Chapter 104: Drugs for the Eye

Chapter 104: Drugs for the Eye

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient begins using timolol [Timoptic] to treat primary open-angle glaucoma (POAG). The nurse gives a dose and notes that the patient develops shortness of breath. The nurse assesses the patient and auscultates wheezes in both lungs. The nurse will ask this patient about a history of which condition?

a.	Asthma
b.	Atrioventricular heart block
c.	Pulmonary hypertension
d.	Sinus bradycardia

 

 

ANS:  A

Timolol is a beta blocker and can precipitate bronchoconstriction when absorbed systemically. Patients with asthma will develop shortness of breath and wheezing. These symptoms are not associated with AV block, pulmonary hypertension, or sinus bradycardia.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 1270

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

2. A nursing student asks the nurse to discuss the differences between POAG and angle-closure glaucoma. Which statement by the nurse is correct?

a.	“Angle-closure glaucoma may be asymptomatic until irreversible damage has occurred.”
b.	“Both types are more common in African American patients.”
c.	“Drug therapy is the definitive treatment for angle-closure glaucoma.”
d.	“Early treatment with prostaglandin analogs can stop the progression of POAG.”

 

 

ANS:  D

Prostaglandin analogs are first-line agents for treating POAG, and early treatment can stop the progression. Angle-closure glaucoma has a rapid onset of painful symptoms. POAG is more common in African Americans but angle-closure glaucoma is not. Surgery, not drugs, is the definitive treatment for angle-closure glaucoma.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 1267-1269

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

3. A nurse administers timolol [Timoptic] ophthalmic drops to a patient who has glaucoma. The patient reports stinging of the eyes shortly after the drops were administered. What will the nurse do?

a.	Monitor the patient’s heart rate, respiratory rate, and blood pressure.
b.	Notify the provider that the patient shows signs of angle-closure glaucoma.
c.	Reassure the patient that these are localized, reversible effects of the drug.
d.	Request an order for an antihistamine to treat this allergic response to the drug.

 

 

ANS:  C

Local effects of timolol and other beta blockers are generally minimal, but transient ocular stinging can occur. There is no need to monitor vital signs, because this does not represent a systemic reaction. This is not a sign of angle-closure glaucoma. Antihistamines will not help.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 1269-1270

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

4. A patient has been using latanoprost [Xalatan] ophthalmic drops. The patient tells the nurse, “My eyes used to be greenish-brown, but now they’re brown.” What will the nurse do?

a.	Reassure the patient that this is a harmless side effect.
b.	Report this toxic effect to the patient’s provider.
c.	Tell the patient that this indicates an increased risk of migraine headaches.
d.	Tell the patient that this effect will reverse when the medication is withdrawn.

 

 

ANS:  A

Latanoprost can cause a harmless, heightened brown pigment of the iris that stops when the medication is discontinued but does not regress. It is not a sign of a toxic reaction. It does not indicate an increased risk of developing migraines. It will not reverse.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 1270

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies