The nurse is providing teaching to a patient taking tetracycline. Which statement by the nurse is correct?

Avoid direct sunlight and tanning beds while on this medication.

Take the medication until you are feeling better.

Milk and cheese products result in increased levels of tetracycline.

Antacids taken with the medication help to reduce gastrointestinal distress.

Answer and Explanation

The Correct Answer is A

Choice A reason: Tetracyclines, like doxycycline, cause photosensitivity by forming phototoxic compounds under UV light, leading to severe sunburn or rashes. Avoiding sunlight and tanning beds prevents skin damage, as tetracycline’s protein synthesis inhibition does not mitigate its phototoxic effects, making this the correct instruction.

Choice B reason: Taking tetracycline only until feeling better is incorrect, as incomplete treatment promotes bacterial resistance. Tetracyclines require a full course to eradicate infection, preventing survival of resistant mutants, which could worsen infections like acne or respiratory infections, making this an unsafe instruction.

Choice C reason: Milk and cheese reduce, not increase, tetracycline levels by chelating the drug, forming insoluble complexes that decrease absorption. This interaction lowers efficacy, requiring tetracycline to be taken away from dairy, making this statement incorrect for patient education.

Choice D reason: Antacids reduce tetracycline absorption by chelating with divalent cations (e.g., calcium, magnesium), forming insoluble complexes. This decreases efficacy, not gastrointestinal distress. Taking tetracycline away from antacids ensures proper absorption, making this statement incorrect and potentially harmful.

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Correct Answer is C

Explanation

Choice A reason: Amoxicillin, a penicillin antibiotic, inhibits bacterial cell wall synthesis and is commonly used for infections like otitis media. It is not associated with tendon rupture, as it lacks the mechanism affecting collagen or connective tissue. Its side effects include gastrointestinal upset and allergic reactions, not musculoskeletal issues.

Choice B reason: Clarithromycin, a macrolide antibiotic, inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit. It is used for respiratory infections but is not linked to tendon rupture. Its side effects include gastrointestinal disturbances and QT prolongation, with no known impact on tendon integrity or collagen metabolism.

Choice C reason: Ciprofloxacin, a fluoroquinolone, is associated with tendon rupture, particularly in the Achilles tendon. It may disrupt collagen synthesis and extracellular matrix integrity, increasing tendon vulnerability, especially in older adults or those on corticosteroids. This rare but serious side effect requires monitoring during therapy.

Choice D reason: Doxycycline, a tetracycline antibiotic, inhibits protein synthesis and is used for infections like acne or Lyme disease. While it can cause photosensitivity or gastrointestinal issues, it is not associated with tendon rupture. Its mechanism does not involve collagen disruption, unlike fluoroquinolones such as ciprofloxacin.

A. Valerian B. St. John’s wort C. Saw palmetto D. Soy

Correct Answer is B

Explanation

Choice A reason: Valerian, used for sleep disorders, has no significant interaction with anticoagulants like warfarin. It may cause sedation but does not affect hepatic CYP450 enzymes or vitamin K-dependent clotting factors, making it safe for patients on anticoagulant therapy, with no impact on bleeding risk or drug metabolism.

Choice B reason: St. John’s wort induces hepatic CYP450 enzymes, particularly CYP3A4, accelerating warfarin metabolism. This reduces warfarin’s anticoagulant effect, decreasing INR and increasing thrombosis risk. Patients must avoid it to maintain therapeutic anticoagulation, making this a critical herbal interaction to report.

Choice C reason: Saw palmetto, used for prostate health, has minimal interaction with anticoagulants. It does not significantly affect CYP450 enzymes or clotting factor synthesis. While it may have mild antiplatelet effects, it is not a primary concern for warfarin therapy compared to St. John’s wort’s enzyme induction.

Choice D reason: Soy has no significant interaction with anticoagulants like warfarin. It does not affect hepatic metabolism or vitamin K-dependent clotting factors. While dietary vitamin K can influence warfarin, soy’s impact is minimal, making it less critical to avoid compared to enzyme inducers like St. John’s wort.

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The nurse is providing teaching to a patient taking tetracycline. Which statement by the nurse is correct?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following antibiotics is associated with a risk of tendon rupture?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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