A patient who is HIV-positive has been receiving medication therapy that includes zidovudine.
The prescriber has decided to stop the zidovudine due to its dose-limiting adverse effect.
Which of these conditions is the dose-limiting adverse effect of zidovudine therapy?
Bone marrow suppression
Retinitis
Renal toxicity
Hepatotoxicity
The Correct Answer is A
Choice A rationale:
Zidovudine, also known as AZT, is a medication used for the treatment of human immunodeficiency virus (HIV) infection. One of the major dose-limiting toxic effects of Zidovudine is hematologic toxicity, which manifests clinically as anemia, neutropenia, and sometimes as platelet deficits with onset after several weeks of treatment. This hematologic toxicity is essentially a form of bone marrow suppression. Therefore, bone marrow suppression is the dose-limiting adverse effect of zidovudine therapy.
Choice B rationale:
Retinitis is not a known dose-limiting adverse effect of zidovudine. While zidovudine has a range of side effects, retinitis is not commonly associated with its use.
Choice C rationale:
Renal toxicity is not a known dose-limiting adverse effect of zidovudine. While zidovudine can have various side effects, renal toxicity is not typically one of them.
Choice D rationale:
Hepatotoxicity is not the dose-limiting adverse effect of zidovudine. While severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of zidovudine, it is not considered the dose-limiting adverse effect. The dose-limiting adverse effect is more specifically related to hematologic toxicity, which includes bone marrow suppression.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
The client stating, “I haven’t had anything to eat or drink since last night” is not a cause for concern. This is because patients are often advised to fast before undergoing certain medical procedures or tests, including an intravenous pyelogram (IVP).
Fasting helps to ensure that the test results are accurate and not influenced by recent food or drink consumption.
Choice B rationale:
The client expressing that “The last time I voided it was painful” could be related to their recurrent kidney stones. Kidney stones can cause discomfort or pain during urination. However, this statement does not necessarily require additional data collection in the context of an IVP. The pain could be a symptom of the kidney stones rather than a contraindication for the IVP1.
Choice C rationale:
The statement “I took my metformin before breakfast” is of concern. Metformin is a medication used to treat type 2 diabetes. It is important for the nurse to collect additional data about this statement because metformin can potentially interact with the iodine-based contrast dye used in an IVP. This interaction can increase the risk of lactic acidosis, a serious and potentially lifethreatening condition. Therefore, patients are often advised to stop taking metformin before and for a couple of days after having an IVP12. Choice D rationale:
The client mentioning, “I took a laxative yesterday” is not necessarily alarming. Laxatives are often used before an IVP to clear the bowels, which helps to ensure clear images during the procedure. Therefore, this statement does not require additional data collection in the context of an IVP1.
Correct Answer is A
Explanation
Choice A rationale:
Rifampin Rifampin is an antitubercular drug that is effective against all strains of Mycobacterium tuberculosis. It works by inhibiting the synthesis of RNA in the bacteria, preventing them from reproducing. However, it does not typically cause a decrease in visual acuity.
Choice B rationale:
Ethambutol Ethambutol is an antitubercular drug that can cause ocular toxicity in the form of visual field changes. It is known to induce toxic optic neuropathy, which is quite common and can lead to a decrease in visual acuity. Patients on Ethambutol therapy are advised to report any changes in visual acuity or eye discomfort immediately to their healthcare provider.
Choice C rationale:
Streptomycin Streptomycin is an aminoglycoside antibiotic used in the treatment of tuberculosis. It works by inhibiting protein synthesis in bacteria. While it can cause side effects such as ototoxicity and nephrotoxicity, it is not typically associated with a decrease in visual acuity.
Choice D rationale:
Isoniazid Isoniazid is a first-line antitubercular drug that works by inhibiting the synthesis of mycolic acids in the cell wall of Mycobacterium tuberculosis. While it can cause peripheral neuropathy, it is not typically associated with a decrease in visual acuity.
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