The nurse is caring for a client receiving isoniazid (INH) for tuberculosis. Which instruction should the nurse include?

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ATI Pharmacology Practice A Questions

Question 1 of 5

The nurse is caring for a client receiving isoniazid (INH) for tuberculosis. Which instruction should the nurse include?

Correct Answer: C

Rationale: Isoniazid treats TB but risks hepatotoxicity, causing jaundice (yellowing skin, choice C), a serious sign needing immediate reporting to prevent liver failure. Food is optional'INH can be taken either way. Tyramine relates to MAOIs, not INH. Bedtime isn't specific'dosing is flexible. Reporting jaundice aligns with INH's side effect profile, critical in TB therapy where long-term use is common, making C the essential instruction for early detection and safety.

Question 2 of 5

A 77-year-old man who has been diagnosed with an upper respiratory tract infection tells the nurse that he is allergic to penicillin. Which is the most appropriate response by the nurse?

Correct Answer: C

Rationale: When a patient reports a drug allergy, it is essential for the nurse to gather specific information about the nature of the reaction. Asking, 'What type of reaction did you have when you took penicillin?' allows the nurse to determine whether the reaction was a true allergy (e.g., anaphylaxis) or a side effect (e.g., gastrointestinal upset). This information is critical for guiding treatment decisions and avoiding potentially life-threatening situations. Dismissing the allergy or making assumptions about its relevance based on the patient's age is inappropriate and could compromise patient safety. Therefore, the nurse's priority is to assess the details of the allergic reaction.

Question 3 of 5

The most serious adverse effect of tricyclic antidepressant (TCA) overdose is:

Correct Answer: B

Rationale: Tricyclic antidepressants (TCAs) are associated with a high risk of toxicity in overdose, with cardiac arrhythmias being the most serious and life-threatening complication. TCAs can block sodium channels in the heart, leading to prolonged QRS intervals, ventricular tachycardia, and even cardiac arrest. Hyperpyrexia, seizures, and metabolic acidosis can also occur, but cardiac arrhythmias are the primary concern due to their potential to cause sudden death. Immediate medical intervention is required to manage TCA overdose, including cardiac monitoring and administration of sodium bicarbonate.

Question 4 of 5

Which of the following drugs need not be avoided or only used at a reduced dose in renal failure?

Correct Answer: A

Rationale: Renal failure alters drug clearance, requiring dose adjustments or avoidance. Prednisolone, a glucocorticoid, is metabolized hepatically to prednisone, with minimal renal excretion, making it safe without adjustment in renal failure. Netilmicin, an aminoglycoside, is renally cleared, risking ototoxicity if not reduced. Metformin, cleared renally, risks lactic acidosis in renal impairment, often avoided. Methotrexate, renally excreted, accumulates in failure, causing toxicity (e.g., marrow suppression). Tinzaparin, a low molecular weight heparin, requires adjustment due to renal clearance. Prednisolone's hepatic handling makes it the exception, safe for use in renal dysfunction without modification.

Question 5 of 5

A patient with a new prescription for a HMG-CoA (statin) drug is instructed to take the

Correct Answer: D

Rationale: The best response among the options provided is "This timeframe correlates better with the natural diurnal rhythm of cholesterol production." Statins work by inhibiting HMG-CoA reductase, an enzyme responsible for cholesterol production in the liver. Cholesterol synthesis follows a diurnal rhythm, with higher levels produced at night. Therefore, taking a statin medication in the evening aligns with the body's natural pattern of cholesterol synthesis, optimizing the drug's effectiveness. This explanation helps the patient understand the rationale behind the timing of taking the medication and promotes better adherence to the prescribed regimen.

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