Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is teaching a client who has active pulmonary tuberculosis about management of medication for the disease.
Which of the following statements is appropriate for the nurse to make?
A. You should anticipate taking medication to treat your disease for at least the next 3 years.
Choice A is wrong because the duration of treatment for active TB is usually 6 to 9 months, not 3 years.
B. You will need to undergo tuberculin skin tests every 6 months while taking medication for your disease.
Choice B is wrong because tuberculin skin tests are not reliable indicators of disease activity or response to treatment, as they can remain positive for years after successful therapy.
C. You should report monthly to have your blood drawn to monitor kidney function while taking medication.
Choice C is wrong because blood tests to monitor kidney function are not routinely required for TB treatment, unless the client has a preexisting renal impairment or is taking drugs that are nephrotoxic.
D. You will need to take two or more medications to treat your disease.
This is because TB is caused by a bacterium that can develop resistance to single-drug therapy, so a combination of drugs is used to prevent or treat drug resistant strains. Some of the common drugs used for TB are isoniazid, rifampin, ethambutol, and pyrazinamide.
This question is an excerpt from Nurse Dive's nursing test bank - ATI RN Pharmacology 2019 Proctored Exam. Take the full exam now
Full Explanation
This is because TB is caused by a bacterium that can develop resistance to single-drug therapy, so a combination of drugs is used to prevent or treat drug-resistant strains. Some of the common drugs used for TB are isoniazid, rifampin, ethambutol, and pyrazinamide.
Choice A is wrong because the duration of treatment for active TB is usually 6 to 9 months, not 3 years.
Choice B is wrong because tuberculin skin tests are not reliable indicators of disease activity or response to treatment, as they can remain positive for years after successful therapy.
Choice C is wrong because blood tests to monitor kidney function are not routinely required for TB treatment unless the client has a preexisting renal impairment or is taking drugs that are nephrotoxic.
Similar Questions
A nurse is caring for a client who has diabetes mellitus and is taking pioglitazone. The nurse should plan to monitor the client for which of the following adverse effects?
A. Tinnitus.
Choice A is wrong because tinnitus, which is ringing or buzzing in the ears, is not a known side effect of pioglitazone.
B. Insomnia.
Choice B is wrong because insomnia, which is difficulty falling or staying asleep, is not a known side effect of pioglitazone.
C. Orthostatic hypotension.
Choice C is wrong because orthostatic hypotension, which is a drop in blood pressure when standing up from a sitting or lying position, is not a known side effect of pioglitazone. In fact, pioglitazone may cause low blood sugar (hypoglycemia) when used with other diabetes medications, which can cause symptoms such as dizziness, sweating, and confusion. Answer and explanation
D. Fluid retention.
Pioglitazone is a medication that belongs to a class of drugs called thiazolidinediones, which are used to treat type 2 diabetes by improving insulin sensitivity. One of the common side effects of pioglitazone is edema, which is swelling caused by excess fluid in the body tissues. This can lead to fluid retention and weight gain, and may worsen heart failure in some patients.
Full Explanation
Pioglitazone is a medication that belongs to a class of drugs called thiazolidinediones, which are used to treat type 2 diabetes by improving insulin sensitivity. One of the common side effects of pioglitazone is edema, which is swelling caused by excess fluid in the body tissues. This can lead to fluid retention and weight gain and may worsen heart failure in some patients.
Choice A is wrong because tinnitus, which is ringing or buzzing in the ears, is not a known side effect of pioglitazone.
Choice B is wrong because insomnia, which is difficulty falling or staying asleep, is not a known side effect of pioglitazone.
Choice C is wrong because orthostatic hypotension, which is a drop in blood pressure when standing up from a sitting or lying position, is not a known side effect of pioglitazone.
In fact, pioglitazone may cause low blood sugar (hypoglycemia) when used with other diabetes medications, which can cause symptoms such as dizziness, sweating, and confusion.
A nurse is teaching a client who has a new prescription for a nitroglycerin transdermal patch.
Which of the following instructions should the nurse include?
A. Apply a new patch if you have chest pain.
Choice A is wrong because nitroglycerin transdermal patches cannot be used to treat an attack of angina once it has begun. They can only be used to prevent attacks of angina. If you have chest pain, you should use another form of nitroglycerin, such as sublingual tablets or spray.
B. Discontinue the patch if you experience a headache.
Choice B is wrong because headache is a common side effect of nitroglycerin transdermal patches and does not mean that you should stop using them. However, you should tell your doctor if the headaches are severe or do not go away. You may also take acetaminophen to relieve the headache.
C. Remove the patch prior to going to bed.
Nitroglycerin transdermal patches are used to prevent episodes of angina (chest pain) in people who have coronary artery disease (narrowing of the blood vessels that supply blood to the heart). They work by relaxing the blood vessels so that the heart does not need to work as hard and therefore does not need as much oxygen.
D. Cover the patch with dry gauze when taking a shower.
Choice D is wrong because you do not need to cover the patch with dry gauze when taking a shower. You may shower while you are wearing a nitroglycerin skin patch. If a patch loosens or falls off, replace it with a fresh one.
Full Explanation
Nitroglycerin transdermal patches are used to prevent episodes of angina (chest pain) in people who have coronary artery disease (narrowing of the blood vessels that supply blood to the heart). They work by relaxing the blood vessels so that the heart does not need to work as hard and therefore does not need as much oxygen.
Choice A is wrong because nitroglycerin transdermal patches cannot be used to treat an attack of angina once it has begun. They can only be used to prevent attacks of angina. If you have chest pain, you should use another form of nitroglycerin, such as sublingual tablets or spray.
Choice B is wrong because headache is a common side effect of nitroglycerin transdermal patches and does not mean that you should stop using them. However, you should tell your doctor if the headaches are severe or do not go away. You may also take acetaminophen to relieve the headache.
Choice D is wrong because you do not need to cover the patch with dry gauze when taking a shower. You may shower while you are wearing a nitroglycerin skin patch. If a patch loosens or falls off, replace it with a fresh one.
A nurse is caring for a client who has heart failure.
The nurse administered furosemide 60 mg IV bolus 30 min earlier. For which of the following findings should the nurse notify the provider?
A. BUN 15 mg/dL.
Choice A is wrong because BUN (blood urea nitrogen) is a measure of kidney function and a normal range is 7 to 20 mg/dL. A BUN of 15 mg/dL is not a cause for concern and does not indicate any adverse effect of furosemide.
B. The client reports difficulty hearing.
Furosemide is a diuretic that is used to treat heart failure by reducing fluid retention and lowering blood pressure. It can cause some side effects, such as increased urination, thirst, dry mouth, headache, dizziness, nausea, and electrolyte imbalance.
C. Potassium 3.8 mEq/L.
Choice C is wrong because potassium is an electrolyte that is important for nerve and muscle function and a normal range is 3.5 to 5.0 mEq/L. Potassium of 3.8 mEq/L is within the normal range and does not indicate any adverse effect of furosemide. However, furosemide can cause low potassium levels (hypokalemia) in some cases, so the nurse should monitor the client’s potassium levels regularly and advise the client to eat foods rich in potassium, such as bananas, oranges, and potatoes.
D. The client reports dizziness upon standing.
Choice D is wrong because dizziness upon standing is a common side effect of furosemide and does not require immediate notification from the provider. However, the nurse should instruct the client to rise slowly from a sitting or lying position to prevent falls and to drink enough fluids to prevent dehydration.
Full Explanation
Furosemide is a diuretic that is used to treat heart failure by reducing fluid retention and lowering blood pressure. It can cause some side effects, such as increased urination, thirst, dry mouth, headache, dizziness, nausea, and electrolyte imbalance.
Choice A is wrong because BUN (blood urea nitrogen) is a measure of kidney function and a normal range is 7 to 20 mg/dL.
A BUN of 15 mg/dL is not a cause for concern and does not indicate any adverse effect of furosemide.
Choice C is wrong because potassium is an electrolyte that is important for nerve and muscle function and a normal range is 3.5 to 5.0 mEq/L.
Potassium of 3.8 mEq/L is within the normal range and does not indicate any adverse effect of furosemide. However, furosemide can cause low potassium levels (hypokalemia) in some cases, so the nurse should monitor the client’s potassium levels regularly and advise the client to eat foods rich in potassium, such as bananas, oranges, and potatoes.
Choice D is wrong because dizziness upon standing is a common side effect of furosemide and does not require immediate notification of the provider. However, the nurse should instruct the client to rise slowly from a sitting or lying position to prevent falls and to drink enough fluids to prevent dehydration.
Choice B is correct because difficulty hearing or hearing loss is a rare but serious side effect of furosemide that may indicate ototoxicity (damage to the inner ear). This can be irreversible if not treated promptly and may affect the client’s quality of life and safety. The nurse should notify the provider immediately if the client reports difficulty hearing or any other signs of ototoxicity, such as ringing in the ears (tinnitus) or vertigo (a sensation of spinning). The provider may need to adjust the dose of furosemide or switch to another diuretic that is less ototoxic.