M. 50: Drugs for Eye and Ear Disorders - NCLEX-Style Questions

A client is diagnosed with​ closed-angle glaucoma. Which treatment should the nurse​ question?

Alpha2​-adrenergic agonist medication An alpha2​-adrenergic medication is approved for​ open-angle glaucoma.​ Iridectomy, drainage​ implants, and laser trabeculoplasty are appropriate treatment options for​ closed-angle glaucoma.

A client is diagnosed with otitis externa. Which drug should the nurse expect the client to be​ prescribed? (Select all that​ apply.)

Analgesic Antibiotic Corticosteroid Otitis externa is typically treated with a topical​ analgesic, antibiotic, and corticosteroid. Chronic otitis externa may be treated with an antifungal medication. An antihistamine and mast cell stabilizer may be prescribed to treat allergic conjunctivitis.

The nurse is assessing a​ client's risk of developing glaucoma. Which medication should the nurse recognize as increasing this​ risk? (Select all that​ apply.)

Antihypertensives Corticosteroids Antihistamines Antidepressants ​Long-term use of​ corticosteroids, antihistamines,​ antidepressants, and some antihypertensives increases the risk of developing secondary glaucoma. NSAIDs do not specifically increase the risk of developing glaucoma.

A client is prescribed timolol​ (Betimol, Timoptic). Which risk factor should the nurse address before administering the​ medication? (Select all that​ apply.)

Asthma Heart failure Sinus bradycardia Timolol is contraindicated in clients with​ asthma, severe chronic obstructive pulmonary disease​ (COPD), sinus​ bradycardia, second- or​ third-degree atrioventricular​ block, heart​ failure, cardiogenic​ shock, or hypersensitivity to the drug. Treatment of hypertension and aphakic glaucoma are therapeutic effects of timolol.

A client is prescribed latanoprost​ (Xalatan). Which client risk factor should the nurse address before administering the​ medication? (Select all that​ apply.)

Closed-angle glaucoma Intraocular infection Pregnancy Latanoprost​ (Xalatan) is contraindicated in​ pregnancy, intraocular​ infection, and​ closed-angle glaucoma. Treatment of​ open-angle glaucoma and ocular hypertension are therapeutic effects of latanoprost.

The nurse is assessing a client with glaucoma. Which finding should indicate to the nurse that medication might be improperly​ used?

Consistent intraocular pressure​ (IOP) readings above 21 mmHg Consistent IOP readings above 21 mmHg indicate possible improper medication use or worsening glaucoma despite proper medication use. Increased length and thickness of eyelashes and a report of burning and stinging sensations in the eye are common adverse effects of certain antiglaucoma​ medications; experiencing adverse effects does not necessarily indicate improper medication use. Antiglaucoma medications help lower IOP and preserve​ vision, but they do not improve vision that has already been lost.

The nurse suspects a client has undiagnosed glaucoma. Which finding should the nurse use to confirm this clinical​ determination? (Select all that​ apply.)

Eye pain Change in visual fields Foggy vision Halos around lights Manifestations of glaucoma include eye​ pain, foggy​ vision, halos around​ lights, and changes in visual fields. A frontal headache is not a manifestation of glaucoma.

The nurse is asked to explain intraocular pressure​ (IOP). Which factor should the nurse​ consider? (Select all that​ apply.)

IOP fluctuates depending on the time of day. Daily activities cause IOP to fluctuate. IOP greater than 30 mmHg requires treatment. Age, daily​ activities, and time of day influence IOP. IOP greater than 30 mmHg requires treatment to prevent permanent visual changes. The median IOP in the population is 15 to 16 mmHg.

The nurse is asked if mydriatic medication is used to treat​ open-angle glaucoma. Which effect of mydriatic medications should the nurse​ explain?

Impairs aqueous humor outflow Mydriatic medications impair aqueous humor outflow and thereby increase IOP and worsen glaucoma. Mydriatic medications do not cause optic nerve​ regeneration, increase aqueous humor​ production, or cause a dangerously low IOP.

A client is taking latanoprost​ (Xalatan). Which should the nurse identify as a systemic adverse effect of the​ medication?

Joint pain Respiratory​ infection, flu,​ angina, and muscle or joint pain are signs of systemic adverse effects from latanoprost​ (Xalatan). Darkening of the​ iris, thicker, darker​ eyelashes, and a sensation of a foreign body in the eye are also adverse​ effects, but are not systemic adverse effects.

A client is diagnosed with allergic conjunctivitis. Which type of medication should the nurse expect to be​ prescribed?

Mast cell stabilizer Mast cell stabilizers and antihistamines are medications prescribed to treat allergic conjunctivitis. This health problem is not treated with a​ mydriatic, cycloplegic, or vasoconstrictor medication.

A​ client's pupils decrease in size from 4 mm to 1 mm. Which factor should the nurse recognize as causing the pupil​ constriction?

Parasympathetic nervous system stimulation Pupil constriction results from stimulation of the parasympathetic nervous system. Sympathetic nervous system stimulation results in pupil dilation. Increased vitreous and aqueous humor production do not affect pupil size.

A client is diagnosed with​ open-angle glaucoma. Which treatment should the nurse​ expect?

Prostaglandin analog medication ​ Iridectomy, drainage​ implants, and laser trabeculoplasty are surgical interventions for​ closed-angle glaucoma.​ Open-angle glaucoma can usually be successfully treated with​ medications, such as a prostaglandin analog medication.

A client with glaucoma reports forgetting to take prescribed medication most days of the week. What should the nurse expect to assess in this​ client?

Reduction in vision Nonadherence to the prescribed treatment for glaucoma may result in the total loss of vision. Nonadherence to the prescribed medication regime will not cause​ drainage, eye​ tearing, or eye redness.

The nurse reviews a​ client's prescribed medications. For which additional medication should the nurse withhold the dose of timolol​ (Betimol, Timoptic)?​ (Select all that​ apply.)

Reserpine Methyldopa Verapamil Hypotension and bradycardia can occur if timolol​ (Betimol, Timoptic) is combined with​ reserpine, verapamil, or methyldopa. Brimonidine and dorzolamide can be taken with timolol to further lower intraocular pressure.

A client has an acute outflow obstruction of aqueous humor in the eye. Which symptom should the nurse​ expect? (Select all that​ apply.)

Seeing colored halos around lights Headache Facial pain Bulging iris Headache, facial​ pain, bulging​ iris, and seeing colored halos around lights are expected symptoms of an acute outflow obstruction of aqueous humor in the eye.​ Also, the client would have a sudden decrease in visual​ acuity, nonreactive pupillary response in the affected​ eye, a reddened​ eye, and possible nausea and vomiting because of ocular pain. An acute outflow obstruction of aqueous humor increases intraocular pressure.

The nurse is asked how a cholinergic agonist reduces intraocular pressure​ (IOP). Which mechanism of action should the nurse include in the​ explanation?

Stretching of the trabecular meshwork A cholinergic agonist decreases IOP by causing a stretching of the trabecular meshwork to allow greater outflow of aqueous humor. A cholinergic agonist does not block the canal of​ Schlemm, decrease aqueous humor​ production, or block aqueous humor flow to the anterior chamber.

A client asks why contact lenses should be removed before instilling antiglaucoma eyedrops. Which teaching should the nurse​ provide? (Select all that​ apply.)

The eyedrop may not reach all surfaces of the eye. Contact lenses may absorb the medication. Contact lenses may absorb the medication​ (resulting in higher than expected amounts in the eye over​ time), or the eyedrop may not reach all surfaces of the eye. Contact lenses should be removed before instilling eyedrops and should be kept out for at least 15 minutes. It is incorrect that IOP will immediately increase and that the risk of systemic medication absorption increases if eyedrops are instilled while contact lenses are in the eyes. To prevent​ contamination, the eyedrop bottle tip should never touch the bare surface of the eye.

The nurse is asked to explain the importance of the​ malleus, incus, and stapes in the ear. Which function should the nurse​ include?

Transmit sound waves to the inner ear The​ malleus, incus, and stapes are responsible for transmission of sound waves to the inner ear. The semicircular canals and vestibule are responsible for equilibrium and balance. The eustachian tube allows air to enter or leave the middle ear​ cavity, which permits equalization of pressure in the middle ear.

The nurse is teaching a client how to administer eyedrops for glaucoma. Which client statement should indicate that teaching was​ effective?

​"I will hold gentle pressure to the tear duct after instilling the​ drop." The client should be instructed to hold gentle pressure to the lacrimal duct for 1 full minute after instilling eyedrops. The eyedrops should be instilled into the conjunctival sac. The eyes should be gently closed to prevent the medication from leaking out and onto the skin. Antiglaucoma eyedrops should not be instilled while contact lenses are in the eyes.