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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Rheumatoid arthritis is a chronic autoimmune inflammatory disease that commonly affects the small joints of the hands and feet bilaterally and symmetrically. Characteristic late-stage findings include ulnar deviation of the fingers, swan-neck deformities (hyperextension of the PIP joint and flexion of the DIP joint), and boutonnière deformities (flexion of the PIP joint and hyperextension of the DIP joint) due to chronic synovial inflammation.
Choice B rationale
Osteoarthritis is a degenerative joint disease characterized by cartilage breakdown, primarily affecting weight-bearing joints but also the hands. Hand findings include Heberden's nodes (DIP joints) and Bouchard's nodes (PIP joints), which are bony enlargements. Unlike rheumatoid arthritis, osteoarthritis is typically asymmetrical and lacks significant inflammation.
Choice C rationale
Gout is a form of inflammatory arthritis caused by uric acid crystal deposition in joints. While it can affect the hands, it most commonly presents as acute, severe pain, swelling, and redness in a single joint, often the great toe. Chronic gout can lead to tophi, which are visible urate deposits, but not the specific deformities seen in rheumatoid arthritis.
Choice D rationale
Paget's disease of bone is a chronic disorder characterized by abnormal bone remodeling, leading to enlarged and misshapen bones. It primarily affects the skull, spine, pelvis, and long bones of the extremities. Hand involvement is uncommon and does not typically result in the characteristic joint deformities seen in the scenario.
Correct Answer is A
Explanation
Choice A rationale
Migraine headaches are classically characterized by unilateral, throbbing pain, often preceded by a prodrome including photophobia (sensitivity to light) or phonophobia (sensitivity to sound), and have a strong genetic predisposition, frequently running in families.
Choice B rationale
Cluster headaches are typically characterized by severe, unilateral pain located around the eye or temple, often accompanied by autonomic symptoms like tearing or nasal congestion, but they are not commonly described as throbbing or associated with photophobia as a premonitory symptom.
Choice C rationale
Tension-type headaches are usually described as a bilateral, pressing or tightening sensation, often mild to moderate in intensity. They are generally not throbbing, unilateral, or associated with significant photophobia as a prominent premonitory symptom.
Choice D rationale
Frontal-type headaches are a descriptive localization of pain rather than a distinct headache type. While pain may be in the frontal region, this term does not encompass the specific clinical characteristics like throbbing nature, premonitory photophobia, and family history indicative of migraine.
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