A patient who is taking rifampin (Rifadin) for tuberculosis calls the clinic and reports having orange discolored urine and tears.
Which response by the nurse reflects accurate knowledge about the medication and the patient's illness?

Query the patient about experiencing shortness of breath, hives, or itching.

Explain that orange discolored urine and tears are normal while taking this medication.

Ask the patient about any visual changes in red-green color discrimination.

Advise the patient to stop the drug and report the symptoms to the health care provider.

Answer and Explanation

The Correct Answer is B

Choice A rationale

While allergic reactions are a concern with many medications, rifampin's primary mechanism of action involves inhibiting bacterial RNA synthesis, leading to its characteristic orange discoloration of body fluids due to the drug's metabolic byproducts being excreted. Shortness of breath, hives, or itching are signs of a hypersensitivity reaction, which, while possible, are not the expected or normal physiological response to rifampin. This choice does not address the specific normal side effect reported.

Choice B rationale

Rifampin, an antibiotic used for tuberculosis, is known to induce an orange-red discoloration of body fluids, including urine, tears, sweat, and saliva. This phenomenon occurs because rifampin and its metabolites are highly pigmented and are excreted through these routes. It is a harmless, expected side effect due to the drug's inherent color and excretion pathway, and patients should be educated about this physiological change.

Choice C rationale

Ethambutol, another antitubercular drug, is specifically associated with optic neuritis, which can manifest as a decrease in visual acuity and red-green color discrimination. Rifampin, however, does not typically cause this ocular toxicity. Therefore, querying about visual changes related to red-green color discrimination would be inappropriate and misleading in the context of rifampin's known side effects.

Choice D rationale

Advising a patient to stop an antitubercular medication like rifampin without consulting the healthcare provider can have serious consequences. Tuberculosis treatment requires strict adherence to a multi-drug regimen to prevent drug resistance and ensure eradication of the infection. The orange discoloration is a benign, expected side effect and not an indication to discontinue therapy, making immediate cessation medically unsound.

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Correct Answer is D

Explanation

Choice A rationale

Tremor is not a common adverse effect of atenolol, a beta-blocker. Beta-blockers primarily work by blocking beta-adrenergic receptors, leading to decreased heart rate, blood pressure, and myocardial contractility. Tremors are often associated with other medications or neurological conditions, not typically beta-blockers.

Choice B rationale

Constipation is not a primary adverse effect of atenolol. While some cardiovascular medications can affect gastrointestinal motility, beta-blockers are not generally known to cause constipation. Gastrointestinal side effects for beta-blockers are more commonly nausea or diarrhea.

Choice C rationale

Cough is not a typical adverse effect of atenolol. While some antihypertensives, such as ACE inhibitors, are known to cause a dry cough, beta-blockers do not commonly induce this side effect. Coughing associated with beta-blockers is rare and usually indicates a different underlying issue.

Choice D rationale

Bradycardia, a slower than normal heart rate (typically below 60 beats per minute), is a common and expected adverse effect of atenolol. Atenolol is a beta-adrenergic blocker that decreases the heart's chronotropic (rate) and inotropic (contractility) effects by blocking beta-1 receptors in the myocardium, thus lowering heart rate and blood pressure.

A. Nitroglycerin. B. Carvedilol. C. Metformin. D. Atorvastatin.

Correct Answer is C

Explanation

Choice A rationale

Nitroglycerin is a vasodilator used for angina and does not directly interact with contrast media to cause acute kidney injury. Its primary mechanism involves nitric oxide release, leading to smooth muscle relaxation and improved blood flow, unrelated to renal clearance of contrast.

Choice B rationale

Carvedilol is a beta-blocker that primarily affects heart rate and blood pressure. It does not have a direct interaction with iodinated contrast material that specifically increases the risk of acute kidney injury; its metabolism and excretion pathways do not significantly involve competitive renal mechanisms.

Choice C rationale

Metformin, an oral hypoglycemic agent, interacts with iodinated contrast material. In the presence of acute kidney injury induced by the contrast, metformin can accumulate, leading to lactic acidosis. This risk is due to its renal excretion and interference with mitochondrial respiration.

Choice D rationale

Atorvastatin is a statin used for lipid lowering. It primarily undergoes hepatic metabolism and does not have a known significant interaction with iodinated contrast media that predisposes clients to acute kidney injury. Its mechanism of action is unrelated to renal elimination or nephrotoxicity with contrast.

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A patient who is taking rifampin (Rifadin) for tuberculosis calls the clinic and reports having orange discolored urine and tears. Which response by the nurse reflects accurate knowledge about the medication and the patient's illness?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has hypertension and a new prescription for atenolol. Which of the following findings should the nurse include as adverse effects of this medication?

Correct Answer is D

Explanation

A nurse is collecting a medication history from a client who is scheduled to have a cardiac catheterization. Which of the following medications taken by the client interacts with contrast material and places the client at risk for acute kidney injury?

Correct Answer is C

Explanation

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A patient who is taking rifampin (Rifadin) for tuberculosis calls the clinic and reports having orange discolored urine and tears.
Which response by the nurse reflects accurate knowledge about the medication and the patient's illness?