Chapter 103: Drugs for the Eye

Chapter 103: Drugs for the Eye

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. The nurse is caring for a patient admitted with syncope and sinus bradycardia. The nurse is passing morning medications and prepares to administer medication for glaucoma. Which category of drugs for glaucoma could exacerbate the patient’s heart problems?

a.	Beta blockers
b.	Prostaglandin analogs
c.	Adrenergic agonists
d.	Anticholinergic agonists

 

 

ANS:   A

Blockade of cardiac beta₁ receptors can produce bradycardia and AV heart block, as well as depress cardiac function. Beta blockers would be contraindicated for patients with existing AV heart block, sinus bradycardia, or cardiogenic shock.

Prostaglandin analogs do not adversely affect the heart.

Adrenergic agonists and anticholinergic agonists do not exacerbate heart problems.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 1220

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. A patient is started on latanoprost (Xalatan) for treatment of glaucoma. The nurse provides patient education on the medication. What statement by the patient best demonstrates understanding of latanoprost?

a.	“The drug may produce drowsiness, so I will use caution when driving or operating dangerous machinery.”
b.	“Nausea and vomiting are common side effects, and antiemetic drugs may be needed.”
c.	“Hypotension is common with this medication, so I should change positions slowly.”
d.	“The drug may cause a harmless, heightened brown pigmentation of the iris.”

 

 

ANS:   D

The most significant side effect of latanoprost is a harmless, heightened brown pigmentation of the iris. This statement indicates understanding.

Latanoprost is not known to cause drowsiness; further teaching is needed.

Nausea and vomiting are not common side effects; further teaching is needed.

Latanoprost does not cause hypotension; further teaching is needed.

 

DIF:    Cognitive Level: Application             REF:    p. 1220

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. The nurse is providing education on timolol (Timoptic) to a patient who has been diagnosed with open-angle glaucoma. Which statement by the patient best demonstrates the need for further teaching?

a.	“I should take my pulse prior to each application.”
b.	“I may experience blurred vision.”
c.	“I should cover my skin when I am out in the sun.”
d.	“I may experience stinging and dry eyes.”

 

 

ANS:   C

Covering the skin when out in the sun is consistent with photosensitivity; timolol is associated with photophobia (sensitivity to bright lights). Further teaching is needed.

Because timolol is a beta blocker, it can reduce the heart rate. The patient should evaluate the pulse for slowing prior to medication administration. No further teaching is needed.

Adverse effects of timolol include transient ocular stinging, blurred vision, conjunctivitis, dry eyes, and photophobia, not photosensitivity. No further teaching is needed.

 

DIF:    Cognitive Level: Application             REF:    p. 1219

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. The nurse practitioner is treating a clinic patient who has been diagnosed with open-angle glaucoma. The prescriber orders pilocarpine (Pilocar). What question about the health history would it be most pertinent for the nurse to ask prior to administering the eye drops? “Do you have a history of

a.	asthma?”
b.	rapid heart rate?”
c.	GERD?”
d.	migraines?”

 

 

ANS:   A

The nurse should ask whether the patient has a history of asthma. Caution should be exercised in patients with asthma or bradycardia, because bronchospasm or bradycardia may worsen as a result of the systemic parasympathomimetic effects of pilocarpine. However, these systemic effects are rare.

The systemic effect, although rare, would be bradycardia not tachycardia.

GERD and migraines are not contraindications to pilocarpine.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 1221

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies