Deck 74: Pharmacotherapy of Eye and Ear Disorders

Question 1

A client,concerned about developing glaucoma because a parent has the disorder,asks the nurse about the different types.The nurse responds that both open-angle and closed-angle glaucoma result in:

A)acute eye pain.
B)floaters in the vitreous humor.
C)a bulging iris.
D)an increased volume of aqueous humor.

Answer 1

an increased volume of aqueous humor.

Question 2

A client with glaucoma is being treated with timolol (Timoptic)ophthalmic drops.The client complains of blurry vision and eye burning and does not want to continue to use the medication.How should the nurse respond?

A)"These are expected side effects for this type of medication and might lessen over time."
B)"If you place a finger over the inner part of your eyes,these problems should become less noticeable."
C)"In order to preserve your eyesight,it is important to keep using these drops.It is normal to experience temporary burning."
D)"These problems might indicate another eye problem.Be sure to tell your ophthalmologist about these concerns."

Answer 2

"In order to preserve your eyesight,it is important to keep using these drops.It is normal to experience temporary burning."

Question 3

The nurse is explaining the anatomy of the eye to an adolescent client who wants to start wearing contact lenses.What eye structure will the nurse identify as supplying nutrients to the eye and removing wastes?

A)Conjunctiva layer
B)Vitreous humor
C)Lacrimal apparatus
D)Aqueous humor

Answer 3

Aqueous humor

Question 4

The nurse explains to a client with open-angle glaucoma that the purpose of using betaxolol (Betoptic),a selective beta-adrenergic blocker,is to:

A)decrease the production of aqueous humor.
B)promote the flow of aqueous humor.
C)reduce the redness and irritation associated with glaucoma.
D)protect the optic nerve from the increased blood supply that could occur.

Question 5

Prior to administering a beta blocker to a client with glaucoma,the nurse should assess for which coexisting health problem that would place the client at increased risk of adverse events?

A)Type 2 diabetes mellitus
B)Sleep apnea
C)Cardiovascular disorders
D)Rheumatoid arthritis

Question 6

A client experiencing sudden acute eye pain is diagnosed with glaucoma.The diagnosis is more likely to be which type of glaucoma?

A)Open-angle
B)Dry type
C)Wet type
D)Closed-angle

Question 7

Which nursing diagnosis should receive highest priority when caring for a client being treated for glaucoma?

A)Noncompliance related to adverse effects of medications
B)Self-Care Deficit: Feeding related to decreased peripheral vision
C)Health Maintenance,Ineffective related to lack of knowledge of disease and pharmacological management
D)Injury,Risk for related to blurred vision secondary to medications

Question 8

A client has received pilocarpine (Isopto Carpine)drops in both eyes.When assessing this client,the nurse will anticipate which reaction?

A)Unequal pupil shape
B)Dilated pupils
C)Constricted pupils
D)Improved distance vision

Question 9

A client with diabetes asks the nurse why regular eye examinations for glaucoma are needed.What is the nurse's most accurate response?

A)"Individuals with diabetes have a greater chance of developing glaucoma,and it is important to find this out early so that treatment can begin."
B)"An adverse effect of insulin is vision loss,and frequent examinations will catch problems at an early stage."
C)"The stress that you are under with this disease can result in an increased production of aqueous humor."
D)"Your diabetes is under such good control that it is probably not necessary to have eye examinations so frequently."

Question 10

A client is prescribed an optic eye medication that will mimic the action of the sympathetic nervous system.The nurse expects that this medication will:

A)prepare the eye for near vision.
B)increase the ability of the eye to tear.
C)constrict the pupil.
D)dilate the pupil.

Question 11

The nurse should encourage a client being treated with corticosteroids for an autoimmune disease to have frequent examinations by an ophthalmologist because corticosteroids increase the risk of:

A)muscle weakness secondary to hypokalemia.
B)glaucoma.
C)sodium and water retention.
D)bone fractures.

Question 12

A client's canal of Schlemm in the right eye is believed to be blocked.The nurse recognizes that the canal of Schlemm is an important structure because it:

A)supports the retina in place.
B)assists the iris in controlling the size of the pupil.
C)produces tears that help lubricate the eye.
D)provides a means for drainage of aqueous humor.

Question 13

When teaching a client about glaucoma,the nurse explains that both open-angle and closed-angle glaucoma can result in blindness because:

A)pressure is applied to the optic chiasm.
B)the retina hemorrhages.
C)the optic nerve is irreversibly damaged.
D)the retina detaches.

Question 14

The nurse is obtaining a history from a client recently diagnosed with open-angle glaucoma.When the nurse asks about symptoms,the client is most likely to respond:

A)"I began to notice colored halos around lights."
B)"I noticed that my vision seemed wavy and blurred."
C)"I had severe eye and facial pain,and I became nauseated."
D)"I had no symptoms of pain or pressure in my eyes."

Question 15

Which client should the nurse advise to seek medical help because of an increased risk of developing glaucoma?

A)A client with cirrhosis experiencing ascites
B)A client who is recovering from a heart attack
C)An individual who has a severe eye injury sustained in a fight at a bar
D)A woman in the third trimester of pregnancy

Question 16

A client with glaucoma is prescribed latanoprost (Xalatan).The nurse instructs the client that this medication,a prostaglandin analog,is used for glaucoma because it:

A)is thought to protect neurons from injury.
B)enhances the outflow of aqueous humor.
C)decreases the production of aqueous humor by the ciliary body.
D)has a relatively short duration of action,and adverse effects can be limited.

Question 17

The nurse administers polyvinyl alcohol (Liquifilm)to a client to prevent:

A)inflammation.
B)redness.
C)infection.
D)dry eyes.

Question 18

A client is receiving latanoprost (Xalatan)for open-angle glaucoma.Which medication information provided by the nurse is incorrect?

A)"The medication will increase the outflow of aqueous humor."
B)"Your eyelashes may grow longer and thicker and could become darker."
C)"Your gray eyes might become more pigmented and turn brown."
D)"You must monitor your blood pressure and pulse prior to administration of this drug."

Question 19

A client newly diagnosed with open-angle glaucoma has been prescribed timolol (Timoptic).Prior to administering this medication,which condition in the client's history should the nurse immediately inform the prescriber about?

A)Primary hypertension
B)Deep-vein thrombosis
C)Supraventricular tachycardia
D)Asthma

Question 20

A client tells the nurse,"It feels like there's something in my eye." To assess the eye for corneal abrasions,the examiner will first instill:

A)fluorescein sodium (Fluorescite).
B)echothiophate iodide (Phospholine Iodide).
C)azelastine (Optivar).
D)naphazoline HCL (Allerest).

Question 21

After completing a physical assessment,the nurse is concerned that a client is at risk for developing glaucoma because of which findings? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)High blood pressure
B)Migraine headaches
C)Type 2 diabetes mellitus
D)Heart failure
E)Gastroesophageal reflux disease

Question 22

A client is being treated for acute closed-angle glaucoma.Immediate treatment to reduce the client's intraocular pressure would include:

A)morphine sulfate to reduce blood pressure.
B)antihistamines for sedation.
C)mannitol administered intravenously.
D)tricyclic antidepressants to relieve anxiety.

Question 23

A 5-month-old infant has been unusually irritable and has been pulling on the ears.The nurse expects that medications for this client will probably include infant acetaminophen and antibiotics for the treatment of:

A)otitis interna.
B)mastoiditis.
C)external otitis.
D)otitis media.

Question 24

In preparation for eye surgery,the nurse is teaching a client about the anatomy of the eye and explains that the purpose of the posterior chamber of the eye is to: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Help the eyeball maintain shape.
B)Keep the retina in place.
C)Change the diameter of the pupil.
D)Provide nutrients to the eye.
E)Remove waste products from the eye.

Question 25

The nurse instructs a client who has been prescribed cyclopentolate (Cyclogyl)about appropriate safety measures.Additional teaching is required if the client states:

A)"I might experience a dry mouth until the effects of the medication are gone."
B)"I will avoid driving or operating hazardous machinery until the effects of the medication are gone."
C)"I will wear dark glasses until the light sensitivity and blurred vision have resolved."
D)"I will use sunscreen or protective clothing when outdoors because of the risk of sunburn due to photosensitivity."

Question 26

A client with glaucoma is being treated with a pilocarpine (Isopto Carpine).To help reduce the risk associated with this medicine,the nurse suggests:

A)assuring that hallways are well lit at night.
B)using skin softeners to reduce the risk of dry skin.
C)wearing sunglasses when doing yard work.
D)using lubricant eyedrops to reduce its drying effects.

Question 27

The nurse is concerned that a client taking bepotastine (Bepreve)for allergic conjunctivitis is experiencing adverse effects of the medication after assessing: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Fatigue and dizziness.
B)Dry mouth and cough.
C)Headache and a bitter taste in the mouth.
D)Pharyngitis and rhinitis.
E)Bronchospasm.

Question 28

The nurse is caring for an older client who has difficulty hearing because of suspected wax accumulation.What measures will the nurse take to help this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Instill a cerumenolytic as prescribed prior to the irrigation.
B)Warm the irrigating solution to normal body temperature.
C)After instilling the irrigating solution,use a cotton-tipped applicator to gently dry the ear canal.
D)Use a large-bore syringe to apply enough pressure to loosen the impacted cerumen.
E)Pull the pinna up and back prior to instilling any medications.

Question 29

During a medication history,a client reports taking acetazolamide (Diamox)for glaucoma.The nurse should assess this client for: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)changes in energy level.
B)nausea and vomiting.
C)known allergies to any medications.
D)recent blood work done for electrolytes.
E)eye burning or excessive tearing.

Question 30

The nurse is planning care for a client with closed-angle glaucoma.What will be included in this plan of care? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Administer prescribed pain medication.
B)Administer antiemetics as prescribed.
C)Instruct the client to use a call light for assistance with ambulation.
D)Administer oral medication as prescribed.
E)Prepare for emergency ocular surgery.

Question 31

A client with open-angle glaucoma is prescribed an alpha₂-adrenergic agonist.What will the nurse instruct the client about this medication? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"You may feel like there is something in your eye when using this medication."
B)"You may have headaches and feel sleepy with this medication."
C)"You may have blurred vision when using this medication."
D)"You may feel nervous or anxious,but this is rare."
E)"Acute eye pain is expected when taking this medication."

Question 32

A client being prepared for eye surgery is instructed that medication will be provided to anesthetize the eye.The nurse will prepare to administer which medication? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Lidocaine (Akten)
B)Proparacaine (Alcaine)
C)Lanolin alcohol (Lacril-lube)
D)Naphazoline (Albalon)
E)Scopolamine hydrobromide (Isopto Hyoscine)

Question 33

A client is using an ophthalmic beta blocking agent for the treatment of glaucoma.Orthostatic hypotension and bradycardia are possible side effects of this medication.What instruction should the nurse provide to reduce the risk of these problems?

A)Apply pressure with the finger over the inside corner of each eye for one minute.
B)Arise from sitting positions slowly.
C)Instill the eyedrops in a sitting position and remain sitting for at least 5 minutes.
D)Assess the blood pressure and pulse before and after each dose.

Question 34

A client reports symptoms of continuing ear pain,difficulty hearing,and tenderness following treatment for otitis media.The area behind the ear is red and swollen.What problem might be indicated by these symptoms?

A)Otitis externa
B)Labyrinthitis
C)Chronic otitis media
D)Mastoiditis

Question 35

A client is prescribed medication for otitis media.What should the nurse instruct the spouse about the administration of this medication? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Warm the solution in the microwave before using.
B)The client should be lying down with the affected ear dominant.
C)Pull the ear pinna down and back before administering the medication.
D)Instill the prescribed number of drops so that they slide down the ear canal.
E)The client should not change position for 5 to 10 minutes after the medication is instilled.