A patient who has been taking isoniazid has a new prescription for pyridoxine. She is wondering why she needs this medication. The nurse explains that pyridoxine is often given concurrently with isoniazid to prevent which condition?

Hair loss

Peripheral neuropathy

Heart failure

Renal failure

Answer and Explanation

The Correct Answer is B

Choice A reason: Hair loss is not a common side effect of isoniazid, nor is it prevented by pyridoxine. Isoniazid primarily causes hepatotoxicity or neurotoxicity due to its metabolism and pyridoxine depletion. Hair loss may occur with other drugs, but pyridoxine supplementation is unrelated to this effect.

Choice B reason: Pyridoxine (vitamin B6) is given with isoniazid to prevent peripheral neuropathy. Isoniazid depletes pyridoxine by forming inactive complexes, impairing nerve function and causing numbness or tingling. Supplementation restores pyridoxine levels, protecting peripheral nerves while allowing isoniazid to effectively treat tuberculosis by inhibiting mycolic acid synthesis.

Choice C reason: Heart failure is not associated with isoniazid or prevented by pyridoxine. Isoniazid’s primary toxicities are hepatic and neurological. Pyridoxine supports nerve health, not cardiac function, and heart failure is more linked to drugs like anthracyclines, not antitubercular therapy.

Choice D reason: Renal failure is not a common side effect of isoniazid, nor is it prevented by pyridoxine. Isoniazid is metabolized by the liver, and its toxicities include hepatotoxicity and neuropathy. Pyridoxine addresses neurological side effects, not renal function, making this an incorrect choice.

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Correct Answer is A

Explanation

Choice A reason: Warfarin overdose causes excessive anticoagulation, increasing bleeding risk by inhibiting vitamin K-dependent clotting factors (II, VII, IX, X). Vitamin K reverses this by restoring clotting factor synthesis, correcting INR and stopping gastrointestinal bleeding, making it the standard treatment for warfarin toxicity.

Choice B reason: Vitamin E has no role in reversing warfarin toxicity. It is an antioxidant with no effect on clotting factor synthesis or warfarin’s mechanism. Its use may be associated with bleeding risk in high doses, making it inappropriate for managing warfarin-induced gastrointestinal bleeding.

Choice C reason: Protamine sulfate reverses heparin, not warfarin. Heparin enhances antithrombin activity, and protamine neutralizes it. Warfarin’s effect on vitamin K-dependent factors is unrelated, and protamine has no impact on warfarin toxicity or gastrointestinal bleeding, making it an incorrect choice.

Choice D reason: Potassium chloride treats hypokalemia, not warfarin toxicity. Warfarin’s bleeding complications result from inhibited clotting factor synthesis, not electrolyte imbalances. Potassium chloride is irrelevant to reversing anticoagulation or managing gastrointestinal bleeding caused by excessive warfarin, making this an inappropriate treatment.

A. Quinolones B. Sulfonamides C. Cephalosporins D. Tetracyclines

Correct Answer is C

Explanation

Choice A reason: Quinolones, like ciprofloxacin, inhibit bacterial DNA gyrase and have no structural similarity to penicillin. They are safe in penicillin-allergic patients, as there is no cross-reactivity. Their side effects, like tendonitis, are unrelated to penicillin’s beta-lactam ring, making this class safe.

Choice B reason: Sulfonamides, like trimethoprim-sulfamethoxazole, inhibit bacterial folate synthesis and are not structurally related to penicillin. They do not cause cross-reactivity in penicillin-allergic patients. Their hypersensitivity reactions are distinct, making them a safe alternative for patients with penicillin allergies.

Choice C reason: Cephalosporins share a beta-lactam ring with penicillins, leading to a 5-10% cross-reactivity risk in penicillin-allergic patients. Allergic reactions, like anaphylaxis, may occur, so the nurse should question cephalosporin orders, especially for first-generation agents, to ensure patient safety.

Choice D reason: Tetracyclines, like doxycycline, inhibit protein synthesis and have no structural similarity to penicillin’s beta-lactam ring. They are safe in penicillin-allergic patients, with no cross-reactivity risk. Their side effects, like photosensitivity, are unrelated to penicillin allergies, making this class safe.

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A patient who has been taking isoniazid has a new prescription for pyridoxine. She is wondering why she needs this medication. The nurse explains that pyridoxine is often given concurrently with isoniazid to prevent which condition?

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Naxlex Comprehensive Predictor Exams

A patient who has been anticoagulated with warfarin has been admitted for gastrointestinal bleeding. The history and physical examination indicate that the patient may have taken too much warfarin. The nurse anticipates that the patient will receive what treatment?

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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