The Correct Answer is D
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Tuberculosis therapy does not stop when symptoms resolve, as residual bacteria may persist, leading to relapse. Standard regimens (e.g., isoniazid, rifampin) last 6-9 months to ensure complete eradication of Mycobacterium tuberculosis, guided by sputum cultures and imaging, not just symptom cessation.
Choice B reason: Lifelong tuberculosis therapy is not typical for active disease. Standard treatment lasts 6-9 months for drug-susceptible tuberculosis, achieving cure in most cases. Lifelong therapy may apply to certain chronic infections, but for tuberculosis, finite regimens are effective, making this statement incorrect.
Choice C reason: Standard treatment for active tuberculosis involves a 6- to 9-month regimen of first-line drugs (isoniazid, rifampin, ethambutol, pyrazinamide). This duration ensures complete bacterial eradication, preventing relapse or resistance. Longer durations may be needed for resistant strains or extrapulmonary disease, aligning with clinical guidelines.
Choice D reason: Therapy does not continue until resistance develops, as this would indicate treatment failure. The goal is to eradicate Mycobacterium tuberculosis before resistance emerges, using combination therapy for 6-9 months. Continuing until resistance occurs is counterproductive and increases the risk of multidrug-resistant tuberculosis.
Correct Answer is C
Explanation
Choice A reason: The purpose of multiple drugs in tuberculosis treatment is not to hope one works but to ensure comprehensive bacterial eradication. Combination therapy targets different aspects of Mycobacterium tuberculosis, preventing resistance and ensuring efficacy, as single-drug therapy is ineffective and promotes resistant strains.
Choice B reason: Multiple drugs do not primarily reduce side effects; they increase the likelihood of adverse effects due to cumulative toxicity (e.g., hepatotoxicity from isoniazid and rifampin). The rationale for combination therapy is to enhance efficacy and prevent resistance, not to mitigate side effects, making this incorrect.
Choice C reason: Combination therapy (e.g., isoniazid, rifampin, ethambutol, pyrazinamide) enhances efficacy by targeting different bacterial populations and metabolic states of Mycobacterium tuberculosis. This synergistic approach ensures rapid bacterial killing, prevents resistance, and shortens treatment duration, making it the standard for effective tuberculosis management.
Choice D reason: The use of multiple drugs is not because drugs are becoming resistant but to prevent resistance development. Combination therapy overwhelms Mycobacterium tuberculosis with multiple mechanisms, reducing the chance of resistant mutants surviving. Resistance occurs with inadequate or monotherapy, not as a rationale for combination therapy.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.