Page 1656 - Saunders Comprehensive Review For NCLEX-RN

Priority Concepts: Clinical Judgment; Perfusion
Reference: Burchum, Rosenthal (2016), p. 1084.

590. Answer: 2

Rationale: Isoniazid is hepatotoxic, and therefore the client is taught to report
signs and symptoms of hepatitis immediately, which include yellow skin and sclera.
For the same reason, alcohol should be avoided during therapy. The client should
avoid intake of Swiss cheese, fish such as tuna, and foods containing tyramine,
because they may cause a reaction characterized by redness and itching of the skin,
flushing, sweating, tachycardia, headache, or lightheadedness. The client can avoid
developing peripheral neuritis by increasing the intake of pyridoxine (vitamin B )
6
during the course of isoniazid therapy.
Test-Taking Strategy: Focus on the subject, client teaching for isoniazid. Because
alcohol intake is prohibited with the use of many medications, eliminate option 1
first. Because the client receiving this medication typically is given supplements of
vitamin B , option 4 is incorrect and is eliminated next. Recalling that the medication
6
is hepatotoxic will direct you to the correct option.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Respiratory Medications: Tuberculosis Medications
Health Problem: Adult Health: Respiratory: Tuberculosis
Priority Concepts: Client Education; Safety
Reference: Skidmore-Roth (2017), pp. 658-659.

591. Answer: 3

Rationale: Rifampin causes orange-red discoloration of body secretions and will
stain soft contact lenses permanently. Rifampin should be taken exactly as directed.
Doses should not be doubled or skipped. The client should not stop therapy until
directed to do so by a primary health care provider. It is best to administer the
medication on an empty stomach unless it causes gastrointestinal upset, and then it
may be taken with food. Antacids, if prescribed, should be taken at least 1 hour
before the medication.
Test-Taking Strategy: Options 2 and 4 are comparable or alike and are inaccurate,
based on general guidelines for medication administration; the client should not
double-dose or discontinue medication independently. Eliminate option 1 next
because of the closed-ended word “always.”
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Respiratory Medications: Tuberculosis Medications
Health Problem: Adult Health: Respiratory: Tuberculosis
Priority Concepts: Client Education; Safety
Reference: Lewis et al. (2017), p. 509.

1656