Deck 77: Pharmacotherapy of Eye and Ear Disorders

Question 1

Drugs that mimic the action of the sympathetic nervous system will:
1)Dilate the pupil.
2)Constrict the pupil.
3)Prepare the eye for near vision.
4)Increase the ability of the eye to tear.

Answer 1

1

Question 2

Which nursing diagnosis should receive highest priority when caring for a client being treated for glaucoma?
1)Noncompliance related to adverse effects of medications
2)Injury, risk for related to blurred vision secondary to medications
3)Self-Care Deficit: Feeding related to decreased peripheral vision
4)Ineffective Health Maintenance, risk for related to lack of knowledge of disease and pharmacological management

Answer 2

2

Question 3

Latanoprost (Xalatan), a prostaglandin analog, is used for glaucoma because it:
1)Enhances the outflow of aqueous humor.
2)Is thought to protect neurons from injury.
3)Decreases the production of aqueous humor by the ciliary body.
4)Has a relatively short duration of action, and adverse effects can be limited.

Answer 3

1

Question 4

Both open-angle and closed-angle glaucoma can result in blindness because:
1)The optic nerve is irreversibly damaged.
2)Pressure is applied to the optic chiasm.
3)The retina hemorrhages.
4)The retina detaches.

Question 5

Both open-angle and closed-angle glaucoma result in:
1)A bulging iris.
2)Floaters in the vitreous humor.
3)The appearance of acute eye pain.
4)An increased volume of aqueous humor.

Question 6

A client has received pilocarpine (Isopto Carpine)bilaterally.When assessing this client, the nurse will anticipate noting:
1)Dilated pupils.
2)Constricted pupils.
3)Unequal pupil shape.
4)Improved distant vision.

Question 7

Prior to administering beta blockers for glaucoma, the nurse should assess for which co-existing health problem that would place the client at increased risk of adverse events?
1)Type 2 diabetes mellitus
2)Cardiovascular disorders
3)Rheumatoid arthritis
4)Sleep apnea

Question 8

The nurse administers the prescribed polyvinyl alcohol (Liquifilm)to prevent:
1)Dry eyes.
2)Redness.
3)Infection.
4)Inflammation.

Question 9

The nurse is obtaining a history from a client recently diagnosed with open-angle glaucoma.In response to questions about symptoms, what response is the client most likely to provide?
1)"I had severe eye and facial pain, and I became nauseated."
2)"I had no symptoms of pain or pressure in my eyes."
3)"I noticed that my vision seemed wavy and blurred."
4)"I began to notice colored halos around lights."

Question 10

Nutrients are supplied to the eye and waste is removed by the:
1)Aqueous humor.
2)Vitreous humor.
3)Lacrimal apparatus.
4)Conjunctiva layer.

Question 11

The nurse explains to a client that the purpose of using betaxolol (Betoptic), a selective beta-adrenergic blocker prescribed for clients with open-angle glaucoma, is to:
1)Promote the flow of aqueous humor.
2)Decrease the production of aqueous humor.
3)Reduce the redness and irritation associated with glaucoma.
4)Protect the optic nerve from the increased blood supply that could occur.

Question 12

A diabetic client asks the nurse the reason that regular eye examination for glaucoma is indicated.The nurse responds by saying:
1)"An adverse effect of insulin is vision loss, and frequent examinations will catch problems at an early stage."
2)"Individuals with diabetes have a greater chance of developing glaucoma, and it is important to find this out early so that treatment can begin."
3)"The stress that you are under with this disease can result in an increased production of aqueous humor."
4)"Your diabetes is under such good control, it is probably not necessary to have eye examinations so frequently."

Question 13

An individual has sudden symptoms of acute eye pain, and is diagnosed with glaucoma.The diagnosis of glaucoma is more likely to be of which type?
1)Open-angle
2)Closed-angle
3)Wet type
4)Dry type

Question 14

The canal of Schlemm is an important structure because it:
1)Supports the retina in place.
2)Produces tears that help lubricate the eye.
3)Assists the iris in controlling the size of the pupil.
4)Provides a means for drainage of aqueous humor.

Question 15

A client with glaucoma has been prescribed timolol (Timoptic)ophthalmic drops.The patient reports burning and blurry vision when she instills the medication.How should the nurse respond?
1)"These are expected side effects for this type of medication, and might lessen over time."
2)"If you place a finger over the inner part of your eyes, these problems should become less noticeable."
3)"These problems might indicate another eye problem.Be sure to tell your ophthalmologist about these concerns."
4)"In order to preserve your eyesight, it is important to keep using these drops.It is normal to experience temporary burning."

Question 16

A client newly diagnosed with open-angle glaucoma has been prescribed timolol (Timoptic).Prior to administering this medication, which information should the nurse communicate immediately to the prescriber? The client's history of:
1)Asthma.
2)Primary hypertension.
3)A deep-vein thrombosis.
4)A supraventricular tachycardia.

Question 17

A client being treated with corticosteroids for an autoimmune disease should be encouraged to have frequent examinations by an ophthalmologist because corticosteroids increase the risk of:
1)Glaucoma.
2)Bone fractures.
3)Sodium and water retention.
4)Muscle weakness secondary to hypokalemia.

Question 18

A client is receiving latanoprost (Xalatan)for open-angle glaucoma.Which information provided by the nurse is incorrect?
1)"The medication will increase the outflow of aqueous humor."
2)"His bluish-gray eyes might become more pigmented and turn brown."
3)"His eyelashes might have an increased growth, and could become darker."
4)"He must monitor his blood pressure and pulse prior to administration of this drug."

Question 19

Which of the following clients should be advised to seek medical help because of an increased risk of developing glaucoma?
1)A client with cirrhosis experiencing ascites
2)A client who is recovering from a heart attack
3)A pregnant woman in the third trimester of her pregnancy
4)An individual who has a severe eye injury sustained in a fight at a bar

Question 20

A client arrives at an urgent care facility reporting the presence of "something" in his eye.To assess the eye for corneal abrasions, the examiner will first instill:
1)Azelastine (Optivar).
2)Naphazoline HCL (Allerest).
3)Fluorescein sodium (Fluorescite).
4)Echothiophate iodide (Phospholine Iodide).

Question 21

A 5-month-old infant has been unusually irritable, and has been pulling on her ears.The expected care will probably include infant acetaminophen and antibiotics for treatment of:
1)External otitis.
2)Otitis interna.
3)Otitis media.
4)Mastoiditis.

Question 22

As a result of a client's admission for acute closed-angle glaucoma, the nurse would expect immediate treatment to reduce the client's intraocular pressure to include:
1)Morphine sulfate to reduce blood pressure.
2)Tricyclic antidepressants to relieve anxiety.
3)Mannitol administered intravenously.
4)Antihistamines for sedation.

Question 23

A client returns to a health care provider to report symptoms of continuing ear pain, difficulty hearing, and tenderness following treatment for otitis media.The area behind his ear is red and swollen.What problem might be indicated by these symptoms?
1)Chronic otitis media
2)Labyrinthitis
3)Otitis externa
4)Mastoiditis

Question 24

A client with glaucoma is being treated with a pilocarpine (Isopto Carpine).To help reduce the risk associated with this medicine, the nurse would suggest:
1)Wearing sunglasses when doing yard work.
2)Assuring that hallways are well-lit at night.
3)Using skin softeners to reduce the risk of dry skin.
4)Using demulcent eyedrops to reduce its drying effects.

Question 25

The 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?
1)Arise from sitting positions slowly.
2)Assess your blood pressure and pulse before and after each dose.
3)Apply pressure with your finger over the inside corner of each eye for one minute.
4)Be sure you are sitting when you instill the eyedrops, and remain sitting for at least five minutes.

Question 26

A client has received cyclopentolate (Cyclogyl), a cycloplegic agent.The nurse advises this client about appropriate safety measures.Additional teaching is required if the client states:
1)"I might experience a dry mouth until the effects of the medication are gone."
2)"I will wear dark glasses until the light sensitivity and blurred vision have resolved."
3)"I will avoid driving or operating hazardous machinery until the effects of the medication are gone."
4)"I will use sunscreen or protective clothing when outdoors because of the risk of sunburn due to photosensitivity."