Chapter 49: Drugs for Eye and Ear Disorders Nursing School Test Banks

Chapter 49: Drugs for Eye and Ear Disorders
Test Bank

MULTIPLE CHOICE

1. The nurse is caring for a patient who has increased intraocular pressure. The provider has ordered a cholinergic agonist. The nurse will perform a thorough health history to make sure the patient does not have a history of which condition?
a. Asthma
b. Diabetes
c. Hypertension
d. Renal disease
ANS: A
Cholinergic agonists can worsen conditions such as asthma and chronic bronchitis because they can cause airway constriction.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 717
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

2. The nurse is performing a medication history on a patient who has glaucoma. The patient cannot remember the name of the drug prescribed but tells the nurse that the drug causes light sensitivity. The nurse knows that the drug is among which class of medications?
a. Alpha-adrenergic agonists
b. Beta-adrenergic blockers
c. Cholinergic agonists
d. Cholinesterase inhibitors
ANS: A
Alpha-adrenergic agonists cause mydriasis, which increases sensitivity to light. Beta-adrenergic blockers cause miosis, which impairs vision in the dark. Cholinergic agonists and cholinesterase inhibitors may cause myopia and will impair vision in the dark.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 719
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

3. The nurse administers proparacaine HCl (Ophthaine) drops to a patient prior to an eye examination. What sign will the nurse look for to determine when the examination can begin?
a. Absence of the blink reflex
b. Blurred vision
c. Drying of the corneal epithelium
d. Photophobia
ANS: A
Ophthaine is a topical anesthetic for the eye and causes loss of the blink reflex. Drying of the corneal epithelium is a side effect but occurs later as a result of the loss of the blink reflex. Blurred vision and photophobia result from mydriasis and miosis.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 710
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

4. The nurse is administering timolol (Timoptic) eye drops to a patient who has glaucoma. To prevent bradycardia, the nurse will perform which action?
a. Apply pressure to the lacrimal ducts.
b. Have the patient sit up after instilling the drops.
c. Prepare to administer an alpha-adrenergic agonist.
d. Wait 5 minutes between drops.
ANS: A
Bradycardia is a systemic side effect of timolol. Applying pressure to the lacrimal ducts prevents the medication from being systemically absorbed and causing systemic side effects such as bradycardia.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 717
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

5. A patient has an infection of the eyelash follicles and in the gland on the eyelid margin. The nurse recognizes these symptoms as being consistent with which condition?
a. Blepharitis
b. Chalazion
c. Endophthalmitis
d. Hordoleum
ANS: D
Hordoleum is a local infection of eyelash follicles and glands on the eyelid margin. Blepharitis is an infection of the margins of the eyelid. Chalazion is an infection of the glands of the eyelids that may produce cysts. Endophthalmitis is an infection of the structures of the inner eye.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 710
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

6. The nurse is preparing to administer dipivefrin (Propine) drops as a mydriatic agent. Which assessment would cause the nurse to withhold the drug and notify the provider?
a. Blood pressure of 140/90 mm Hg
b. Heart rate of 60 beats per minute
c. Respiratory rate of 12 breaths per minute
d. Temperature of 37.9 C
ANS: A
Dipivefrin is a prodrug of epinephrine and can cause systemic cardiovascular side effects such as tachycardia and hypertension. An elevated blood pressure warrants holding the drug and notifying the provider.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 718
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

7. The nurse is preparing to administer olopatadine (Patanol) eyedrops to a patient who has allergic conjunctivitis. The patient tells the nurse that the drops have caused burning and stinging. What action will the nurse take?
a. Administer the drops and reassure the patient that this is a normal side effect.
b. Offer an over-the-counter eye lubricant to minimize this adverse effect.
c. Request an order for antibiotic eyedrops.
d. Withhold the medication and notify the provider.
ANS: A
Burning and stinging are the most common side effects of this class of drugs but do not warrant withholding the medication. An over-the-counter lubricant is not indicated. These symptoms are not an indication of infection.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 710
TOP: NURSING PROCESS: Nursing Intervention/Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

8. The nurse is providing teaching for a patient who will begin using tobramycin ointment (Nebcin) 0.5 inches 3 times daily. The patient currently uses pilocarpine HCl (Isopto Carpine) drops to treat glaucoma. Which statement by the patient indicates a need for further teaching?
a. I should apply the third dose of tobramycin at bedtime each day.
b. I should instill the drops in the conjunctival sac of the lower eyelid.
c. I should not stop the medications without consulting my provider.
d. I should put the ointment on first and then instill the eyedrops.
ANS: D
Patients using both drops and ointments should instill the drops prior to applying the ointment. Ointments should be applied at bedtime if possible. Drops should be instilled into the conjunctival sac of the lower lid. Patients should always consult with their provider before discontinuing any medication.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 711
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

9. The nurse is counseling an adolescent patient who has recurrent otitis externa and who works as a lifeguard in the summer about preventing this condition. The nurse will teach this patient to
a. avoid using ear plugs while swimming.
b. request a prescription for prophylactic antibiotic eardrops.
c. use a hair dryer to dry the ears after swimming.
d. wear a medical alert bracelet.
ANS: C
To help prevent otitis externa, patients should be counseled to use a portable hair dryer to dry the ears after swimming. Ear plugs are recommended. Prophylactic antibiotic eardrops are not indicated. A medical alert bracelet is not necessary.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 722
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

10. The nurse is caring for an African-American patient who has been diagnosed with glaucoma. The nurse anticipates that which medication will be most effective for this client?
a. Bimatoprost (Lumigan)
b. Latanoprost (Xalatan)
c. Travoprost (Travatan Z)
d. Unoprostone (Rescula)
ANS: C
Travoprost has been found to be more effective in African Americans than in non-African Americans.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 715
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

11. The parent of a toddler asks the nurse what can be done to prevent otitis media. What will the nurse recommend?
a. Administer diphenhydramine when the child has a runny nose.
b. Give phenylephrine (Neo-Synephrine Ophthalmic) to prevent congestion.
c. Keep the childs immunizations up to date.
d. Remove cerumen with carbamide peroxide (Auro Ear Drops).
ANS: C
The pneumococcal conjugate vaccine (PCV) protects children against S. pneumoniae and should be administered to all children to prevent otitis media. Antihistamines and decongestants have been shown to be ineffective in preventing otitis media. Removing cerumen helps to prevent otitis externa.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 722
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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