Question 1

The Centers for Disease Control recommends all newborn infants receive prophylactic administration of __________ within 1 hour of birth.&#10;A) Gentamicin ophthalmic ointment&#10;B) Ciprofloxacin ophthalmic drops&#10;C) Erythromycin oral suspension&#10;D) Erythromycin ophthalmic ointment&#10;

Accepted Answer

The Centers for Disease Control recommends all newborn infants receive prophylactic administration of Erythromycin ophthalmic ointment within 1 hour of birth to prevent neonatal conjunctivitis caused by chlamydia and gonorrhea. A and B are not recommended for this purpose, while C is not effective for preventing neonatal conjunctivitis.

Question 2

Conjunctivitis in a child that is accompanied by acute otitis media is treated with:&#10;A) Sulfacetamide 10% ophthalmic solution (Bleph-&#10;10)&#10;B) Bacitracin/polymyxin B (Polysporin) ophthalmic drops&#10;C) Ciprofloxacin (Ciloxan) ophthalmic drops&#10;D) High-dose oral amoxicillin&#10;

Accepted Answer

Acute otitis media is an infection of the middle ear, and is usually treated with antibiotics. Since the child in this scenario has both conjunctivitis and acute otitis media, it is likely that the infection has spread and systemic treatment is necessary. High-dose oral amoxicillin is effective against the most common bacteria that cause both of these infections. Ophthalmic drops alone are not enough to treat the ear infection.

Question 3

Patient education regarding the use of ciprofloxacin-hydrocortisone (Cipro HC otic) ear drops includes:&#10;A) Fill the canal with the drops with each dose.&#10;B) Some redness and itching around the ear canal is normal.&#10;C) Warm the bottle of ear drops in his or her hand before administering.&#10;D) Cipro HC otic may cause ototoxicity.&#10;

Accepted Answer

Warming the bottle can help prevent dizziness or vertigo that can be caused by using cold ear drops. 
Answer: D
 It is important for patients to be aware of the potential risk of ototoxicity (hearing loss or damage to the ear) with the use of this medication. A healthcare provider should be consulted if any hearing problems or symptoms of ototoxicity occur. 
Therefore, the correct choice is CD.

Question 4

__________ is / are prescribed to prevent swimmer's ear.&#10;A) Ciprofloxacin otic drops (Ciloxan)&#10;B) Isopropyl ear drops (EarSol)&#10;C) Colistin (Coly-Mycin S Otic)&#10;D) Gentamicin otic drops&#10;

Accepted Answer

Isopropyl ear drops (EarSol) are commonly prescribed to prevent swimmer's ear. These drops help to dry out the ear canal and decrease the likelihood of bacterial growth. They can be used before and after swimming to prevent infection.

Question 5

Education of women who are being treated with ophthalmic antibiotics for conjunctivitis includes:&#10;A) Throwing away eye makeup and purchasing new&#10;B) Redness and intense burning is normal with ophthalmic antibiotics&#10;C) When applying eye ointment, set the tip of the tube on the lower lid and squeeze in inch&#10; &#10;D) Use a cotton swab to apply ointment, spreading the ointment all over the lid and in the conjunctival sac&#10;

Accepted Answer

The answer of Education of women who are being treated...

Question 6

Sadie was prescribed betaxolol ophthalmic drops by her ophthalmologist to treat her glaucoma. Oral beta blockers should be avoided in patients who use ophthalmic beta blockers because:&#10;A) There may be an antagonistic reaction between the two.&#10;B) The additive effects may include bradycardia.&#10;C) They may potentiate each other and cause respiratory depression.&#10;D) The additive effects may cause metabolic acidosis.&#10;

Accepted Answer

Oral beta blockers and ophthalmic beta blockers can have additive effects on lowering the heart rate, leading to bradycardia. Thus, it is typically recommended to avoid oral beta blockers in patients using ophthalmic beta blockers.

Question 7

Twenty-year-old Annie comes to the clinic complaining of copious yellow-green eye discharge. Gram stain indicates she most likely has gonococcal conjunctivitis. While awaiting the culture results, the plan of care should be:

A) None, wait for the culture results to determine the course of treatment
B) Ciprofloxacin (Ciloxan) ophthalmic drops
C) IM ceftriaxone
D) High-dose oral amoxicillin

Accepted Answer

Given the high probability of gonococcal conjunctivitis, treatment should not be delayed until culture results are available. Intramuscular ceftriaxone is the recommended initial treatment for gonococcal conjunctivitis. Topical antibiotics are not effective for treating systemic infections like gonococcal conjunctivitis. Amoxicillin is not the drug of choice for treating gonococcal infections.

Question 8

David presents to the clinic with symptoms of allergic conjunctivitis. He is prescribed cromolyn sodium (Opticrom) eye drops. The education regarding using cromolyn eye drops includes:&#10;A) He should not wear his soft contacts while using the cromolyn eye drops.&#10;B) Cromolyn drops are instilled once a day to prevent allergy symptoms.&#10;C) Long-term use may cause glaucoma.&#10;D) He may experience bradycardia as an adverse effect.&#10;

Accepted Answer

Soft contact lenses should not be worn while using cromolyn eye drops as they contain benzalkonium chloride, which can be absorbed by soft contact lenses and cause eye irritation or even an allergic reaction.

Question 9

Ciprofloxacin otic drops are contraindicated in:&#10;A) Children&#10;B) Patients with acute otitis externa&#10;C) Patients with a perforated tympanic membrane&#10;D) Swimmer's ear&#10;

Accepted Answer

Ciprofloxacin otic drops are contraindicated in patients with a perforated tympanic membrane as it can cause damage to the inner ear and potentially lead to hearing loss. It is safe to use in patients with acute otitis externa (also known as swimmer's ear), but not as the answer choice D implies. It is also safe to use in children under the guidance of a healthcare provider.

Question 10

Janie presents to the clinic with hard ear wax in both ear canals. Instructions regarding home removal of hard cerumen include:&#10;A) Moisten a cotton swab (Q-tip) and swab the ear canal twice daily.&#10;B) Instill tap water in both ears while bathing.&#10;C) Squirt hydrogen peroxide into ears with each bath.&#10;D) Instill carbamide peroxide (Debrox) twice daily until canals are clear.&#10;

Accepted Answer

The best choice for home removal of hard cerumen is to instill carbamide peroxide (Debrox) twice daily until canals are clear. This softens and loosens the wax, making it easier to remove. Moisten cotton swabs can push the wax further into the ear canal, while instilling tap water can sometimes cause further impaction. Squirt hydrogen peroxide can cause irritation or damage to the ear canal.

Deck 26: Drugs Used in Treating Eye and Ear Disorders