Pharmacology Exam 5 - Ear & Eye Disorders

A 3-year-old child, who is brought to the clinic with ear pain, nasal congestion, and low-grade fever, is diagnosed with mild otitis media. The parent becomes upset when an antibiotic is not prescribed immediately. Which statements describe the rationale behind withholding antibiotics? Select all that apply. Acute otitis media usually resolves within 72 hours. Immediate prescription of antibiotics is limited to infants and children with severe illness. Supportive care for pain and fever is usually sufficient for acute otitis media. Side effects and adverse effects can occur with antibiotics. Antibiotics are not effective against most types of otitis media. An antibiotic prescription would require hospitalization for intravenous therapy.

Acute otitis media usually resolves within 72 hours. Immediate prescription of antibiotics is limited to infants and children with severe illness. Supportive care for pain and fever is usually sufficient for acute otitis media. Side effects and adverse effects can occur with antibiotics.

A patient with glaucoma is prescribed timolol after using other medications for increased intraocular pressure. The patient says, "I think there has been a mistake. Isn't that medicine for heart problems?" Which response by the nurse would be appropriate? "This drug in oral form is prescribed for other health issues." "This diuretic acts on the heart and eye to lower pressure." "You might be correct. Let me contact the health care provider for clarification." "Timolol drops only affect the eye pressure, not the heart directly."

"this drug in oral form is prescribed for other health issues"

Which time frame is the duration of action of latanoprost? 2 hours 8 hours 12 hours 24 hours

24 hours

A child is brought to the clinic with possible otitis externa. Which finding would indicate a contraindication for using antibiotic otic drops? Child less than 6 months of age Nasal congestion and discharge Presence of a cough and fever Otalgia and rubbing the ear

Child less than 6 months of age

Which statement describes the action of acetic acid otic drops? Provides analgesic pain relief Dries the external ear canal Serves as an antibiotic for infection Soothes ear canal inflammation

Dries the external ear canal

Which medication would the nurse expect to administer to a newborn to prevent ophthalmia neonatorum? Amoxicillin Erythromycin Loteprednol Natamycin

Erythromycin

A patient is prescribed two ophthalmic drugs, one in drop form and the other in ointment form. Which action would the nurse take to ensure the effectiveness of these drugs? Ask the health care provider to change one drug to oral form. Give the ointment first, wait 1 hour, and then give the drops. Give the drops first, wait 5 minutes, and then use the ointment. Give the ointment, have patient close their eyes, then administer the drops with the patient's eyes closed.

Give the drops first, wait 5 minutes, and then use the ointment.

Which response would the nurse expect to find when assessing a patient 4 weeks after starting timolol, 1 drop daily, for glaucoma? Clouding of the lens has resolved. Intraocular pressure is in normal range. The eye infection has healed. Discharge and tearing are not present.

Intraocular pressure is in normal range.

A child taking amoxicillin has occasional diarrhea. The parent calls the clinic inquiring if the drug should be stopped. Which response would the nurse provide? Reassure the parent that occasional diarrhea may occur, but the drug should not be stopped because of this response. Tell the parent to stop the drug immediately, and report to the health care provider. Instruct the parent to collect a stool sample, and bring it to the clinic for analysis. Ask the parent to hold the drug for 24 hours and to give oral electrolyte solution.

Reassure the parent that occasional diarrhea may occur, but the drug should not be stopped because of this response.

After the nurse instills ear drops, the patient complains of stinging. Which action would the nurse take? Reassure the patient that this is a typical response. Stop the drug, and notify the health care provider. Dilute the drug with normal saline before giving. Use mineral oil in the ear before giving drops.

Reassure the patient that this is a typical response

The nurse is observing a nursing student administer eye ointment. In which situation would the nurse intervene? The lower eyelid is pulled forward to instill the ointment. Ointment is instilled in the lower cul-de-sac starting from inner canthus to outer eye. The student asks the patient to look up while ointment is inserted. The patient is instructed to keep the eye open for 1 minute.

The patient is instructed to keep the eye open for 1 minute.

The nurse is observing a family member use ear drops on a 2-year-old child. The nurse would intervene when the family member takes which action? Positions the child on the side with affected ear up Touches the medication dropper to external ear Pulls external ear down and back Places cotton in the ear after drops are instilled

Touches the medication dropper to external ear

A 2-year-old child is diagnosed with acute otitis media. The nurse would anticipate incorporating which antibiotic into the plan of care? Amoxicillin oral suspension Erythromycin capsules Ciprofloxacin drops Carbamide peroxide drops

Amoxicillin oral suspension

To minimize systemic absorption of an ophthalmic drug administered in drop form, which action would the nurse take? Instill the drops in the outer eye cul-de-sac. Have the patient hold their head still for about 5 minutes. Apply pressure to the punctum on the inner canthus. Instruct the patient to squeeze their nose for 1 minute.

Apply pressure to the punctum on the inner canthus.

A parent contacts the clinic regarding a child who is receiving amoxicillin for acute otitis media. The parent states that the child is not eating and has developed white patches in the mouth. Which action would the nurse take? Reassure the parent that this is probably thrush and should resolve on its own. Ask the parent to bring the child to the clinic because this is probably thrush and needs to be treated. Encourage the parent to give the child cold Popsicles to provide pain relief and hydration. Instruct the parent to discontinue amoxicillin immediately because this could be an allergic response.

Ask the parent to bring the child to the clinic because this is probably thrush and needs to be treated.

The nurse is teaching a patient how to administer eye ointment. After instilling ointment into the lower eye cul-de-sac, which instruction would the nurse give the patient? Close the eyes for about 1 minute. Rapidly blink eyes to distribute the drug. Use punctual pressure on the inner canthus. Place a patch over the eye to protect it.

Close the eyes for about 1 minute.

A patient admitted to the intensive care unit after neurosurgery has lost the eye-blink reflex. Which drug would the nurse anticipate administering to protect the eye and minimize drying? Loteprednol Cyclosporine Tetryzoline Olopatadine

Cyclosporine

A patient is prescribed gatifloxacin drops for an eye infection. Which is the action of this drug? Inhibits DNA synthesis in susceptible gram-positive and some gram-negative bacteria Impedes bacterial protein synthesis primarily in gram-positive and gram-negative organisms Restricts spread of disease by blocking an enzyme and preventing viral multiplication Disrupts the transport system within cell walls and causes cell destruction

Inhibits DNA synthesis in susceptible gram-positive and some gram-negative bacteria

A patient prescribed latanoprost for the treatment of glaucoma calls the nurse to report a headache and intense eye pain. Which action would the nurse take? Reassure the patient that this is an expected response to the drug. Encourage the patient to close his or her eyes and rest for about 1 hour. Instruct the patient to immediately go to the clinic or emergency department. Advise the patient to hold the drug and wait 24 hours before resuming.

Instruct the patient to immediately go to the clinic or emergency department.

A patient is prescribed amoxicillin for the treatment of acute otitis media. The nurse would expect the peak action of amoxicillin to occur within which time frame? 1 to 2 hours 6 to 8 hours 12 to 14 hours 18 to 24 hours

1-2 hours

A patient is prescribed loteprednol, a corticosteroid, for inflammation after eye surgery. Which information is important to convey to the patient to minimize adverse effects of this drug? Continue this drug only for the length of time specified by your health care provider. Wear an eye shield for 1 hour after instillation of this drug. Rise slowly from a sitting position to reduce dizziness with this drug. Do not use this drug with other ophthalmic drugs because of interactions.

Continue this drug only for the length of time specified by your health care provider.

The school nurse is conducting a health class about preventing "swimmer's ear." Which instructions would be included in the class? Select all that apply. Dry the outer ear completely after swimming or bathing. Use a cotton swab to make sure the ear canal is dry. Remove moisture by using a towel-covered finger to wipe the external ear. Tilt the head to the side to drain moisture from the ear. Use a hair dryer to help keep the ear canal dry. Avoid use of alcohol in the ear canal because it causes itching.

Dry the outer ear completely after swimming or bathing Remove moisture by using a towel-covered finger to wipe the external ear Tilt the head to the side to drain moisture from the ear Use a hair dryer to keep the ear canal dry

The nurse would monitor a postoperative ophthalmic surgery patient for which outcome after administering loteprednol? Lowered intraocular pressure in affected eye Reduced postoperative pain and inflammation Promotion of the flow of tears through the lacrimal duct Decreased risk for superficial infection caused by surgery

Reduced postoperative pain and inflammation

Which statement describes the rationale for using hydrocortisone for otitis externa? Treats the current ear infection Reduces swelling and inflammation Softens the ear wax to aid healing Dries the external ear canal

Reduces swelling and inflammation

Which statement describes the rationale for using carbamide peroxide otic drops? Prevents and treats otitis media Decreases inflammation in the ear Removes excessive cerumen Decreases pain from infection

Removes excessive cerumen

A patient comes to the emergency department complaining of eye pain and excessive tearing. The nurse suspects eye trauma and secures fluorescein sodium drops. Which is the rationale for using fluorescein? Stains the eye for better visualization Dilates the pupil for clear internal analysis Anesthetizes the eye to decrease sensitivity Lubricates and provides eye moisture

Stains the eye for better visualization

A patient is prescribed oral amoxicillin for acute otitis media. Before administration the nurse notes that the patient is allergic to penicillin. Which action would the nurse take? Give the drug because the health care provider is probably aware of the allergy. Hold the drug, and notify the health care provider about the penicillin allergy. Administer amoxicillin because it is not a penicillin drug. Secure an antihistamine prescription to administer before the amoxicillin.

Hold the drug, and notify the health care provider about the penicillin allergy.

When preparing to administer hydrocortisone ear drops, the nurse finds that the patient has a ruptured tympanic membrane. Which action would the nurse take? Give the ear drops because it was prescribed. Hold the ear drops and notify the health care provider. Use a wick to slowly give the drug. Apply warmth to promote healing.

Hold the ear drops and notify the health care provider

A patient with otitis externa reports having ear pain when instilling otic drops. Which action would the nurse take? Reassure the patient that this is a common side effect. Instruct the patient to warm the drug by rolling the container between the hands. Encourage the patient to contact the health care provider with this information. Advise the patient to immediately discontinue using the drops.

Instruct the patient to warm the drug by rolling container between the hands

The patient's hands are shaking while trying to administer eye drops. To promote self-care for a patient who is having difficulty instilling eye drops, which action would the nurse take? Inquire if patient needs an antianxiety drug to lessen shaking. Suggest that a family member learn to give the drops. Ask the health care provider about switching to an oral medication. Indicate that adaptive eye devices might help with instillation.

Indicate that adaptive eye devices might help with instillation.

A patient comes to the clinic for a routine eye examination and is diagnosed with an eye infection. Which drug may be given to treat this infection? Cyclosporine (dry eyes) Tetryzoline (eye inflammation) Homatropine (pupil dialation) Gatifloxacin (anti-bacterial)

Gatifloxacin

A patient is prescribed timolol drops for glaucoma. Which information would the nurse include when teaching about the pharmacodynamics of this drug? The drug's onset of action is immediate, and it lasts for about 12 hours. Drops should be used frequently due to its short duration of action. It may take a few weeks of taking the drug to get the full effect. Only use the drug when irritation of the eye occurs.

It may take a few weeks of taking the drug to get the full effect.

A patient with glaucoma has a prescription for latanoprost drops. Which action of latanoprost causes reduction in ocular pressure? Relaxes eye blood vessels, promoting drainage Decreases aqueous humor production Reduces drainage space through pupil miosis Increases outflow through pupil dilation

Relaxes eye blood vessels, promoting drainage

A patient asks the nurse how timolol works to relieve glaucoma. Which explanation would the nurse provide? The drug reduces production of aqueous humor in the eye, thereby reducing intraocular pressure. The drug acts like a diuretic, eliminating fluid from the body and the eye. The drug lowers systemic blood pressure, which in turn reduces the pressure within the eye. The drug reduces intraocular pressure through antiinflammatory action.

The drug reduces production of aqueous humor in the eye, thereby reducing intraocular pressure.

After administering ophthalmic drops, which instructions would the nurse give the patient? Keep the eyes open for 1 minute. Blink rapidly to distribute the drug. Squeeze the eyes tightly shut. Use punctual pressure for 2 to 3 minutes.

Use punctual pressure for 2 to 3 minutes.

The nurse is teaching a patient about using timolol for glaucoma. Which safety concerns would the nurse emphasize? Select all that apply. When moving from a light room to a dark room, pause a few minutes to allow vision to adjust. Report any drooling or sweating (symptoms of drug overdose) to the health care provider. Use caution when driving because vision may be blurred with this drug. Dizziness may occur with this drug. Move slowly from a sitting to a standing position. Be aware that this drug may cause dry, itchy, or red eyes after use. Development of brown discoloration of the pupil may impair vision.

When moving from a light room to a dark room, pause a few minutes to allow vision to adjust. Use caution when driving because vision may be blurred with this drug. Dizziness may occur with this drug. Move slowly from a sitting to a standing position.