Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 38

Question 1

Type: MCSA

In the anterior chamber of the eye, what is the medical term for the watery fluid that is found here?

1. Ciliary body
2. Canal of Schlemm
3. Trabecular meshwork
4. Aqueous humor

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 640

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-1 Describe important anatomy relevant to disorders of the eyeball.

Question 2

Type: MCSA

The client has been diagnosed with acute glaucoma. What are the common causes for this condition?

1. Trauma or hemorrhage
2. Increased intracranial pressure
3. Decreased intraocular pressure
4. Diabetes mellitus or renal disease

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 642

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-2 Identify the major risk factors associated with closed-angle glaucoma and open-angle glaucoma, and explain how increased intraocular pressure may cause blindness.

Question 3

Type: MCSA

The nurse is caring for a client who is diagnosed with glaucoma. The client wants to know why this condition can lead to blindness. What is the best response by the nurse?

1. The fluid in the eye blocks the optic nerve.
2. Pressure around the optic nerve builds over time.
3. The optic nerve cannot transmit signals with glaucoma.
4. The optic nerve atrophies.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 642

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-2 Identify the major risk factors associated with closed-angle glaucoma and open-angle glaucoma, and explain how increased intraocular pressure may cause blindness.

Question 4

Type: MCMA

The nurse is caring for a client with closed-angle glaucoma. What are the characteristics of this disorder the nurse must be aware of when providing care? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. It is caused by stress.
2. It is the most common type of glaucoma.
3. It is caused by impact injury.
4. The pressure develops slowly, over time.
5. The pressure develops quickly.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 642

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-2 Identify the major risk factors associated with closed-angle glaucoma and open-angle glaucoma, and explain how increased intraocular pressure may cause blindness.

Question 5

Type: MCMA

The nurse is caring for a client with open-angle glaucoma. What are the characteristics of this disorder the nurse must be aware of when providing care? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. It is caused by impact injury.
2. It is the most common type of glaucoma.
3. Intraocular pressure develops slowly.
4. The iris does not cover trabecular meshwork.
5. Intraocular pressure develops quickly.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 642

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-2 Identify the major risk factors associated with closed-angle glaucoma and open-angle glaucoma, and explain how increased intraocular pressure may cause blindness.

Question 6

Type: MCMA

Which medications increase the outflow of aqueous humor? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Miotics
2. Sympathomimetics
3. Prostaglandins
4. Beta blockers
5. Calcium channel blockers

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 642

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-3 Explain the two major mechanisms by which drugs reduce intraocular pressure.

Question 7

Type: MCMA

Which medications decrease the formation of aqueous humor? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Carbonic anhydrase inhibitors
2. Alpha₂-adrenergic agents
3. Osmotic diuretics
4. Prostaglandins
5. Beta-adrenergic blockers

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 644

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-3 Explain the two major mechanisms by which drugs reduce intraocular pressure.

Question 8

Type: MCSA

A client has been prescribed latanoprost (Xalatan). The nurse informs the client regarding potential side effects. Which side effect is not appropriate for the nurse to include in the client teaching?

1. Decreased pigmentation
2. Dryness
3. Photophobia
4. Heightened pigmentation

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 643

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-4 Identify important drugs that increase the outflow of aqueous humor and discuss primary actions and possible adverse effects.

Question 9

Type: MCSA

The client has been prescribed travoprost (Travatan). When does the nurse anticipate the maximum effect of this medication occurs?

1. 12 hours after administration
2. 4 hours after administration
3. 2 hours after administration
4. 6 hours after administration

Cognitive Level: Remembering

Client Need: Physiological Integrity

Page Number: 643

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-4 Identify important drugs that increase the outflow of aqueous humor and discuss primary actions and possible adverse effects.

Question 10

Type: MCSA

A client has been prescribed timolol (Timoptic). When does the maximum therapeutic effect occur for the medication?

1. It takes 6–8 weeks.
2. It begins immediately.
3. It takes 2–4 weeks.
4. It takes 1–2 weeks.

Cognitive Level: Remembering

Client Need: Physiological Integrity

Page Number: 644

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-5 Identify important drugs that decrease the formation of aqueous humor and discuss primary actions and possible adverse effects.

Question 11

Type: MCSA

The client complains of blurry vision after using pilocarpine (Isopto Carpine). Which explanation about the blurry vision is most appropriate by the nurse?

1. “This is a common reaction, but should be temporary.”
2. “Use only half the dose, and monitor the results.”
3. “I will have the physician prescribe something different for you.”
4. “You have an allergy, and should stop using the drops.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 643

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-4 Identify important drugs that increase the outflow of aqueous humor and discuss primary actions and possible adverse effects.

Question 12

Type: MCSA

What is the most appropriate explanation as to why dipivefrin hydrochloride (Propine) effectively decreases intraocular pressure?

1. The exact mechanism is not fully understood.
2. It decreases the formation of aqueous humor.
3. It reduces plasma volume very quickly.
4. It converts to epinephrine and increases outflow of aqueous humor.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 643

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-4 Identify important drugs that increase the outflow of aqueous humor and discuss primary actions and possible adverse effects.

Question 13

Type: MCSA

To prevent systemic absorption of timolol (Timoptic), what administration instructions are appropriate for the nurse to include in the teaching?

1. Apply pressure over the lacrimal sac for 1 minute.
2. Wait 5 minutes before administering other ophthalmic solutions.
3. Administer the eyedrop in the conjunctival sac.
4. Remove contact lenses prior to administering eyedrops.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 646

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-5 Identify important drugs that decrease the formation of aqueous humor and discuss primary actions and possible adverse effects.

Question 14

Type: MCMA

Which medications are appropriate for minor irritation and injury? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. NSAIDs
2. Diphenhydramine HCl (Benadryl)
3. Antimicrobials
4. Local anesthetics
5. Insulin (Humulin R)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 647

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-6 Identify examples of drugs that dilate or constrict pupils, relax ciliary muscles, constrict ocular blood vessels, or moisten eye membranes.

Question 15

Type: MCSA

Which medication does the nurse anticipate for a client who will undergo an ophthalmic examination?

1. Antimicrobials and local anesthetics
2. Local anesthetics and NSAIDs
3. Corticosteroids and antibiotics
4. Cycloplegics and mydriatics

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 647

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 38-6 Identify examples of drugs that dilate or constrict pupils, relax ciliary muscles, constrict ocular blood vessels, or moisten eye membranes.

Question 16

Type: MCSA

Following an extensive eye examination where a mydriatic agent was utilized, which nursing diagnosis is most appropriate for the client?

1. Pain, related to chemical agents
2. Risk for injury, related to visual acuity deficits
3. Self-care deficit, related to impaired vision
4. Deficient knowledge, related to disease process

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 647

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 38-6 Identify examples of drugs that dilate or constrict pupils, relax ciliary muscles, constrict ocular blood vessels, or moisten eye membranes.

Question 17

Type: MCSA

The client asks the nurse which OTC medication will lubricate the eye and cause vasoconstriction. Which response by the nurse is correct?

1. “Oxymetazoline (OcuClear).”
2. “Betaxolol (Betaoptic).”
3. “Polyvinyl alcohol (Liquifilm).”
4. “Lanolin alcohol (Lacri-lube).”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 647

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 38-6 Identify examples of drugs that dilate or constrict pupils, relax ciliary muscles, constrict ocular blood vessels, or moisten eye membranes.

Question 18

Type: MCSA

The nurse is reviewing a medication administration record. Which medication from the list is considered a mydriatic agent?

1. Phenylephrine (Neo-Synephrine)
2. Cyclopentolate (Cyclogyl)
3. Atropine sulfate (Isopto Atropine)
4. Scopolamine hydrobromide (Isopto Hyoscine)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 647

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 38-6 Identify examples of drugs that dilate or constrict pupils, relax ciliary muscles, constrict ocular blood vessels, or moisten eye membranes.

Question 19

Type: MCSA

The nurse is providing education to a client with a history of earwax buildup. Which medication does the nurse include in the teaching session?

1. Acetic acid and hydrocortisone (Vosol HC)
2. Ciprofloxacin hydrochloride and hydrocortisone (Cipro HC)
3. Carbamide peroxide (Debrox)
4. Polymyxin B, neomycin, and hydrocortisone (Cortisporin)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 649

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 38-7 Identify examples of drugs that treat conditions of the ear.

Question 20

Type: MCSA

What instructions are appropriate for the nurse to include when teaching a client ways to prevent “swimmer’s ear”?

1. Use of glucocorticoid drops to prevent inflammation
2. Application of 2% acetic acid to the ear canal after swimming
3. Gently cleaning the ear canal with a swab to remove water or debris
4. Use of earwax-dissolving agents to help prevent irritation

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 649

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 38-7 Identify examples of drugs that treat conditions of the ear.

Question 21

Type: MCSA

The nurse is caring for a client who is experiencing inflammation that involves the middle ear. What is the appropriate medical term for the nurse to include in the documentation for this client?

1. Swimmer’s ear
2. Mastoiditis
3. Otitis media
4. Otitis externa

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 648

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-7 Identify examples of drugs that treat conditions of the ear.

Question 22

Type: MCSA

Neomycin and hydrocortisone (Cortisporin) may be used in combination to treat ear infections. What is the combined effect of these medications?

1. Antipyretic and antifungal
2. Anti-inflammatory and antibiotic therapy
3. Antibiotic therapy with an analgesic
4. Antibiotic and prophylactic therapy

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 649

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 38-7 Identify examples of drugs that treat conditions of the ear.

Question 23

Type: MCSA

What instruction is appropriate for a client who wants to clean the ear canal?

1. Use a bulb syringe approved for removing debris and cold water.
2. Never attempt to clean the ear canal at home.
3. Use a bulb syringe approved for removing debris and warm water.
4. Use a cotton swab.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 649

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:38-7 Identify examples of drugs that treat conditions of the ear.

Question 24

Type: MCSA

Which area of the eye is responsible for allowing aqueous humor to drain from the anterior chamber?

1. Ciliary body

2. Canal of Schlemm

3. Trabecular meshwork

4. Aqueous humor

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 641

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-1 Describe important anatomy relevant to disorders of the eyeball.