After 2 months of tuberculosis (TB) treatment with isoniazid (INH), rifampin (Rifadin), pyrazinamide (PZA), and ethambutol, a patient continues to have positive sputum smears for acid-fast bacilli (AFB). Which action should the nurse take next?
a. Teach about treatment for drug-resistant TB treatment.
b. Ask the patient whether medications have been taken as directed.
c. Schedule the patient for directly observed therapy three times weekly.
d. Discuss with the health care provider the need for the patient to use an injectable antibiotic.
Question 2An alcoholic and homeless patient is diagnosed with active tuberculosis (TB). Which intervention by the nurse will be most effective in ensuring adherence with the treatment regimen?
a. Arrange for a friend to administer the medication on schedule.
b. Give the patient written instructions about how to take the medications.
c. Teach the patient about the high risk for infecting others unless treatment is followed.
d. Arrange for a daily noon meal at a community center where the drug will be administered.
Question 3An older patient is receiving standard multidrug therapy for tuberculosis (TB). The nurse should notify the health care provider if the patient exhibits which finding?
a. Yellow-tinged skin
b. Orange-colored sputum
c. Thickening of the fingernails
d. Difficulty hearing high-pitched voices
Question 4A patient who is taking rifampin (Rifadin) for tuberculosis calls the clinic and reports having orange discolored urine and tears. Which is the best response by the nurse?
a. Ask if the patient is experiencing shortness of breath, hives, or itching.
b. Ask the patient about any visual abnormalities such as red-green color discrimination.
c. Explain that orange discolored urine and tears are normal while taking this medication.
d. Advise the patient to stop the drug and report the symptoms to the health care provider.
Question 5The nurse teaches a patient about the transmission of pulmonary tuberculosis (TB). Which statement, if made by the patient, indicates that teaching was effective?
a. I will avoid being outdoors whenever possible.
b. My husband will be sleeping in the guest bedroom.
c. I will take the bus instead of driving to visit my friends.
d. I will keep the windows closed at home to contain the germs.
Question 6A patient is admitted with active tuberculosis (TB). The nurse should question a health care provider's order to discontinue airborne precautions unless which assessment finding is documented?
a. Chest x-ray shows no upper lobe infiltrates.
b. TB medications have been taken for 6 months.
c. Mantoux testing shows an induration of 10 mm.
d. Three sputum smears for acid-fast bacilli are negative.
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