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Chapter 44: Eye and Ear Disorders
from TEST BANK_PHARMACOLOGY A Patient-Centered Nursing Process Approach 10th Edn by Linda McCuistion
by ACADEMIAMILL
McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 10th Edition
Multiple Choice
1. The nurse is caring for a patient who has increased intraocular pressure. The provider has ordered levobunolol 0.5% ophthalmic solution. 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
Levobunolol is a non-selective beta blocker that can be used to treat increased intraocular pressure. This agent is contraindicated in patients with asthma.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies a. Alpha-adrenergic agonists b. Beta-adrenergic blockers c. Cholinergic agonists d. Cholinesterase inhibitors
2. The nurse is performing a medication history on a patient who has glaucoma. The patient has a prescription for brimonidine (Alphagan P). The nurse knows that this drug belongs to which class of medications?
ANS: A
Brimonidine is an alpha-adrenergic agonist.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies a. Absence of the blink reflex b. Blurred vision c. Drying of the corneal epithelium d. Photophobia
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?
ANS: A
Proparacaine 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) TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 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.
4. The nurse is administering timolol (Timoptic) eye drops to a patient who has glaucoma. To prevent bradycardia, the nurse will perform which action?
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)
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies a. Blepharitis b. Chalazion c. Endophthalmitis d. Hordeolum
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?
ANS: D
Hordeolum is a local infection of eyelash follicles and glands on the eyelid margin and is also known as a “stye.” 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)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies a. Tachycardia b. Diarrhea c. Bradycardia d. Constipation
6. The nurse is preparing to administer atropine sulfate drops as a mydriatic agent. Which of the following is considered a contraindication to therapy?
ANS: A
Atropine sulfate is an anticholinergic medication that is contraindicated in patients with tachycardia and glaucoma. Anticholinergic effects could contribute to worsening constipation, but the presence of constipation would not be considered a contraindication.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 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.
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?
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)
TOP: Nursing Process: Nursing Intervention/Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 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.”
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?
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)
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 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.
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 do which of the following?
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)
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies a. Administer diphenhydramine when the child has a runny nose. b. Give phenylephrine (Neo-Synephrine Ophthalmic) to prevent congestion. c. Keep the child’s immunizations up to date. d. Remove cerumen with carbamide peroxide (Auro Ear Drops).
10. The parent of a toddler asks the nurse what can be done to prevent otitis media. What will the nurse recommend?
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)
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
