Chapter 50

Which classification of prescription should the nurse plan to administer to the client experiencing a closed angle glaucoma attack? 1) Beta-adrenergic antagonists 2) Prostaglandin analogs 3) Osmotic diuretics 4) Carbonic anhydrase inhibitors

3) Osmotic diuretics p.816

Which should the nurse monitor the client for who has experienced a significant systemic absorption of Timolol (Betimol)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Blurred vision 2) Dysrhythmias 3) Hypertension 4) Hypotension 5) Hyperglycemia

2) Dysrhythmias 4) Hypotension p.816

Which information should the nurse provide the client that asks how glaucoma develops? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "Having diabetes is a risk factor in the development of glaucoma." 2) "Glaucoma exists when the pressure in your eye is high enough to cause optic nerve damage." 3) "High blood pressure can certainly lead to the development of glaucoma." 4) "A history of hyperthyroidism is a risk factor in the development of glaucoma." 5) "Drugs like antihistamines and antidepressants can contribute to glaucoma."

1) "Having diabetes is a risk factor in the development of glaucoma." 2) "Glaucoma exists when the pressure in your eye is high enough to cause optic nerve damage." 3) "High blood pressure can certainly lead to the development of glaucoma." 5) "Drugs like antihistamines and antidepressants can contribute to glaucoma." p812

The nurse has completed the education for a client prescribed timolol (Timoptic). Which statement made by the client indicates an understanding of the information? 1) "I understand I may experience blurred vision after administering the prescription." 2) "I will store my drops in the refrigerator and make sure it is room temperature before instilling the drops." 3) "I will restrict my caffeine to one cup of coffee per day." 4) "I will discontinue the drops if my eyes appear reddened."

1) "I understand I may experience blurred vision after administering the prescription." p.816

Which statements indicate a client understands the diagnosis of open-angle glaucoma? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "My eye cannot drain the fluid that it produces." 2) "One of the first signs of this is pain behind my eyes." 3) "My type of glaucoma is a medical emergency." 4) "This is a gradual process; it may take years to develop." 5) "This is the most common kind of glaucoma."

1) "My eye cannot drain the fluid that it produces." 4) "This is a gradual process; it may take years to develop." 5) "This is the most common kind of glaucoma." p.813

Which is most often associated with otitis media? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply 1) Allergies 2) Asthma 3) Colds 4) Lower respiratory infections 5) Auditory tube irritations

1) Allergies 5) Auditory tube irritations p. 819

Which condition should the nurse be concerned about for a client prescribed beta-adrenergic blocker ophthalmic drops for the treatment of glaucoma? 1) Asthma 2) Diabetes mellitus 3) Pancreatitis 4) Duodenal ulcer

1) Asthma p. 815

Which best describes open-angle glaucoma? 1) Bilateral with a slow onset 2) Less common than closed-angle glaucoma 3) Accompanied by eye pain 4) Unilateral with a rapid onset

1) Bilateral with a slow onset p.813

Which classification of drugs should the nurse anticipate to be administered for a client requiring an eye exam? 1) Mydriatics 2) Vasoconstrictors 3) Prostaglandins 4) Beta-adrenergic blockers

1) Mydriatics p.818

A client asks the nurse how dipivefrin (Propine) will decrease their IOP. Which information should the nurse provide? 1) The prescription will dilate the pupil increasing the outflow of the aqueous humor. 2) The prescription will lower IOP by enhancing the outflow of aqueous humor. 3) The prescription will decrease the production of aqueous humor. 4) The prescription acts by decreasing the production of aqueous humor by the ciliary body.

1) The prescription will dilate the pupil increasing the outflow of the aqueous humor. p. 815

Which testing should the nurse schedule the client for 2 months after pharmacotherapy has begun to treat open-angle glaucoma? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Visual field changes 2) Dilation of the pupils 3) Light refraction 4) Intraocular pressure 5) Slit lamp exam

1) Visual field changes 4) Intraocular pressure p.813

A client tells the nurse that the timolol (Timoptic) eyedrops sting their eyes. Which response should the nurse provide the client? 1) "Hold the next dose and contact your healthcare provider." 2) "This is a normal and expected effect of the drops." 3) "Your eyedrops may have expired; check the date." 4) "You should flush your eyes immediately with saline."

2) "This is a normal and expected effect of the drops." p. 816

Which statements made by a client indicate that they may be experiencing closed-angle glaucoma? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "My vision has gotten worse over time." 2) "I have a headache that will not go away." 3) "I see hallows around bright lights." 4) "I have been experiencing a dull pain in my eyes." 5) "My eyes are so blood shot."

2) "I have a headache that will not go away." 3) "I see hallows around bright lights." 4) "I have been experiencing a dull pain in my eyes." 5) "My eyes are so blood shot." p.813

A client asks the nurse what swimmer's ear is. Which information should the nurse include in the discussion? 1) "The fluid is trapped in the middle ear." 2) "It is an inflammation of your external auditory canal." 3) "The infection is behind the tympanic membrane." 4) "There is fluid in the vestibule of the inner ear."

2) "It is an inflammation of your external auditory canal." p. 819

Which describes the mechanism of action of prostaglandin analogs used for the treatment of intraocular pressure? 1) Produce miosis, constriction of the pupil, and contraction of the ciliary muscle 2) Enhance the outflow of aqueous humor 3) Decreasing the production of aqueous humor by the ciliary body 4) Decrease the formation of aqueous humor by reducing the plasma volume

2) Enhance the outflow of aqueous humor p.816

Which information should the nurse include in the education for a client prescribed eye drops for glaucoma? 1) Keep the lights dim after administration to avoid light sensitivity. 2) Instill the drops into the conjunctival sack and lacrimal duct area. 3) Hold pressure for 5 minutes to prevent leakage into the nasopharynx. 4) Avoid wearing contact lenses until treatment is completed.

2) Instill the drops into the conjunctival sack and lacrimal duct area. p.817

Which symptom does the nurse anticipate for a client who has experienced systemic absorption of cholinergic eye drops? 1) Bradycardia 2) Salivation 3) Hypotension 4) Tremors

2) Salivation p.814

Which findings should the nurse discuss with the prescriber prior to administering a client prescribed brinzolamide (Azopt)? 1) The client is a vegetarian. 2) The client is allergic to sulfa. 3) The client has a history of atopic dermatitis. 4) The client's father had a myocardial infarction at age 35.

2) The client is allergic to sulfa. p. 816

Which is responsible for the secretion of aqueous humor? 1) Anterior chamber 2) Posterior chamber 3) Ciliary body 4) Canal of Schlemm

3) Ciliary body p. 811

Which assessment finding indicates the pharmacological treatment for the client with open-angle glaucoma is therapeutic? 1) Decreased photophobia 2) IOP of 32 mmHg 3) Improved visual acuity 4) Absence of headaches

3) Improved visual acuity p. 817

Which should the nurse plan to administer to a client that requires the enhancement of tear production? 1) Topical corticosteroid 2) Cetirizine ophthalmic (Zerviate) 3) Lifitegrast (Xiidra) 4) Olopatadine (Patanol)

3) Lifitegrast (Xiidra) p. 818, 819

Which initial technique should the nurse use to facilitate the removal of cerumen? 1) A sterile cotton-tipped applicator to remove cerumen 2) Instill 2% acetic acid in each ear 3) Flush with warm water 4) Instill an earwax softener

4) Instill an earwax softener p.820

Which measurements of intraocular pressure should the nurse recognize requires pharmacological intervention? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) A single reading of 14 mmHg. 2) A consistent reading trending between 15 and 16 mmHg. 3) A single reading of 19 mmHg. 4) Readings consistently higher than 21 mmHg. 5) A single reading of 32 mmHg.

4) Readings consistently higher than 21 mmHg. 5) A single reading of 32 mmHg. p.813

The nurse has provided client education about the treatment for open-angle glaucoma. Which statement made by the client indicates an understanding of the information? 1) "The eyedrops are only required if I feel discomfort in my eyes." 2) "The strength of the prescription will continue to be increased." 3) "I can stop the eyedrops when the glaucoma has resolved." 4) "I will have to use eyedrops for the rest of my life."

4) "I will have to use eyedrops for the rest of my life." p. 812, 813

The nurse has provided discharge teaching for a client prescribed a mydriatic drug. Which statement made by the client indicates further teaching is required? 1) "I may have periods of blurry vision for several days." 2) "I will wear sunglasses while I am outside." 3) "I will not drive until this drug wears off." 4) "I will use artificial tears if my eyes feel dry."

4) "I will use artificial tears if my eyes feel dry." p. 818

Which structures contain aqueous humor? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Fovea 2) Sclera 3) Conjunctiva 4) Anterior chamber 5) Posterior chamber

4) Anterior chamber 5) Posterior chamber p. 811

Which should the nurse anticipate to be prescribed for the primary treatment of mastoiditis? 1) Corticosteroid 2) Wax softener 3) Antifungal agent 4) Antibiotic

4) Antibiotic p.819

Which finding is an adverse effect of prostaglandins, such as latanoprost (Xaltan)? 1) Hypotension 2) Nausea 3) Tachycardia 4) Eye pain

4) Eye pain p.815

Which describes the primary mechanism of action of beta-adrenergic blockers for the treatment of open-angle glaucoma? 1) Increase the outflow of aqueous humor 2) Constrict the pupil. 3) Dilate the pupil to increase outflow. 4) Reduce production of aqueous humor.

4) Reduce production of aqueous humor. p.815

Which information should the nurse provide the client prescribed cycloplegic eye drops prior to an eye examination? 1) The drugs will dilate the pupil and lubricate the eye to provide additional comfort during the examination. 2) The drops will paralyze the muscles that move the eye so that examination can take place. ) The drops will dilate the pupil so that the physician can better visualize the retina during examination. 4) The drops dilate the pupil and paralyze the ciliary muscle to prevent the lens from moving during examination.

4) The drops dilate the pupil and paralyze the ciliary muscle to prevent the lens from moving during examination. p.818