Chapter 43: Drugs Used to Treat Glaucoma and Other Eye Disorders

Chapter 43: Drugs Used to Treat Glaucoma and Other Eye Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is preparing a patient for an ophthalmic examination. Which action occurs when the nurse instills eye drops to produce mydriasis?

a.	Drying of tears in the eyes
b.	Extreme dilation of the pupil
c.	Opening of the canal of Schlemm
d.	Paralysis of the ciliary muscle

 

 

ANS:  B

Dilating the eye before eye examinations allows for better visualization of the interior of the globe. Anticholinergic drugs may produce drying of tears in the eye as an adverse effect of use. Obstruction of the canal of Schlemm results in glaucoma. Paralysis of the ciliary muscle is cycloplegia.

 

DIF:    Cognitive Level: Application           REF:   p. 678             OBJ:   6

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

2. Which type of medication would be used to dilate the pupils before an eye examination?

a.	Osmotics
b.	Adrenergic agent
c.	Beta adrenergic agent
d.	Corticosteroid

 

 

ANS:  B

Adrenergic agents are sympathomimetic. They cause pupil dilation, increased outflow of aqueous humor, vasoconstriction, relaxation of ciliary muscle, and a decrease in the formation of aqueous humor. Adrenergic agents are used to lower intraocular pressure (IOP) in open angle glaucoma, relieve congestion and hyperemia, and produce mydriasis for ocular examinations. Osmotics are given to reduce IOP. Beta adrenergics are given for the treatment of asthma. Corticosteroids are given for acute allergic reactions in the eye.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 688             OBJ:   4

TOP:   Nursing Process Step: Evaluation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

3. Which medication is used to produce miosis following a diagnostic procedure?

a.	Pilocarpine (Pilocar)
b.	Mannitol (Osmitrol)
c.	Atropine (Isopto Atropine)
d.	Epinephrine (EpiPen)

 

 

ANS:  A

Pilocarpine is a direct acting cholinergic agent that is used to counter the effects of mydriatic and cycloplegic agents after surgery or eye ophthalmoscopic examinations. Cholinergic agents also reduce IOP in glaucoma patients by widening the filtration angle that permits outflow of aqueous humor. Mannitol is an osmotic diuretic given to decrease ocular pressure by drawing aqueous humor from the eye. Atropine is a mydriatic agent given to dilate the pupil. Epinephrine may be used to treat certain types of glaucoma.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 687             OBJ:   6

TOP:   Nursing Process Step: Evaluation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

4. Which discharge instruction will the nurse include for a patient sent home from the clinic who is taking an adrenergic ophthalmic solution for an acute inflammation?

a.	Headaches and eye pain are adverse effects to be reported to the health care provider immediately.
b.	Mouth dryness should be reported immediately.
c.	Avoid driving or operating machinery until blurring subsides.
d.	“Halos” or yellow rings around objects will be seen while taking this medication.

 

 

ANS:  C

Adrenergic agents cause the smooth muscle of the ciliary body and iris to relax, producing mydriasis. Blurred vision will temporarily occur until the patient can adjust to the increased light coming into the eyes. Activities such as driving or operating machinery should be avoided until vision stabilizes. Sunglasses help reduce the brightness. These are common, mild adverse effects and usually resolve with continued therapy. Mouth dryness is a common adverse effect. Halos are a sign of acute closed angle glaucoma.

 

DIF:    Cognitive Level: Application           REF:   pp. 688-689    OBJ:   4 | 6

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

 

5. What is the action of timolol maleate (Timoptic), a beta adrenergic blocking agent?

a.	Draws aqueous humor from the eye into the circulatory network
b.	Increases the production of aqueous humor
c.	Increases the outflow of aqueous humor
d.	Decreases the production of aqueous humor

 

 

ANS:  D

Timolol maleate is a beta adrenergic blocking agent used to reduce increased intraocular pressure. The exact mechanism of action of these medications is unknown, but they are believed to reduce the production of aqueous humor. Timolol is believed to decrease production of aqueous humor.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 689             OBJ:   6

TOP:   Nursing Process Step: Evaluation

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance