Question 1

A patient has a new prescription for an antiglaucoma eyedrop. The next day, she calls the clinic and states, "The package insert says this medication might make my blue eyes turn brown! Is this true?" The nurse realizes that the patient has a prescription for which eye medication?

A) latanoprost ( Xalatan ), a prostaglandin agonist
B) dorzolamide (Trusopt ), an ocular carbonic anhydrase inhibitor
C) betaxolol ( Betoptic ), a direct-acting beta blocker
D) pilocarpine ( Pilocar ), a direct-acting cholinergic

Accepted Answer

There is one unique adverse effect associated with all prostaglandin agonists-in some people with hazel, green, or bluish-brown eye color, eye color will turn permanently brown, even if the medication is discontinued. This adverse effect appears to be cosmetic only, with no known ill effects on the eye. The other medications do not have this effect.

Question 2

The nurse is reviewing the use of ophthalmic preparations. Indications for the direct- and indirect-acting miotics include which condition?&#10;A) Cataracts&#10;B) Removal of foreign bodies&#10;C) Open-angle glaucoma&#10;D) Ocular infections

Accepted Answer

Indications for the direct- and indirect-acting miotics include open-angle glaucoma, angle-closure glaucoma, ocular surgery, and convergent strabismus.

Question 3

A patient will be receiving mannitol (Osmitrol), 1.5 g/kg IV 1 hour before ocular surgery. The patient weighs 110 pounds. The medication is available as a 25% solution. Based on this patient's dose, calculate how many milliliters of mannitol this patient will receive, using the 25% solution.

Accepted Answer

300 mL&#10;Convert the patient's weight to kilograms: 110 lbs &#184; 2.2 = 50 kg&#10;Calculate the dose of mannitol: 50 kg &#215; 1.5 g/kg = 75 g of mannitol&#10;Using the 25% solution, which contains 25 g of mannitol in 100 mL of solution, calculate the milliliters needed:&#10;25 g : 100 mL :: 75 g : x mL&#10;(25 &#215; x) = (100 &#215; 75); 25x = 7500; x = 300 mL of the 25% mannitol solution

Question 4

A patient with an eye injury requires an ocular examination to detect the presence of a foreign body. The nurse anticipates that which drug will be used for this examination?&#10;A) phenylephrine (Neo-Synephrine)&#10;B) fluorescein sodium (AK-Fluor)&#10;C) atropine sulfate (Isopto Atropine)&#10;D) olopatadine (Patanol)

Accepted Answer

Fluorescein sodium is an ophthalmic diagnostic dye used to identify corneal defects and to locate foreign objects in the eye. Phenylephrine is an ocular decongestant; atropine sulfate has mydriatic and cycloplegic effects, which are useful for examining the inner eye structures; olopatadine is an ophthalmic antihistamine.

Question 5

The nurse is administering dipivefrin (Propine) eyedrops to a patient who has just started therapy with these drops. What potential systemic effect will the nurse monitor the patient for after this medication is given?

A) Hypotension
B) Bradycardia
C) Chest pain
D) Increased heart rate

Accepted Answer

Although systemic effects associated with the use of sympathomimetic mydriatics such as dipivefrin are uncommon, they are theoretically possible, especially with the use of larger doses or prolonged drug therapy. They include cardiovascular effects, such as extrasystoles, tachycardia, and hypertension. Other effects that may be noticed are headache and faintness. Hypotension, bradycardia, and chest pain are not systemic effects of these drugs.

Question 6

The nurse will be giving ophthalmic drugs to a patient with glaucoma. Which drug is used to reduce intraocular pressure?&#10;A) tobramycin (Tobrex)&#10;B) bacitracin (AK-Tracin)&#10;C) mannitol (Osmitrol)&#10;D) ketorolac (Acular)

Accepted Answer

Drugs used to reduce intraocular pressure include osmotic diuretics such as mannitol. Tobramycin and bacitracin are antibiotics; ketorolac has antiinflammatory actions.

Question 7

A patient is about to undergo ocular surgery. The preoperative nurse anticipates that which drug will be used for local anesthesia?&#10;A) Oral glycerin&#10;B) proparacaine ( Alcaine )&#10;C) timolol ( Timoptic )&#10;D) dipivefrin ( Propine )

Accepted Answer

Proparacaine (Alcaine) and tetracaine are used as a local anesthetic for ocular surgery or other procedures. The other drugs are used for glaucoma.

Question 8

A patient has been taking the corticosteroid dexamethasone (Decadron) but has developed bacterial conjunctivitis and has a prescription for gentamicin (Garamycin) ointment. The nurse notes that which interaction is possible if the two drugs are used together?

A) The infection may become systemic.
B) The gentamicin effects may become more potent.
C) The corticosteroid may cause overgrowth of nonsusceptible organisms.
D) Immunosuppression may make it more difficult to eliminate the eye infection.

Accepted Answer

Concurrent use of corticosteroids, such as dexamethasone and ophthalmic antimicrobials, may cause immunosuppression that may make it more difficult to eliminate the eye infection.

Question 9

When teaching a patient about the proper application of timolol ( Timoptic ) eyedrops, the nurse will include which instruction?&#10;A) &#34;Apply the drops into the conjunctival sac instead of directly onto the eye.&#34;&#10;B) &#34;Apply the drops directly to the eyeball ( cornea ) for the best effect.&#34;&#10;C) &#34;Blot your eye with a tissue immediately after applying the drops.&#34;&#10;D) &#34;Tilt your head forward before applying the eyedrops.&#34;

Accepted Answer

All ophthalmic drugs should be administered in the conjunctival sac. Gently use a tissue to remove excess eye medication-do not blot the eye after giving the medication. Tilt the head back before giving the eyedrops.

Question 10

A patient is receiving ocular cyclosporine (Restasis) and also has an order for an artificial tears product. The nurse includes which instructions in the teaching plan for these medications?&#10;A) &#34;These two eye drugs cannot be given together. Let's check with your prescriber.&#34;&#10;B) &#34;You may take these two drugs together at the same time.&#34;&#10;C) &#34;First take the artificial tears, and then take the Restasis after 5 minutes.&#34;&#10;D) &#34;Take the Restasis first, and then wait 15 minutes before taking the artificial tears.&#34;

Accepted Answer

Restasis can be used together with artificial tears if the drugs are given 15 minutes apart. The other options are incorrect.

Question 11

The nurse is administering ophthalmic drops. Place the following administration steps in the correct order.&#10;A) Close the eye gently.&#10;B) Apply gentle pressure to the inner canthus/lacrimal sac for 1 minute.&#10;C) Place drops into the conjunctival sac.&#10;D) Clean debris from the eye as needed.&#10;E) Have the patient tilt the head back and look up at the ceiling.&#10;F) Remove excess medication gently from around the eyes.&#10;

Accepted Answer

The answer of The nurse is administering ophthalmic drops. Place...

Question 12

The nurse is reviewing the medical record of a patient and notes an order for ophthalmic dexamethasone (Decadron) solution. The nurse knows that indications for ophthalmic dexamethasone include which conditions? (Select all that apply.)

A) Uveitis
B) Allergic conditions
C) Removal of foreign bodies
D) Ocular infections
E) Glaucoma
F) Conjunctival inflammation

Accepted Answer

The answer of The nurse is reviewing the medical record...

Question 13

The nurse is administering antibiotic eyedrops to a patient for the first time. After the first drop is given, the patient states, "That eyedrop is making my eye sting! Is that normal?" Which is the best response by the nurse?

A) "That's unusual. Let me rinse the medication from your eye."
B) "Sometimes these eyedrops may cause burning and stinging, but it should go away soon."
C) "These may be serious side effects, so I will notify your doctor before the next dose is due."
D) "Let's wait and see if these effects happen the next time you receive these drops."

Accepted Answer

The answer of The nurse is administering antibiotic eyedrops to...

Deck 57: Ophthalmic Drugs